Handbook of Histopathology and Immunohistochemistry

Atlas for students in medicine, dental medicine and pharmacy, for interns and practising physicians

Table of contents
Preface - E. Poryazova......................................................................................10
Histological Sample preparation - N. Penkova, E. Poryazova....................11
Special /histochemical/ staining - D. Serteva...............................................13
Immunohistochemical testing - E. Poryazova...............................................14
Chapter I. General pathology...........................................................................15
Reversible cell damage (acute and chronic) - E. Poryazova........................16
Intracellular accumulation of pathologic substances - E. Poryazova........17
Fig. 1 Hepatitis epidemiсa (viralis)...............................................................17
Fig. 2 Hydropic degeneration: renal tubular cells.........................................17
Fig. 3 Degeneratio adiposa hepatis (steatosis hepatis)................................. 18
Fig. 4 Degeneratio adiposa hepatis, Sudan III...............................................18
Accumulation of pigments - E. Poryazova....................................................19
Fig. 5 Anthracosis pulmonis..........................................................................19
Fig. 6 Haemosiderosis pulmonis...................................................................20
Fig. 7 Haemosiderosis pulmonis, Perls.........................................................20
Fig. 8 Icterus hepatis.....................................................................................21
Fig. 9 Icterus renis.........................................................................................21
Accumulation of pathologic substances in the intercellular matrix -
E. Poryazova......................................................................................................22
Fig. 10 Degeneratio mucoidea – Toluidin Blue.............................................23
Fig. 11 Corpus albicans ovarii.......................................................................23
Fig. 12 Hyalinosis arteriolarum renis............................................................24
Fig. 13 Hypertonia arterialis benigna (cerebrum)..........................................24
Fig. 14 Amyloidosis renis..............................................................................25
Fig. 15 Amyloidosis renis, Congo rot............................................................25
Fig. 16 Amyloidosis localis (glandulae mammae).........................................26
Fig. 17 Amyloidosis lienis.............................................................................26
Fig. 18 Amyloidosis hepatis..........................................................................27
Fig. 19 Tophi urici.........................................................................................27
Fig. 20 Calcificatio aortae..............................................................................28
Compensatory-adaptive processes - N. Penkova, E. Poryazova....................29
Fig. 21 Hypertrophia myocardii.....................................................................29
4 Handbook of Histopathology and Immunohistochemistry
Fig. 22 Normal myocardium..........................................................................30
Fig. 23 Hyperplasia mucosae uteri glandularis cystica..................................30
Fig. 24 Hyperplasia glandulae prostatae........................................................31
Fig. 25 Atrophia fusca hepatis.......................................................................31
Fig. 26 Atrophia fusca myocardii..................................................................32
Fig. 27 Atrophia gl. Thyreoideae...................................................................32
Irreversible cell damage. Necrosis - I. Bivolarski.........................................33
Fig. 28 Necrosis coagulativa lienis................................................................34
Fig. 29 Necrosis colliquativa cerebri.............................................................34
Fig. 30 Steatonecrosis pancreatis..................................................................35
Fig. 31 Necrosis caseosa lymphonodi...........................................................35
Circulatory disorders - D. Serteva..................................................................36
Fig. 32 Cyanosis hepatic................................................................................36
Fig. 33 Hepar mouschatum...........................................................................37
Fig. 34 Haemorrhagiae punctatae cerebri.....................................................37
Fig. 35 Oedema pulmonis.............................................................................38
Fig. 36 Thrombus mixtus..............................................................................38
Fig. 37 Embolia adiposa pulmonis, Sudan III..............................................39
Fig. 38 Infarctus anaemicus renis.................................................................39
Fig. 39 Infarctus haemorrhagicus pulmonis...................................................40
Inflammation - V. Belovejdov...........................................................................41
Fig. 40 Pericarditis fibrinosa..........................................................................41
Fig. 41 Leptomeningitis purulenta.................................................................42
Fig. 42 Appendicitis phlegmonosa.................................................................42
Fig. 43 Myocarditis acuta abscedens.............................................................43
