zx1 19 zx2 Bone zx3 10 zx4 Bone zx5 Chondrosarcoma of the pelvis zx6 Chondrosarcoma zx7 Malign zx8 T1X500 zx9 M92203 zx0 G zy1 zy2 •The specimen is a hemi-pelvis. Note the normal bones and muscles of the pelvis around the periphery. •The central part of the specimen (flanked by the white arrows) is the tumor. •Note the white, glistening appearance typical of chondrosarcomas. | zx1 47 zx2 GI zx3 7001 zx4 Small Intestine zx5 Infarction of small intestine zx6 Infarct zx7 Degen zx8 T64000 zx9 M54700 zx0 g zy1 zy2 UCHC •This is a segment of small intestine (ileum) •Approximately 3/4 of the specimen shows transmural hemorrhage and infarction (the dark red region). The attached mesentery is also hemorrhagic. •This is the result of twisting of this loop of bowel about its mesentery (volvulus), thus impeding arterial flow and venous return. •Note the junction of the more normal appearing tan-pink bowel with the hemorrhagic bowel. | zx1 48 zx2 GI zx3 7002 zx4 Small Intestine zx5 hemorrhagic infarction zx6 Infarct zx7 Degen zx8 T64000 zx9 M54700 zx0 G zy1 zy2 UCHC •This close-up image of the bowel serosa shows the junction of infarcted tissue (dark red) and more normal tan bowel •The line of demarcation is typically quite sharp (Arrow) •The omentum seen on the lower left attached to the bowel is also hemorrhagic | zx1 49 zx2 GI zx3 7003 zx4 Appendix zx5 Acute Appendicitis - gross zx6 Appendicitis zx7 Inf zx8 T66000 zx9 M41000 zx0 G zy1 zy2 UCHC •This appendix has been cross sectioned at one end •The cross sectioned end appear dilated and the wall appears thickened and edematous •The serosa is congested with yellow plaques of exudate(arrow) •The serosal surface of the intact appendix shows congested vessels | zx1 50 zx2 GI zx3 7004 zx4 Colon zx5 Adenocarcinoma of rectum zx6 Adenocarcinoma zx7 Malign zx8 T67000 zx9 M81403 zx0 G zy1 zy2 UCHC •This colon has been opened longitudinally. •Note ulcerated mass with raised rolled borders(arrows). •The remaining mucosa is tan with normal folds. | zx1 51 zx2 GI zx3 7005 zx4 Colon zx5 Adenocarcinoma of rectum - close up zx6 Adenocarcinoma zx7 Malign zx8 T67000 zx9 M81403 zx0 G zy1 zy2 UCHC •Tumor is sharply demarcated from adjoining normal mucosa •Raised rolled borders(arrow) are common in colorectal carcinoma •Depressed center is necrotic tumor | zx1 52 zx2 GI zx3 7006 zx4 Colon zx5 Adenocarcinoma with Lymph Node Metastases zx6 Adenocarcinoma zx7 Malign zx8 T67000 zx9 M81403 zx0 G zy1 zy2 UCHC •This is a view of the entire thickness of the colon wall and mesentery. •Note the mucosal tumor(white arrow) •Tumor involves full thickness of the muscularis propria advancing into the the pericolic fat(black arrow) •Multiple enlarged lymph nodes contain metastatic carinoma which is white to tan(green arrows) | zx1 53 zx2 GI zx3 7007 zx4 Colon zx5 Adenocarcinoma of Cecum zx6 Adenocarcinoma zx7 Malign zx8 T67000 zx9 M81403 zx0 G zy1 zy2 UCHC •The cecum has been opened displaying the mucosal surface •A probe is in the ileocecal valve •The red tumor mass near the ileocecal valve has typical raised rolled clearly demarcated margins(arrow) •Adjoining normal mucosa is smooth, tan and has normal folds | zx1 57 zx2 GI zx3 7011 zx4 Gall Bladder zx5 Chronic Cholecystitis and cholelithiasis zx6 Cholecystitis,_Chronic zx7 Inf zx8 T57000 zx9 M43000 zx0 G zy1 zy2 UCHC •Partially opened gallbladder contains numerous yellow brown gallstones(black arrow). •Mucosa(green arrow) has lost its normal granular tan appearance. Smooth white appearance indicates fibrosis. | zx1 58 zx2 GI zx3 7012 zx4 Liver zx5 Focal Nodular Hyperplasia zx6 Focal_Nodular_Hyperplasia zx7 Growth zx8 T56000 zx9 M72000 zx0 G zy1 zy2 UCHC | zx1 59 zx2 GI zx3 7013 zx4 Liver zx5 Focal Nodular Hyperplasia zx6 Focal_Nodular_Hyperplasia zx7 Growth zx8 T56000 zx9 M72000 zx0 G zy1 zy2 UCHC | zx1 60 zx2 GI zx3 7014 zx4 Small Intestine zx5 Gastrointestinal Stromal Tumor(GIST) zx6 GIST zx7 Malign zx8 T65200 zx9 M88903 zx0 G zy1 zy2 UCHC •This opened segment of ileum has a mass protruding into the lumen which led to intussusception •The white tan fleshy cut surface has focal hemorrhage and cystic softening due to poor central vascularization related to tumor size •This mesenchymal tumor orignated in the muscularis and in this case grew into the lumen while in other cases it may grow outwards protruding from the serosa of the gut | zx1 61 zx2 GYN zx3 7015 zx4 Ovary zx5 Papillary Serous Cystadenoma zx6 Cystadenoma_Serous zx7 Benign zx8 T87000 zx9 M84410 zx0 G zy1 zy2 UCHC •Bisected ovary exhibiting multiple cysts. •Some cysts show septations. •Smooth glistening lining. •No solid mass of neoplasm. •Fluid was clear, colorless and thin. | zx1 62 zx2 GYN zx3 uterus_accreta7016 zx4 Uterus zx5 Uterus with Placenta Percreta zx6 Percreta zx7 Vasc zx8 T82000 zx9 M14430 zx0 G zy1 zy2 UCHC •This is a uterus following ceserean section. •Note the vertical, anterior incision along the uterus. •Arrows show the defect in the uterine wall resulting from the invasion of the placenta through to the serosa. | zx1 63 zx2 GYN zx3 7018 zx4 Uterus zx5 Uterine Leiomyomoma (external view) zx6 Leiomyoma zx7 Benign zx8 T85000 zx9 M88900 zx0 G zy1 zy2 UCHC •This is the external surface of a portion of the uterus containing an ovoid leiomyoma. •Smooth, bulging external surface. | zx1 65 zx2 Bone zx3 7020 zx4 Bone zx5 Chondrosarcoma lower end of humerus zx6 Chondrosarcoma zx7 Malign zx8 T1X500 zx9 M92203 zx0 G zy1 zy2 UCHC •Note large whitish mass attached to bone. •Hemorrhage is denoted by the areas of red color. | zx1 66 zx2 GYN zx3 7021 zx4 Placenta zx5 Abruptio placentae zx6 Abruption zx7 Vasc zx8 T88100 zx9 M29360 zx0 G zy1 zy2 UCHC •Cross section of placenta; fetal surface at top. •Long arrow = retroplacental hemorrhage. •Short arrows = area of infarcted villi due to compression. | zx1 67 zx2 GYN zx3 7017 zx4 Placenta zx5 Monochorionic-Monoamniotic Twin Placenta zx6 Twin_MoMo zx7 Con zx8 T88100 zx9 M29050 zx0 G zy1 