Virtual Slide Review- GU Tract

The following are a few of the High Yield cases collected from virtual slides on www.PathPresenter.net. If you haven't yet discovered this AWESOME, FREE resource, GO CHECK IT OUT! I love that allows you to examine entities you may not otherwise get to see during your daily practice or at your training program. Let's not forget to mention the educational value!


During my studies, I have taken screenshots of some classic findings from these slides and organized them here for rapid fire/quick review. These are great to flip through prior to covering a service you haven't been on in a while, or as a quick refresher when trying to formulate a differential diagnosis.


I highly recommend you open the virtual slide (link provided) and review the case on your own prior to viewing the answer. The final diagnosis and classic "high yield histology" can be found below the final histologic image. I do plan on going through and adding labels to each picture one day (when I find time)... sigh...

CASE 44: View Virtual Slide


LOW POWER:

MEDIUM POWER:

HIGH POWER:


FINAL DIAGNOSIS:

SYNOVIAL SARCOMA, MONOPHASIC

  • Monophasic or biphasic pattern

  • Spindle cell or epithelial cell component

  • Fascicles of cells

  • Staghorn like vessels

  • Translocation: SYT:SSX (X;18)

CASE 54: View Virtual Slide


LOW POWER:

MEDIUM POWER:

HIGH POWER:


FINAL DIAGNOSIS:

METANEPHRIC ADENOMA

  • Well circumscribed, unencapsulated lesion with a pushing border

  • Organized small, tightly packed acini separated by acellular stroma

  • Somewhat primitive glands/tubular appearance with a few "intraductal papilloma"-like areas

CASE 55: View Virtual Slide


LOW POWER:

HIGHER POWER:

FINAL DIAGNOSIS:

ADENOMATOID TUMOR

  • Two major components: epithelial-like cells and fibrous stroma

  • Tubular networks of slit-like tubules or cords

  • Flat, cuboidal, or low columnar tubular cells

  • Round to oval nuclei and abundant dense cytoplasm

  • Cytoplasm may contain intracytoplasmic vacuoles

  • Fibrous, hyalinized stroma

  • Peripheral lymphoid aggregates

CASE 56: View Virtual Slide


LOW POWER:

MEDIUM:

HIGH:

FINAL DIAGNOSIS:

CLEAR CELL RENAL CELL CARCINOMA

  • Alveolar nests and sheets of clear cells

  • Delicate "chicken wire" vascular network

  • Graded based on nuclear atypia & ability to see a nucleolus at low/high power (see separate post on how to grade RCC).

CASE 58: View Virtual Slide


LOW:

MEDIUM:

HIGH:

HIGH: In the image below, notice the sclerotic glomerulus (left) compared to an intact residual glomerulus (right). There is markedly increased fibrosis and inflammation in the interstitium with atrophic, cystically dilated tubules.


FINAL DIANGOSIS:

ADULT POLYCYSTIC KIDNEY DISEASE

  • Autosomal Dominant Method of inheritance

  • Enlarged kidneys (gross)

  • Single, flat to cuboidal lining of cysts

  • Cysts contain proteinaceous material (can look like thyroid gland hence the term "thyroidization of the kidney" in ESRD)

  • Intervening kidney with interstitial fibrosis, tubular atrophy

  • Few intact glomeruli with many globally sclerotic glomeruli

  • Small papillary projections may be seen


MORE CASES COMING SOON... CHECK BACK LATER!

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DISCLAIMER: THIS WEBSITE DOES NOT PROVIDE MEDICAL ADVICE

These posts contain high yield information collected from various educational resources including textbooks, journal articles, educational websites and more. They are intended for educational use only and should NOT be taken as medical advice. I strongly believe the spreading of knowledge and depth of learned information should be encouraged in today's society rather than coveted. Membership is required to view these posts  and should be used solely for educational purposes only.