Fig. 44 Granulatio..........................................................................................43
Fig. 45 Polypus nasalis..................................................................................44
Fig. 46 Granuloma typus corporis alieni.......................................................44
Fig. 47 Echinococcus hepatis........................................................................45
Fig. 48 Chitin and germinative membranes (Echinococcus cyst)..................45
Fig. 49 Lymphadenitis granulomatosa..........................................................46
Fig. 50 Langhans giant cell...........................................................................46
Fig. 51 Mesaortitis luetica.............................................................................47
Fig. 52 Actinomycosis...................................................................................47
Table of content 5
Regeneration and fibrosis - D. Serteva........................................................48
Fig. 53 Cicatrix myocardii.............................................................................48
Fig. 54 Cicatrix myocardii-Van Gieson.........................................................49
Fig. 55 Regeneratio medullae ossea..............................................................49
Tumours - E. Poryazova...................................................................................50
Fig. 56 Lipoma..............................................................................................53
Fig. 57 Haemangioma cavernosum hepatis...................................................53
Fig. 58 Haemangioma capillarae cutis..........................................................54
Fig. 59 Leiomyoma uteri...............................................................................54
Fig. 60 Leiomyosarcoma...............................................................................55
Fig. 61 Teratoma adultum..............................................................................55
Fig. 62 Carcinoma basocellulare...................................................................56
Fig. 63 Squamous cell papilloma ..................................................................56
Fig. 64 Carcinoma planocellulare keratodes.................................................57
Fig. 65 Carcinoma planocellulare nonkeratodes...........................................57
Fig. 66 Undifferentiated carcinoma...............................................................58
Fig. 67 Normal skin.......................................................................................58
Fig. 68 Merkel cell carcinoma.......................................................................59
Fig. 69 Naevus pigmentosus..........................................................................59
Fig. 70 Melanoma malignum.........................................................................60
Fig. 71 Lymphogenous tumour embolism.....................................................60
Fig. 72 Perineural invasion (adenocarcinoma)..............................................61
Fig. 73 Angiosarcoma....................................................................................61
Fig. 74 Rabdomyosarcoma............................................................................62
Fig. 75 В-cell malignant lymphoma .............................................................62
Chapter II. Clinical pathology..........................................................................63
Respiratory system - V. Belovejdov.................................................................63
Fig. 76 Normal lung......................................................................................65
Fig. 77 Lung of newborn (with intraalveolar hemorrhages).........................65
Fig. 78 Bronchitis chronica............................................................................66
Fig. 79 Emphysema pulmonis........................................................................66
Fig. 80 Pneumonia crouposa..........................................................................67
Fig. 81 Silicosis pulmonis.............................................................................67
Fig. 82 Carcinoma pulmonis planocellulare keratodes..................................68
6 Handbook of Histopathology and Immunohistochemistry
Fig. 83 Carcinoma adeno-squamosus pulmonis.............................................68
Fig. 84 Carcinoma pulmonis parvocellulare..................................................69
Cardiovascular system - E. Poryazova............................................................70
Fig. 85 Atherosclerosis aortae........................................................................71
Fig. 86 Endocarditis verrucosa.......................................................................72
Fig. 87 Normal myocardium.........................................................................72
Fig. 88 Infarctus myocardii recens................................................................73
Fig. 89 Myocarditis reumatica.......................................................................73
Autoimmune diseases and connective tissue disorders - D. Serteva...........74
Fig. 90 Struma lymphomatosa (Hashimoto thyroiditis)................................75
Fig. 91 Polyartheriitis nodosa........................................................................75
Fig. 92 Polyarthritis rheumatoides................................................................76
Hemato / lymphopoietic system - N. Penkova, E. Poryazova......................76
Fig. 93 Normal spleen...................................................................................78
Fig. 94 Normal thymus..................................................................................79
Fig. 95 Normal liver......................................................................................79