zy2 UCHC •This is a twin placenta. Note the two umbilical cords. •There is no membrane dividing the two umbilical cords which is indicative of a monoamniotic placenta. •Note the entanglement of the umbilical cords. | zx1 70 zx2 GYN zx3 7024 zx4 Placenta zx5 Fetal membranes zx6 Normal_Membranes zx7 Normal zx8 T88200 zx9 M00100 zx0 M zy1 zy2 UCHC •This is a photo of fetal membranes. •Black arrow indicates the simple squamous to cuboidal amniontic epithelium. Note the layer of amniotic connective tissue beneath the epithelium. •There is artifactual separation of the amnion and chorion. •Blue arrow points to the trophoblast cells of the chorion which form a continuous layer. The connective tissue of the chorion is the thin layer just above the trophoblasts. | zx1 71 zx2 GYN zx3 7025 zx4 Placenta zx5 Monochorionic-Diamniotic Twin Placenta zx6 Twin_MoDi zx7 Normal zx8 T88100 zx9 M29040 zx0 M zy1 zy2 UCHC •This is a section of the dividing membranes of a monochorionic, diamniotic placenta. •Note that the dividing membrane is two amnions juxtaposed in back to back fashion. •The simple squamous amniotic epithelium lines the amniotic sac of each twin. | zx1 74 zx2 Skin zx3 7028 zx4 Skin zx5 Squamous Cell Carcinoma zx6 Squamous_Cell_Carcinoma zx7 Malign zx8 T01000 zx9 M80703 zx0 G zy1 zy2 UCHC | zx1 75 zx2 Bone zx3 MFH7029 zx4 Soft Tissue zx5 Malignant Fibrous Histiocytoma zx6 Malignant_Fibrous_Histiocytoma zx7 Malign zx8 T1X000 zx9 M88303 zx0 M zy1 zy2 UCHC | zx1 76 zx2 Bone zx3 7030 zx4 Soft Tissue zx5 Anaplastic neoplasm of peripheral neuro-ectodermal origin zx6 Neuro_ectodermal_tumor zx7 Malign zx8 T1X100 zx9 M92603 zx0 G zy1 zy2 UCHC •Large tumor in subcutaneous tissue •Note area of hemorrhage and ulceration at top. •This may have presented as a non-healing ulcer. | zx1 77 zx2 CV zx3 7031 zx4 Myocardium zx5 Healed anteroseptal myocardial infarct with mural thrombus zx6 Infarct_Old zx7 Degen zx8 T33010 zx9 M54750 zx0 G zy1 zy2 UCHC •Outflow tract of left ventricle. Note: aortic valve; endocardial surface of interventricular septum ( •); posterior papillary muscle arising from posterior left ventricular wall (white arrow); anterolateral wall of left ventricle (black arrow) •Mural thrombus (green arrow) filling concavity resulting from thinning of septal wall by fibrotic healed infarct. | zx1 78 zx2 GI zx3 bodystalkanomaly7032 zx4 Stomach zx5 Body-Stalk Anomaly zx6 Anomaly zx7 Con zx8 T89000 zx9 M28100 zx0 G zy1 zy2 UCHC •Body-stalk anomaly is a defect of abdominal wall closure as a manifestation of early amnion rupture •Abdominal viscera protrude into a thin membrane lined sac •Note the extruded liver(arrow) •The limbs are usually hypoplastic, a finding not present in this case | zx1 81 zx2 GI zx3 7035 zx4 Colon zx5 Rectum - ulcerative colitis zx6 Ulcerative_Colitis zx7 Inf zx8 T67000 zx9 D6255 zx0 G zy1 zy2 UCHC •This segment of rectum has been opened longitudinally •Note the small red 1mm punctate ulcers throughout the specimen.(hard to see!) •Diffuse mucosal red color reflects congestion second to the diffuse mucosal inflammation •Anus is at left, white line(arrow) is Pectinate Line | zx1 84 zx2 GI zx3 7038 zx4 Appendix zx5 Acute Appendicitis zx6 Appendicitis zx7 Inf zx8 T66000 zx9 M41000 zx0 G zy1 zy2 UCHC •Granular roughened serosa with marked congestion at tip (yellow arrow) •Grey yellow purulent exudate on the surface (green arrows) •Marked increase in diameter | zx1 86 zx2 GI zx3 7040 zx4 Colon zx5 Rectum - Ulcerative Colitis - mucosa zx6 Ulcerative_Colitis zx7 Inf zx8 T67000 zx9 D6255 zx0 G zy1 zy2 UCHC •Anal mucosa(black arrow). •Large irregular mucosal ulceration of rectum (white arrow). •Focal mucosal hemorrhage (blue arrow) | zx1 87 zx2 GI zx3 7041 zx4 Colon zx5 Adenocarcinoma of Rectum zx6 Adenocarcinoma zx7 Malign zx8 T67000 zx9 M81403 zx0 G zy1 zy2 UCHC •Carcinoma has a button-like appearance(arrow) with raised rolled margins •Hemorrhoidal polyps(green arrow) are seen at the anal-rectal junction | zx1 91 zx2 GI zx3 7045 zx4 Colon zx5 Colon - low grade dysplasia zx6 Dysplasia zx7 Growth zx8 T67000 zx9 M74000 zx0 M zy1 zy2 UCHC •Nuclear changes: hyperchromasia, cigar shaped nuclei. •Functional changes: decrease in mucin production. •Architectural changes: early loss of polarity with pseudopalisading. | zx1 92 zx2 GI zx3 7046 zx4 Colon zx5 Colon - low grade dysplasia zx6 Dysplasia zx7 Growth zx8 T67000 zx9 M74000 zx0 M zy1 zy2 UCHC •N = normal glands with small basally placed nuclei and ample amounts of mucin •Dysplastic cells have cigar shaped hyperchromatic nuclei. •Lack of severe architectural disarray(pseudopalisading) and continued mucin production distinguish this from high grade dysplasia. | zx1 93 zx2 GI zx3 7047 zx4 Colon zx5 Colon - high grade dysplasia zx6 Dysplasia zx7 Growth zx8 T67000 zx9 M74000 zx0 M zy1 zy2 UCHC •Defining characteristics are high grade nuclear pleomorphism and severe architectural disarray with prominent palisading. •Note total absence of mucin production. | zx1 94 zx2 GI zx3 7048 zx4 Colon zx5 Colon - Adenomatous Polyp - Cross Section zx6 Adenoma zx7 Benign zx8 T67000 zx9 M81400 zx0 M zy1 zy2 UCHC •Polyp has a mushroom-like cap of epithelial proliferation on a well defined stalk. •Adjacent mucosal projections are normal folds in mucosa. | zx1 95 zx2 GI zx3 7049 zx4 Colon zx5 Polyposis Coli - Opened Colon zx6 Polyposis zx7 Benign zx8 T67000 zx9 M82210 zx0 G zy1 zy2 UCHC •Hundreds of smooth raised small early polyps cover entire surface | zx1 96 zx2 GI zx3 7050 zx4 Gall Bladder zx5 Papillary Adenocarcinoma of Gallbladder zx6 Papillary_Adenocarcinoma zx7 Malign zx8 T57000 zx9 M82603 zx0 G zy1 zy2 UCHC •The gall bladder has been opened displaying a normal velvety mucosa •A papillary carcinoma(arrows) protrudes into the lumen | zx1 97 zx2 GI zx3 7051 zx4 Liver zx5 Multiple Liver Abscesses zx6 Abscess zx7 Inf zx8 T56000 zx9 M41740 zx0 G zy1 zy2 UCHC •Note the multiple yellow to white nodules within the red parenchyma of the liver. •The differential diagnosis is between abscess and metastatic. carcinoma. •Microscopic appearance of the biopsy resolves the differential diagnosis. •The most common cause is previous intra-abdominal operations. •Culture of the lesions is a critical step towards the treatment plan. | zx1 98 zx2 GI zx3 7052 zx4 Liver zx5 Lymphoma in liver zx6 Lymphoma zx7 Malign zx8 T56000 zx9 M95906 zx0 G zy1 zy2 UCHC •This is the cut surface of the liver. •Note the yellow mass at the portahepatis -arrow- and tiny yellow spots in liver parenchyma - in the lower left. •Distinction from cholangiocarcinoma requires biopsy and microscopic examination. •Lymphoma of liver is always secondary to disseminated systemic lymphoma. | zx1 99 zx2 Resp zx3 7053 zx4 Larynx zx5 Squamous cell carcinoma of larynx zx6 Squamous_Cell_Carcinoma zx7 Malign zx8 T24100 zx9 M80703 zx0 G zy1 zy2 UCHC | zx1 100 zx2 GU zx3 7054 zx4 Testis zx5 Abscesses zx6 Abscess zx7 Inf zx8 T78000 zx9 M41740 zx0 G zy1 zy2 UCHC •The photograph shows testis (T) surrounding tissues and spermatic cord (SC). •The soft tissues surrounding the testis are matted together showing no defined epididymis nor walls of the tunica vaginalis. •Within the peri-testicular soft tissue are multiple yellow-tan abscesses (A). | zx1 101 zx2 CV zx3 7055 zx4 zx5 Amyloid deposition zx6 amyloidosis zx7 zx8 T41000 zx9 M55100 zx0 M zy1 zy2 UCHC •This is a small blood vessel with amyloid desposits. •Note the amyloid deposits stain red with congo red stain and exhibit an apple green birefringence with polarized light. | zx1 102 zx2 Bone zx3 7056 zx4 Joint zx5 Synovial Chondromatosis zx6 Synovial_chondromatosis zx7 Benign zx8 T12040 zx9 M92101 zx0 G zy1 zy2 UCHC •Tumor is composed of cartilaginous tissue. •Note the bosselations and the hard but pliable appearance typical of cartilage. | zx1 104 zx2 CV zx3 7058 zx4 Aorta zx5 Atherosclerotic plaque zx6 Atherosclerosis zx7 Degen zx8 T41000 zx9 M52110 zx0 M zy1 zy2 UCHC •Field shows atheromatous plaque in intima with no other layers of the arterial wall visible. •The more deeply pinker staining right upper portion of the field is the sclerotic fibrous cap ( •). The lighter stain elsewhere is due to deposition of neutral fats which are washed out by the tissue processing for slide preparation. •Note the slit like clear spaces (black arrow) which were occupied by washed out cholesterol esters crystals before processing. •The fine blue stipples throughout are calcific spherules. | zx1 105 zx2 CV zx3 7059 zx4 Aorta zx5 Atherosclerotic plaque zx6 Atherosclerosis zx7 Degen zx8 T41000 zx9 M52110 zx0 M zy1 zy2 UCHC •Higher power view of previous image showing stippling by blue calcific spherules, cholesterol crystal clefts, and fibrous cap. | zx1 107 zx2 GI zx3 7061 zx4 Esophagus zx5 Ulcerative Fungal Esophagitis zx6 Fungal_Esophagitis zx7 Inf zx8 T62000 zx9 M40030 zx0 G zy1 zy2 UCHC •normal pale white intact esophageal mucosa(black arrow). •Multiple pink-tan erosions/ulcerations(yellow arrow). . | zx1 108 zx2 GI zx3 livermets_colonca7062 zx4 Liver zx5 Metastatic colon adenocarcinoma to liver zx6 Metastatic_Adenocarcinoma zx7 Malign zx8 T56000 zx9 M81406 zx0 G zy1 zy2 UCHC •This is a section of liver containing a single large tumor which is partially hemorrhagic and necrotic in its center. •Note that the liver parenchyma is normal - noncirrhotic. •A single large liver mass is usually a primary hepatocellular carcinoma; specially in the context of cirrhosis. •Single metastatic carcinoma in liver is treatable by surgical excision. | zx1 109 zx2 GI zx3 7063 zx4 Esophagus zx5 Esophageal varices zx6 Varices zx7 Vasc zx8 T62000 zx9 M32600 zx0 G zy1 zy2 UCHC •This is a portion of esophagus and stomach displaying their mucosal surfaces. •Gastroesophageal junction (blue arrows). •Dilated tortuous veins (varices) beneath the mucosa (black arrows). | zx1 111 zx2 GI zx3 7065 zx4 Colon zx5 Pseudomembranous Colitis - Mucosal Surface zx6 Pseudomembranous_Colitis zx7 Inf zx8 T67000 zx9 M40590 zx0 G zy1 zy2 UCHC •This segment of colon has been opened longitudinally. •Tan tellow plaque-like pseudomembranes (black arrow) form on top of ulcerated red mucosa (green arrow) . | zx1 112 zx2 GI zx3 7066 zx4 Colon zx5 Diverticulosis of Colon zx6 Diverticulitis zx7 Inf zx8 T67000 zx9 M46420 zx0 G zy1 zy2 UCHC •This is a portion of colon opened longitudinally. •The tan mucosa is unremarkable with normal folds. •The probe is within a diverticulum...... | zx1 113 zx2 GI zx3 7067 zx4 Liver zx5 Metastatic esophageal carcinoma to liver zx6 Metastatic_Esophageal_Carcinoma zx7 Malign zx8 T56000 zx9 M80706 zx0 G zy1 zy2 UCHC •This is the external surface of the liver showing multiple yellow nodules. •Such nodules are usually metastatic cancer but abscesses can have similar appearance. •Note that the intervening parenchyma is noncirrhotic. •The multiplicity of the lesions and absence of cirrhosis indicate that the neoplasms are metastatic as opposed to primary. | zx1 114 zx2 GI zx3 7068 zx4 Esophagus zx5 Ulcerated Fungal Esophagitis zx6 Fungal_Esophagitis zx7 Inf zx8 T62000 zx9 M40030 zx0 G zy1 zy2 UCHC •This is the mucosal surface of the esophagus. •Intact mucosa is pale white. •Multiple mucosal ulcers (black arrows) with yellow grey depressed base filled with exudate and necrotic tissue. | zx1 115 zx2 GI zx3 7069 zx4 Gall Bladder zx5 Adenocarcinoma of Gallbladder zx6 Adenocarcinoma zx7 Malign zx8 T57000 zx9 M81403 zx0 G zy1 zy2 UCHC •Hemissected gallbladder contains firm white fairly flat carcinoma(blue arrow) occupying a small portion of the mucosa •Thickened white wall(green arrow) represents transmural spread of the tumor •Compare with the normal gallbladder wall(White arrow) | zx1 116 zx2 GI zx3 7070 zx4 Stomach zx5 Gastric Stromal Tumor zx6 Stromal zx7 Malign zx8 T63000 zx9 M88903 zx0 G zy1 zy2 UCHC •Hemissection of the tumor reveals a typical grey-white rubbery fleshlike surface •The yellow areas represent foci of necrosis