Fig. 96 Lymphadenosis leucaemica hepatis...................................................80
Fig. 97 Myelosis leucaemica hepatis.............................................................80
Fig. 98 Follicular hyperplasia (lymph node).................................................81
Fig. 99 Lymphoma malignum typus non Hodgkin........................................81
Fig. 100 Morbus Hodgkin (Lymphogranulomatosis maligna)......................82
Fig. 101 Plasmocytoma.................................................................................82
Digestive system - E. Poryazova.....................................................................83
Fig. 102 Gingivitis chronica hypertroficans..................................................84
Fig. 103 Stomatitis candidosa.......................................................................85
Fig. 104 Leucoplakia.....................................................................................85
Fig. 105 Epulis gigantocellularis...................................................................86
Fig. 106 Carcinoma planocellulare linguae...................................................86
Fig. 107 Cysta radicularis..............................................................................87
Fig. 108 Sialoadenitis chronica......................................................................87
Fig. 109 Amelloblastoma (Adamantinoma)..................................................88
Fig. 110 Adenoma pleomorphae glandulae parotis.......................................88
Fig. 111 Adenolymphoma, Warthin’s tumor..................................................89
Fig. 112 Tonsilitis chronica (hypertroficans).................................................89
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Pathological changes of the stomach - E. Poryazova..................................90
Fig. 113 Gastritis chronica atrophicans.........................................................91
Fig. 114 Ulcus acutum duodeni.....................................................................92
Fig. 115 Ulcus chronicum ventriculi exacerbate...........................................92
Fig. 116 Adenocarcinoma ventriculi..............................................................93
Fig. 117 Signet ring cell carcinoma...............................................................93
Pathological changes of the small and large intestines - E. Poryazova.........94
Fig. 118 Colitis chronica................................................................................97
Fig. 119 Tubular adenoma (large colon)........................................................98
Fig. 120 Adenomatous polyp (with high-grade dysplasia)...........................98
Fig. 121 Adenocarcinoma of colon (moderately differentiated).................99
Fig. 122 Adenocarcinoma gellatinosum (colon), PAS................................99
Fig. 123 Carcinoid tumour, (small intestine)...............................................100
Pathological changes of the liver, gall bladder and exocrine pancreas -
E. Poryazova....................................................................................................100
Fig. 124 Hemangiosarcoma hepatis.............................................................102
Fig. 125 Cirrhosis hepatis micronodularis...................................................102
Fig. 126 Cholecystitis chronica...................................................................103
Endocrine system - V. Belovejdov................................................................103
Fig. 127 Struma colloides............................................................................105
Fig. 128 Struma Basedowiana......................................................................106
Fig. 129 Carcinoma papillare gl. thyreoideae..............................................106
Fig. 130 Glomerulosclerosis diabetica........................................................107
Kidney and urinary tract - I. Bivolarski.....................................................107
Fig. 131 Normal kidney...............................................................................110
Fig. 132 Glomerulonephritis semilunaris (subacuta)...................................110
Fig. 133 Glomerulonephritis mesangiocapillaris.........................................111
Fig. 134 Nephrosclerosis glomerulonephritica............................................111
Fig. 135 Pyelonephritis acuta abscedens.....................................................112
Fig. 136 Pyelonephritis chronica.................................................................112
Fig. 137 Carcinoma renis.............................................................................113
Fig. 138 Carcinoma vesicae urinariae...........................................................113
Female reproductive system - E. Poryazova.................................................114
8 Handbook of Histopathology and Immunohistochemistry
Diseases related to pregnancy - E. Poryazova..............................................114
Fig. 139 Abortus...........................................................................................115
Fig. 140 Decidua...........................................................................................115
Fig. 141 Arias-Stella reaction.......................................................................116
Fig. 142 Mola hydatidosa.............................................................................116
Fig. 143 Choriocarcinoma (chorionepithelioma).........................................117
Diseases of the cervix - V. Belovejdov............................................................117
Uterine body and endometrium disorders - E. Poryazova..........................118
Fig. 144 Hyperplasia mucosae uteri glandularis cystica..............................120
Fig. 145 Atypical endometrial hyperplasia..................................................120
Fig. 146 Endometriosis................................................................................121
Fig. 147 Adenocarcinoma corporis uteri.....................................................121
Inflammatory and tumour disorders of the ovaries - E. Poryazova..............122
Fig. 148 Cystadenoma papilliferum serosum ovarii....................................123
Fig. 149 Cystadenocarcinoma papilliferum serosum ovarii........................123
Mammary gland disorders - E. Poryazova....................................................124
Fig. 150 Fibrosis cystica glandulae mammae..............................................125
Fig. 151 Fibroadenoma glandulae mammae................................................125
Fig. 152 Carcinoma ductale glandulae mammae.........................................126
Fig. 153 Carcinoma scirrhosum...................................................................126
Male reproductive system - D. Serteva...........................................................127
Fig. 154 Carcinoma glandulae prostate.......................................................129
Fig. 155 Atrophic testis................................................................................129
Fig. 156 Seminoma testis.............................................................................130
Fig. 157 Yolk sac tumor (tumor of Teilum).................................................130
Nervous system - E. Poryazova.....................................................................131
Fig. 158 Polioencephalitis acuta..................................................................133
Fig. 159 Poliomyelitis anterior acuta...........................................................133
Tumours of the nervous system - E. Poryazova............................................135
Fig. 160 Astrocytoma...................................................................................136
Fig. 161 Glioblastoma multiforme...............................................................136
Fig. 162 Neurinoma (schwanoma)...............................................................137
Fig. 163 Meningioma...................................................................................137
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CHAPTER III. Immunohistochemical testing...........................................138
Reading the results of the IHC test - E. Poryazova......................................138
IHC-markers for proving the histogenesis of tumours - E. Poryazova.....140
Fig. 164 IHC-testing, Cytokeratin................................................................140
Fig. 165 IHC-testing ,Cytokeratin 20..........................................................140
Fig. 166 IHC-testing, Cytokeratin 7............................................................141
Fig. 167 IHC-testing, Vimentin....................................................................141
Fig. 168 IHC-testing, S-100 protein , Х100................................................142
Fig. 169 IHC-testing, СЕА..........................................................................142
Fig. 170 IHC-testing, S-100 protein............................................................143
Fig. 171 IHC-testing, Desmin......................................................................143
Fig. 172 IHC-testing, CD 117 .....................................................................144
Fig. 173 IHC-testing, CDX2........................................................................144
Fig. 174 IHC-testing, Chromogranin A.......................................................145
Fig. 175 IHC-testing, CD20.........................................................................145
Fig. 176 IHC-testing, CD3...........................................................................146
Fig. 177 IHC-testing, Factor VIII................................................................146
IHC-markers for detecting the proliferative activity of tumours -
E. Poryazova....................................................................................................147
Fig. 178 IHC-testing, Ki-67.........................................................................147
Fig. 179 IHC-testing, Ki-67.........................................................................147
Fig. 180 IHC-testing, p-53...........................................................................148
Fig. 180 IHC-testing, p-53...........................................................................148
Fig. 182 IHC-testing, p-53...........................................................................149
Fig. 183 IHC-testing, E –Cadherin..............................................................149
Fig. 184 IHC-testing, Beta-catenin..............................................................150
Fig. 185 IHC-testing, AMACR....................................................................150
Fig. 186 IHC-testing, AMACR....................................................................151
IHC-testing of the hormone receptors and the antigens of growth factorsm -
E. Poryazova....................................................................................................151
Fig. 187 IHC-testing, ЕR.............................................................................151
Fig. 188 IHC-testing, РR.............................................................................152
Fig. 189 IHC-testing, Her 2.........................................................................152
Fig. 190 IHC-testing, Her 2.........................................................................153
Index............................................................................................................154