caused by the large size of the tumor outgrowing its blood supply •Note the thin rim of intact mucosa on the surface of the tumor which has arisen in the muscularis propria | zx1 118 zx2 CNS zx3 7072 zx4 Brain zx5 Semilobar holoprosencephaly zx6 Holoprosencephaly zx7 Con zx8 TX2000 zx9 M20100 zx0 G zy1 zy2 UCHC •Face of an infant with semilobar holoprosencephaly •Shows closeset eyes, absent nose and abnormal mouth often seen in this form of holoprosencephaly | zx1 119 zx2 CNS zx3 7073 zx4 Brain zx5 Intracerebral Hemorrhage zx6 Hemorrhage,_Intracerebral zx7 Vasc zx8 TX2000 zx9 M37000 zx0 G zy1 zy2 UCHC •A coronal section of brain through the thalamus showing a large intracerebral hemorrhage •Note the shift of structures toward the opposite side including the cingulate gyrus, lateral and third ventricles and thalamus •There is blood in the ventricles as well | zx1 120 zx2 CNS zx3 7074 zx4 Brain zx5 Subarachnoid Hemorrhage zx6 Hemorrhage zx7 Vasc zx8 TX1500 zx9 M37000 zx0 G zy1 zy2 UCHC • Two coronal sections of brain one their side. • Note the dark reddish color of the leptomeninges. • This represents subarachnoid hemorrhage from a ruptured berry aneurysm | zx1 121 zx2 CNS zx3 7075 zx4 Brain zx5 Cerebral Aneurysm zx6 Aneurysm zx7 Vasc zx8 TX2000 zx9 M32400 zx0 G zy1 zy2 UCHC •A view of the base of the brain at the level of the optic chiasm showing a giant aneurysm (arrow) that was found incidently at autopsy. •It had not ruptured but compressed cranial nerves. | zx1 122 zx2 CNS zx3 7076 zx4 Brain zx5 Subarachnoid Hemorrhage zx6 Hemorrhage zx7 Vasc zx8 TX1500 zx9 M37000 zx0 G zy1 zy2 UCHC •A view of the base of the brain showing dark reddish blood in the subarachnoid space over the optic and other cranial nerves and brainstem from a ruptured anterior communicating artery berry aneurysm. •Note how generally swollen the brain is, . | zx1 123 zx2 CNS zx3 7077 zx4 Brain zx5 Middle Cerebral Artery Infarct zx6 Cerebral_Infarct,_NOS zx7 Degen zx8 TX2000 zx9 M54700 zx0 G zy1 zy2 UCHC •A coronal section through the brain at the level of the thalamus and lenticular nuclei. •The arrow points to a very old middle cerebral artery infarct in which most of the affected cerebral cortex, white matter, lenticular nucleus, and part of the thalamus has been destroyed by loss of blood supply to the region. •After the infarct occurred, macrophages picked up the dead tissue and disposed of it leaving a large cavity. | zx1 124 zx2 CNS zx3 7078 zx4 Brain zx5 Hemorrhagic Infarct zx6 Cerebral_Infarct,_NOS zx7 Degen zx8 TX2000 zx9 M54700 zx0 G zy1 zy2 UCHC •A coronal section through the brain at the level of the caudate nucleus and putamen. •The arrow points to hemorrhagic infarction of the putamen and caudate nucleus. •The overlying cerebral cortex and white matter is also involved but the hemorrhagic part of a hemorrhagic infarct is usually confined to the grey matter. •Note how swollen the affected hemisphere is with herniation of structures across the midline. •Most hemorrhagic infarcts are due to emboli. | zx1 125 zx2 CNS zx3 7079 zx4 Brain zx5 Recent cerebral Infarct zx6 Cerebral_Infarct,_Acute zx7 Degen zx8 TX2000 zx9 M54720 zx0 G zy1 zy2 UCHC •A horizontal section of the brain at the level of the upper third ventricle showing a recent infarct in the middle cerebral artery distribution manifested by discoloration and disintegration (cracking) of the tissue of part of one hemisphere. •Note the marked swelling of the affected hemisphere with herniation of structures across the midline. •Pale infarcts such as this are usually due to thrombi. | zx1 126 zx2 CNS zx3 7080 zx4 Brain zx5 Lacunar Infarcts of cerebrum zx6 Cerebral_Infarct,_NOS zx7 Degen zx8 TX2000 zx9 M54700 zx0 G zy1 zy2 UCHC •A coronal section of brain through the lenticular nucleus and internal capsule •The arrows point to small cyst-like infarcts which are known as lacunes or lacunar infarcts because of their small size. •They are thought to be due to occlusion of small arteries. | zx1 131 zx2 GI zx3 7085 zx4 Liver zx5 Hepatocellular Carcinoma zx6 Hepatocellular_Carcinoma zx7 Malign zx8 T56000 zx9 M81703 zx0 G zy1 zy2 UCHC •This is a cross section of liver showing a large yellow mass with irregular borders. •Better to replace this; better pictures are available . | zx1 132 zx2 GI zx3 7086 zx4 Salivary Glands zx5 Pleomorphic Adenoma zx6 Adenoma zx7 Benign zx8 T55100 zx9 M89400 zx0 G zy1 zy2 UCHC •This is a cross section of salivary gland. •The lobulated yellow-tan tissue is normal salivary gland. •The tumor mass on the right us well circumscribed due to encapsulation •Cut surface of the tumor is typically grey-white or tan-white •Note the lack of hemorrhage or necrosis | zx1 133 zx2 GI zx3 7087 zx4 Colon zx5 Hemorrhagic Infarction of Colon zx6 Infarct zx7 Degen zx8 T67000 zx9 M54700 zx0 G zy1 zy2 UCHC •This is a segment of unopened colon with attached mesenteric fat. •Note the hemorrhagic appearance of the serosa at arrow. •Compare with the pink serosa of the non-ischemic bowel. | zx1 134 zx2 GYN zx3 7088 zx4 Ovary zx5 Malignant Mixed Tumor of Ovary (closeup) zx6 Adenosarcoma zx7 Malign zx8 T87000 zx9 M89513 zx0 G zy1 zy2 •Cut surface of neoplasm completely replacing normal ovary. •Regions of hemorrhage and cystic degeneration. | zx1 135 zx2 GYN zx3 7089 zx4 Ovary zx5 Ovarian Mixed Mullerian Tumor (interior) zx6 Adenosarcoma zx7 Malign zx8 T87000 zx9 M89513 zx0 G zy1 zy2 UCHC •Cut surface of an ovary totally replaced by neoplasm. •Regions of tan firm tissue alternating with hemorrhage and necrosis. •Small cystic foci (probably due to necrosis). | zx1 136 zx2 GYN zx3 7090 zx4 Ovary zx5 Ovarian Mixed Mullerian Tumor (exterior) zx6 Adenosarcoma zx7 Malign zx8 T87000 zx9 M89513 zx0 G zy1 zy2 UCHC •External view of an ovary completely replaced by malignant neoplasm. •External surface smooth and glistening. | zx1 138 zx2 GU zx3 7092 zx4 Kidney zx5 Cystic Renal Dysplasia zx6 Cystic_renal_dysplasia zx7 Con zx8 T71000 zx9 M23070 zx0 G zy1 zy2 UCHC •This is the external appearance of a surgically removed kidney from a 3 year old child. •The kidney is deformed by multiple cysts of varying sizes and is no longer reniform in shape. | zx1 139 zx2 GU zx3 7093 zx4 Kidney zx5 Cystic Renal Dysplasia zx6 Cystic_renal_dysplasia zx7 Con zx8 T71000 zx9 M23070 zx0 G zy1 zy2 UCHC •This is the cut surface appearance of a kidney surgically removed from a 3 year old child. •The kidney consists of multiple cysts of varying sizes. There is no grossly recognizable normal renal parenchyma. | zx1 141 zx2 GU zx3 7095 zx4 Kidney zx5 Hemorrhagic Papillary Necrosis zx6 Papillary_necrosis zx7 Degen zx8 T71120 zx9 M54000 zx0 G zy1 zy2 UCHC •The dark hemorrhagic areas are renal papillae that are necrotic. •The overlying cortical tissue is relatively spared of the necrotizing process, especially in the mid lower field of the photograph. | zx1 143 zx2 GU zx3 7097 zx4 Kidney zx5 Congenital hydronephrosis zx6 Congenital_hydronephrosis zx7 Con zx8 T71000 zx9 M23050 zx0 G zy1 zy2 UCHC •The photograph shows the bladder, both ureters, and both kidneys. •Both ureters and the bladder are dilated. •There was complete proximal urethral obstruction. •Though not seen well in this photograph, both kidneys showed multiple cystic lesions. | zx1 148 zx2 GU zx3 7102 zx4 Kidney zx5 Renal Cell Adenocarcinoma zx6 Renal_cell_adenocarcinoma zx7 Malign zx8 T71000 zx9 M83123 zx0 G zy1 zy2 UCHC •The kidney has been bivalved to show the cut surface of a large spherical tumor involving the upper pole (arrowheads). •The tumor has sharply defined borders and show a variegated cut surface. Areas of grossly viable tumor (v) are seen with areas of necrosis (n) and hemorrhage (h). | zx1 150 zx2 GU zx3 7104 zx4 Bladder zx5 Bladder Calculi zx6 Bladder_calculi zx7 Mech zx8 T74000 zx9 M30000 zx0 G zy1 zy2 UCHC •The photograph shows numerous calculi removed from a patients bladder. | zx1 151 zx2 CNS zx3 7105 zx4 Brain zx5 Cerebral Atrophy zx6 Atrophy zx7 Degen zx8 TX2000 zx9 M58000 zx0 G zy1 zy2 •One half of a coronal section of the brain at the level of the lenticular nucleus and internal capsule resting on its side •Note the marked widening of the sulci and narrowing of the gyri and markedly enlarged lateral ventricle •This is a case of severe atrophy due to Battens disease, a ceroid-lipofuscinosis which produces what is known as hydrocepholus ex vacuo; that is, enlarged ventricles due to loss of parenchymal tissue. | zx1 152 zx2 GYN zx3 7106 zx4 Placenta zx5 Partial Mole zx6 Mole zx7 Benign zx8 T88100 zx9 M91000 zx0 G zy1 zy2 •This is tissue that was removed from the uterus. •Note the macerated fetal structure at the white arrow. •The remaining tissue is placental tissue. •The yellow arrows show some hydropic, enlarged chorionic villi which have a "grape-like" appearance. | zx1 153 zx2 GYN zx3 7107 zx4 Uterus zx5 Uterine Leiomyoma with Degeneration zx6 Leiomyoma zx7 Benign zx8 T85000 zx9 M88900 zx0 G zy1 zy2 •This is a solitary, ovoid leiomyoma which has been bisected. •The center is soft, brown and degenerated. •Arrow shows the rim of firm, white tissue typical of a leiomyoma. | zx1 154 zx2 GYN zx3 7108 zx4 Ovary zx5 Benign cystic teratoma/Dermoid cyst zx6 Dermoid zx7 Benign zx8 T87000 zx9 M90840 zx0 G zy1 zy2 •This is an cystic ovary which has been partially opened to reveal its inner surface. •The inner lining of the cyst shows additional cystic structures. •The arrow points to a more solid white area which is abortive tooth structures. | zx1 156 zx2 GYN zx3 7110 zx4 Uterus zx5 Normal endocervical canal (close up) zx6 Normal_Endocervical_Canal zx7 Normal zx8 T83300 zx9 M00100 zx0 G zy1 zy2 UCHC •Close up view of endocervical canal. •Endometrial cavity to the right; exocervical os to the left. | zx1 157 zx2 GYN zx3 7111 zx4 zx5 Fallopian tube with ectopic pregnancy zx6 Ectopic zx7 Mech zx8 T86100 zx9 F31100 zx0 G zy1 zy2 UCHC •This is a dilated fallopian tube. •Note the fimbriated end on the left (yellow arrow) •Note the blue-purple discoloration of the center of the tube. This area is dilated and hemorrhagic secondary to a tubal pregnancy. | zx1 159 zx2 GYN zx3 7113 zx4 Ovary zx5 Ovarian Papillary Serous Cystadenoma zx6 Cystadenoma_Serous zx7 Benign zx8 T87000 zx9 M84410 zx0 G zy1 zy2 UCHC •This is a cross-section of the ovary showing a few thin walled cysts. •The inner lining of the cysts are smooth and glistening. | zx1 160 zx2 GYN zx3 7116 zx4 Placenta zx5 Placental Chorangioma zx6 Chorangioma zx7 Benign zx8 T88100 zx9 M91200 zx0 G zy1 zy2 UCHC •This is a cross-section of placental at the point of umbilical cord insertion. •The arrows mark the lesion: a large ovoid,red-tan mass at the base of the umbilical cord. •Note the gelatinous character of the more distal umbilical cord. | zx1 161 zx2 GYN zx3 7117 zx4 Uterus zx5 Implantation Site - Post Partum Uterus zx6 Normal_Implantation_Site zx7 Normal zx8 T88900 zx9 M00100 zx0 G zy1 zy2 UCHC •This is a uterus that has been opened. The arrow points to the cervix. •Note the rough,red appearance of this endometrium shortly after delivery of the placenta. | zx1 162 zx2 GYN zx3 7118 zx4 Uterus zx5 Implantation Site - Post Partum zx6 Normal_Implantation_Site zx7 Normal zx8 T88900 zx9 M00100 zx0 G zy1 zy2 UCHC •This is a close-up of the rough,red endometrium shortly after delivery of the placenta. •Arrow points to myometrium which is much thinner than the non-pregnant uterus. | zx1 163 zx2 GYN zx3 7119 zx4 Uterus zx5 Implantation Site - Post Partum zx6 Normal_Implantation_Site zx7 Normal zx8 T88900 zx9 M00100 zx0 G zy1 zy2 UCHC •This is a close-up of the rough,red endometrium shortly after delivery of the placenta. •Arrow on myometrium. | zx1 164 zx2 GYN zx3 7120 zx4 Uterus zx5 Uterine Leiomyoma (cut surface) zx6 Leiomyoma zx7 Benign zx8 T85000 zx9 M88900 zx0 G zy1 zy2 UCHC •This is a cross section of a leiomyoma. •Note the round, well defined borders. •Note the white, whorled cut surface. •No recognizable normal uterus. | zx1 168 zx2 GYN zx3 7128 zx4 Ovary zx5 Dysgerminoma zx6 Dysgerminoma zx7 Malign zx8 T87000 zx9 M90603 zx0 G zy1 zy2 UCHC • On the left is the external view of the ovary and fallopian tube. • The fallopian tube comprises the upper portion of the specimen. • The external surface is smooth and glistening. • The right side of the image shows the cut surface. • The neoplasm is predominantly gray white but some areas of hemorrhage and necrosis are present. | zx1 170 zx2 GYN zx3 7130 zx4 Ovary zx5 Ovarian Dysgerminoma zx6 Dysgerminoma zx7 Malign zx8 T87000 zx9 M90603 zx0 G zy1 zy2 UCHC •Bisected ovary and portion of fallopian tube (yellow arrow). •Green arrow points to typical appearance of neoplasm. •White arrow points to unusual hemorrhagic component which should prompt search for another germ cell tumor type. | zx1 171 zx2 GI zx3 7125 zx4 Liver zx5 Hepatocelluar Carcinoma zx6 Hepatocellular_Carcinoma zx7 Malign zx8 T56000 zx9 M81703 zx0 G zy1 zy2 UCHC •The external and cross sectional view of a single large liver tumor. •This can be a primary hepatocellular ca., a benign liver cell adenoma or a single metastatic carcinoma. •Clinically, hepatocelluar ca. is suspected if the patient shows elevated Alpha-Fetoprotein in the serum. Metastatic adenoca. is suspected if serum CEA is elevated but Alpha -Feto protein is normal; liver adenoma has no serum markers. •A Biopsy is needed to characterize the neoplasm. •Since the intervening parenchyma is normal, the surgical excision is feasible and often indicated with good prognosis. | zx1 172 zx2 GI zx3 7126 zx4 Liver zx5 Hepatocellular Carcinoma zx6 Hepatocellular_Carcinoma zx7 Malign zx8 T56000 zx9 M81703 zx0 G zy1 zy2 UCHC | zx1 173 zx2 GI zx3 7127 zx4 Liver zx5 Hepatocellular Carcinoma zx6 Hepatocellular_Carcinoma zx7 Malign zx8 T56000 zx9 M81703 zx0 G zy1 zy2 UCHC •Closeup of the hepatocellular carcinoma in the previous caption. Notice multiple foci of hemorrhage and necrosis which favors a malignant neoplasm. | zx1 174 zx2 Bone zx3 7114 zx4 Bone zx5 Avascular Necrosis zx6 Avascular_Necrosis zx7 Degen zx8 T11711 zx9 M54200 zx0 G zy1 zy2 •The specimen is a bisected head of a femur. •Note, the triangular area demarcated by the black arrows. •Note as well, that the articular cartilage overlying this section of bone, has lifted off. •The triangular area is an area of avascular necrosis of bone. •The change in the articular cartilage is secondary to the bone lesion. | zx1 175 zx2 Bone zx3 7115 zx4 Bone zx5 Avascular Necrosis zx6 Avascular_Necrosis zx7 Degen zx8 T11711 zx9 M54200 zx0 G zy1 zy2 UCHC •Avascular necrosis head of femur viewed from above. •The yellow arrows flank an area of necrosis. •Note that the cartilage in this area is disintegrating. | zx1 176 zx2 Endo zx3 7131 zx4 Parathyroid zx5 Parathyroid Adenoma (External View) zx6 Adenoma zx7 Benign zx8 T97000 zx9 M81400 zx0 G zy1 zy2 UCHC • External view of a parathyroid adenoma. • Smooth surface is typical of a benign neoplasm. • Cannot separate hyperplasia from adenoma on the basis of gross findings in one gland. • Parathyroid carcinoma would probably show adhesions reflecting difficulty in dissecting it from adjacent invaded structures. | zx1 177 zx2 Endo zx3 7132 zx4 Parathyroid zx5 Parathyroid Adenoma (Cut Surface) zx6 Adenoma zx7 Benign zx8 T97000 zx9 M81400 zx0 G zy1 zy2 UCHC • Homogeneous red tan surface of adenoma. • Cannot identify any normal gland compressed to one side. • Cannot predict histologic cell type based on gross. • Cannot prove this is adenoma vs. hyperplasia without seeing other glands either grossly or microscopically. | zx1 178 zx2 Endo zx3 7133 zx4 Parathyroid zx5 Parathyroid Adenoma (Composite View) zx6 Adenoma zx7 Benign zx8 T97000 zx9 M81400 zx0 G zy1 zy2 UCHC • Upper view is external; lower view is cut surface. • Smooth external surface is consistent with benign proliferation. • Homogeneous red tan cut surfaces fail to show any normal parathyroid. | zx1 181 zx2 GU zx3 7136 zx4 Kidney zx5 Wilms tumor zx6 Wilms_tumor zx7 Malign zx8 T71000 zx9 M89603 zx0 G zy1 zy2 UCHC •The photograph shows the cut surface of a kidney with Wilms tumor. •The tumor has massively replaced much of the kidney. Only a small remnant of grossly recognizable kidney is seen (arrow). •On cut section, the tumor is light tan, fleshy and shows irregular areas of hemorrhage. | zx1 183 zx2 Breast zx3 7138 zx4 Breast zx5 Intraductal Carcinoma (Low Power) zx6 Intraductal_Carcinoma zx7 Malign zx8 T04000 zx9 M85002 zx0 M zy1 zy2 UCHC • This is a low power view of a form of ductal carcinoma in situ. • The arrows point to inspissated secretions, which may calcify. • The secretions are not the same as necrosis. • The diagnosis of DCIS cannot be made at this power for this pattern ("clinging") of intraductal disease. | zx1 184 zx2 Breast zx3 7139 zx4 Breast zx5 Ductal Carcinoma in situ (Med Power) zx6 Intraductal_Carcinoma zx7 Malign zx8 T04000 zx9 M85002 zx0 M zy1 zy2 UCHC • This is a medium power view of ductal carcinoma in situ (DCIS). • The black arrows point to the intact basement membrane surrounding the ducts and confining the neoplastic cells to the duct. • The blue arrows point to the profound nuclear atypia which can even be spotted from this power. • In this type of DCIS the duct is not filled with neoplastic cells but close attention to the cytologic detail of the lining cells reveals their abnormality. | zx1 185 zx2 Breast zx3 7140 zx4 Breast zx5 Ductal Carcinoma in situ (High Power) zx6 Intraductal_Carcinoma zx7 Malign zx8 T04000 zx9 M85002 zx0 M zy1 zy2 UCHC • This close up view enables the diagnosis of DCIS to be made. • The yellow arrows point to the intact basement membrane, surrounded by delimiting fibroblasts. • The red arrows point to some neoplastic nuclei containing nucleoli. • No myoepithelial cells can be seen. • The cells have lost their normal relationship to the lumen so that the nuclei hang into the lumen. • The blue arrows point to some necrosis within the lumen (insufficient to make the diagnosis of comedo type carcinoma in situ). | zx1 186 zx2 Breast zx3 7141 zx4 Breast zx5 Ductal Carcinoma in situ (Low Power) zx6 Intraductal_Carcinoma zx7 Malign zx8 T04000 zx9 M85002 zx0 M zy1 zy2 UCHC • This low power view shows several large ducts containing microcalcifications (arrows). • The blackish discoloration at the edge of the tissue is due to the application of silver nitrate as a method of marking the margin of resection. • Although not obvious at this power the ducts are lined by abnormal cells of one type, rather than the usual myotepithelial and epithelial cell layers. • The diagnosis of carcinoma in situ cannot be made at this magnification. | zx1 187 zx2 Breast zx3 7142 zx4 Breast zx5 Ductal Carcinoma in situ (Medium Power) zx6 Intraductal_Carcinoma zx7 Malign zx8 T04000 zx9 M85002 zx0 M zy1 zy2 UCHC • This photograph shows numerous microcalcifications within dilated ducts. • The lining cells show atypia, not visible at this magnfication, and lack a myoepithelial cell layer. • The basement membrane is intact. • Despite the fact that the lumen is not filled with abnormal cells, this is still a case of carcinoma in situ, ductal ("clinging type"). | zx1 188 zx2 Breast zx3 7143 zx4 Breast zx5 Ductal Carcinoma in situ (Med Power) zx6 Intraductal_Carcinoma zx7 Malign zx8 T04000 zx9 M85002 zx0 M zy1 zy2 UCHC • The lumen contains microcalcifications. • Although the basement membrane and delimiting fibroblasts are normal, the epithelial lining of this duct is abnormal. • At this power the fact that nuclei are found at the lumenal border is indicative of the abnormality of this duct. | zx1 189 zx2 Breast zx3 7144 zx4 Breast zx5 Ductal Carcinoma in situ (Hi Power) zx6 Intraductal_Carcinoma zx7 Malign zx8 T04000 zx9 M85002 zx0 M zy1 zy2 • This image shows a dense lumenal calcification. • The cells lining the intact duct have a large N:C. • Many have irregularly shaped nuclei and prominent nucleoli. • Some cells do contain mucin vacuoles. • No myoepithelial cells can be recognized. • No organization of the epithelium so that the nuclei are basal and cytoplasm is lumenal can be found. | zx1 190 zx2 Breast zx3 7145 zx4 Breast zx5 Ductal Carcinoma in situ (Low Power) zx6 Intraductal_Carcinoma zx7 Malign zx8 T04000 zx9 M85002 zx0 M zy1 zy2 UCHC • This shows a very large duct containing scant eosinophilic debirs. • The lining cells show occasional tiny micropapillations (arrows). • At this power the nuclei can be seen hanging into the lumen, when they should be at the basement membrane side of the epithelium. • The diagnosis of ductal carcinoma in situ cannot be made at this magnification. | zx1 191 zx2 Breast zx3 7146 zx4 Breast zx5 Ductal Carcinoma in situ (Medium Power) zx6 Intraductal_Carcinoma zx7 Malign zx8 T04000 zx9 M85002 zx0 M zy1 zy2 • This is a view of a portion of a duct lined by cells lacking the usual two layer organizaton and exhibiting nuclear atypia. • The basement membrane is intact. • The epithelium is thrown up in small micropapillae. • The nuceli are large and hyperchromatic and some actually extend into the lumen. | zx1 192 zx2 Breast zx3 7147 zx4 Breast zx5 Ductal Carcinoma in situ (High Power) zx6 Intraductal_Carcinoma zx7 Malign zx8 T04000 zx9 M85002 zx0 M zy1 zy2 UCHC • The epithelium is thrown up in small papillae which lack fibrovascular cores. • The epithelial cells are arranged haphazardly. • The N:C is increased; the nuclei are hyperchromatic. • There are scattered prominent nucleoli and irregularly shaped nuclei. | zx1 193 zx2 Breast zx3 7148 zx4 Breast zx5 Ductal Carcinoma in situ (Medium Power) zx6 Intraductal_Carcinoma zx7 Malign zx8 T04000 zx9 M85002 zx0 M zy1 zy2 UCHC • The duct shows abnormal epithelium forming a small arch (arrows). • This round Roman (as opposed to pointed Gothic) arch is found in carcinoma in situ. | zx1 194 zx2 Breast zx3 7149 zx4 Breast zx5 Ductal Carcinoma in situ (High Power) zx6 Intraductal_Carcinoma zx7 Malign zx8 T04000 zx9 M85002 zx0 M zy1 zy2 UCHC • This is a closeup of the cells forming a Roman arch in ductal carcinoma in situ. • The nuclei show pleomorphism, striking hyperchromasia (particularly in nuclei at the lumen), variation in size, and prominent nucleoli. • The basement membrane is intact. | zx1 195 zx2 GI zx3 7150 zx4 Stomach zx5 Gastric Fundus x4 zx6 Normal zx7 Normal zx8 T63000 zx9 M00100 zx0 M zy1 zy2 UCHC •Gastric pits (blue arrow) occupy less than 20% of fundic mucosa •Muscularis mucosa (black arrows) •Submucosa (green arrow) is normally inconspicuous •Muscularis propria, with red arrow at junction of outer longitudinal and inner circular layers | zx1 198 zx2 GI zx3 7153 zx4 Stomach zx5 Normal Cardia x40 zx6 Normal zx7 Normal zx8 T63000 zx9 M00100 zx0 M zy1 zy2 UCHC •Normal cardia contains only mucous secreting glands similar to the antrum | zx1 200 zx2 GI zx3 7155 zx4 Colon zx5 Normal colonic mucosa x10 zx6 Normal zx7 Normal zx8 T67000 zx9 M00100 zx0 M zy1 zy2 UCHC •Note regular spacing of glands which have little lamina propria containing scant mononuclear cells •Epithelium shows diffuse uniform mucous production with small basally placed regular nuclei | zx1 203 zx2 GI zx3 7158 zx4 Esophagus zx5 Normal esophageal and tracheal mucosa zx6 Normal zx7 Normal zx8 T62000 zx9 M00100 zx0 M zy1 zy2 UCHC •Nonkeratinizing sqamous epithelium of esophagus(black arrow) •Ciliated columnar tracheal epithelium(green arrow) •Cartilaginous tracheal ring(yellow arrow) | zx1 204 zx2 GI zx3 7159 zx4 Esophagus zx5 normal esophageal and tracheal mucosa zx6 Normal zx7 Normal zx8 T62000 zx9 M00100 zx0 M zy1 zy2 •Nonkeratinizing esophageal sqamous epithelium(black arrow) •Columnar respiratory epthium of trachea(green arrow) •Developing cartilaginous tracheal ring(white arrow) •Interface between esophagus and trachea(double arrow) | zx1 205 zx2 GI zx3 7160 zx4 Esophagus zx5 Normal esophageal wall zx6 Normal zx7 Normal zx8 T62000 zx9 M00100 zx0 M zy1 zy2 UCHC •Submucosal"cardia type"glands(black arrow) normally found distally in the esophageal submucosa. •White arrow demonstrates junction of outer longitudinal and inner circular layers of muscularis propria. •Surface epithelium(green arrow). | zx1 207 zx2 GI zx3 7162 zx4 Esophagus zx5 Normal esophageal mucosa zx6 Normal zx7 Normal zx8 T62000 zx9 M00100 zx0 M zy1 zy2 UCHC •A delicate muscularis mucosa(arrow) separates the lamina propria(above) from the submucosa(below) •Surface is non-keratinizing squamous epithelium •Note the absence of any inflammation •Submucosal mucin producing "cardia" type glands are seen in the distal esophagus | zx1 208 zx2 GI zx3 7163 zx4 Esophagus zx5 Normal Esophageal Mucosa x40 zx6 Normal zx7 Normal zx8 T62000 zx9 M00100 zx0 M zy1 zy2 UCHC •Mucosa is non-keratinizing squamous epithelium. •Note absence of inflammation. | zx1 209 zx2 GI zx3 7164 zx4 Small Intestine zx5 Normal Ileal Mucosa x4 zx6 Normal_Ileum zx7 Normal zx8 T65200 zx9 M00100 zx0 M zy1 zy2 UCHC •The mucosa forms delicate narrow papillary projections with the villous(finger-like projection)/crypt(below arrow) ratio normally being 4-5/1. •Minimal lympho/plasmacytic infiltrate | zx1 217 zx2 GI zx3 7172 zx4 Salivary Glands zx5 Normal parotid zx6 Normal zx7 Normal zx8 T55100 zx9 M00100 zx0 M zy1 zy2 UCHC •The majority of the acini are serous type(black arrow) which are filled with basophilic zymogen granules •Interlobular ducts are seen in cross section(yellow arrows) •Scattered fat cells are normaly seen(red arrow) •Note how tightly packed the acini are within the lobule without intervening connective tissue | zx1 218 zx2 GI zx3 7173 zx4 Salivary Glands zx5 Normal parotid zx6 Normal zx7 Normal zx8 T55100 zx9 M00100 zx0 M zy1 zy2 UCHC •The acini contain serous glands(black arrow) identified by their basophilic zymogen cytoplasmic granules •Striated ducts(yellow arrows) are identified by their columnar lining cells | zx1 219 zx2 GI zx3 7174 zx4 Salivary Glands zx5 Normal parotid zx6 Normal zx7 Normal zx8 T55100 zx9 M00100 zx0 M zy1 zy2 UCHC •The acini are composed almost exclusively by serous cells with basophilic cytoplasmic zymogen granules •Striated portion of the interlobular duct(yellow arrow) are identified by their columnar epithelium •The pale cells(red arrow) represent the cuboidal cells of intercalated ducts | zx1 221 zx2 GI zx3 7184 zx4 Salivary Glands zx5 Normal sublingual gland x10 zx6 Normal zx7 Normal zx8 T55200 zx9 M00100 zx0 M zy1 zy2 UCHC •A predominance of mucous secreting glands are seen | zx1 222 zx2 GI zx3 7185 zx4 Salivary Glands zx5 Normal sublingual gland zx6 Normal zx7 Normal zx8 T55200 zx9 M00100 zx0 M zy1 zy2 UCHC •The sublingual gland contains primarily mucus cells(arrow) | zx1 223 zx2 GI zx3 7186 zx4 Salivary Glands zx5 Normal sublingual gland zx6 Normal zx7 Normal zx8 T55200 zx9 M00100 zx0 M zy1 zy2 UCHC •The sublingual gland contains primarily mucus glands | zx1 224 zx2 GI zx3 7187 zx4 Salivary Glands zx5 Normal submaxillary gland x10 zx6 Normal zx7 Normal zx8 T55300 zx9 M00100 zx0 M zy1 zy2 UCHC •A marked predominance of serous glands are seen similar to the the Parotid Gland | zx1 225 zx2 GI zx3 7188 zx4 Salivary Glands zx5 Normal submaxillary gland zx6 Normal zx7 Normal zx8 T55300 zx9 M00100 zx0 M zy1 zy2 UCHC •Submaxillary gland contains primarily serous cells(black arrow) with only a few mucus cells seen(yellow arrow) •Intralobular ducts are common | zx1 226 zx2 GI zx3 7189 zx4 Salivary Glands zx5 Normal submaxillary gland zx6 Normal zx7 Normal zx8 T55300 zx9 M00100 zx0 M zy1 zy2 UCHC •Submaxillary gland acini contains primarily serous cells(black arrow), with few mucus cells(red arrow) present •Intralobular ducts of the striated type(yellow arrow) are columnar, in distinction to intercalated ducts with cuboidal or flattened cells •Note how tightly packed the epithelium is, without intervening stroma | zx1 227 zx2 GI zx3 7175 zx4 Stomach zx5 Normal pylorus x4 zx6 Normal_Pylorus zx7 Normal zx8 T63700 zx9 M00100 zx0 M zy1 zy2 UCHC •Black arrow at junction of gastric pits(above) and glands below •Muscularis mucosa(green arrow) •Submucosa(red arrow) •Pyloric sphincter(blue arrow) is thickened band of circular smooth muscle | zx1 228 zx2 GI zx3 7176 zx4 Stomach zx5 Normal Pyloric Mucosa zx6 Normal_Pylorus zx7 Normal zx8 T63700 zx9 M00100 zx0 M zy1 zy2 UCHC •Foveolar pits occupy top 50% of the mucosal thickness •Cells are almost exclusively columnar mucous producing •Mild infiltrate of lymphocytes may be found in normal pyloric mucosa | zx1 230 zx2 GI zx3 7178 zx4 Stomach zx5 Normal pyloric glands x40 zx6 Normal_Pylorus zx7 Normal zx8 T63700 zx9 M00100 zx0 M zy1 zy2 UCHC •Pyloric glands are lined almost exlusively with mucous producing cells having small basally placed nuclei •Lamina propria contains scattered T-lymphocytes(arrows) | zx1 232 zx2 GI zx3 7180 zx4 Stomach zx5 Normal gastric fundus x10 zx6 Normal zx7 Normal zx8 T63000 zx9 M00100 zx0 M zy1 zy2 UCHC •Short gastric pits with mucous producing cells(top) •Underlying glands are tightly packed with a virtual absence of inflammatory cells •Delicate muscularis mucosa(arrow) | zx1 234 zx2 GI zx3 7182 zx4 Stomach zx5 Normal gastric fundus x40 zx6 Normal zx7 Normal zx8 T63000 zx9 M00100 zx0 M zy1 zy2 UCHC •Parietal cells(black arrows) with ample amounts of eosinophilic cytoplasm •Chief cells(green arrow) slightly smaller with basophilic cytoplasm •Note absence of inflammatory cells | zx1 235 zx2 CNS zx3 7203 zx4 Brain zx5 Brainstem ependymoma zx6 Ependymoma zx7 Malign zx8 TX2000 zx9 M93913 zx0 G zy1 zy2 UCHC •A coronal section through the brainstem and cerebellum •The dark irregular tissue invading half the brainstem and the fourth ventricle represents one of the three important posterior fossa tumors of childhood - the ependymoma. | zx1 236 zx2 CNS zx3 7204 zx4 Brain zx5 Cerebral Astrocytoma zx6 Astrocytoma,_Cerebral zx7 Malign zx8 TX2000 zx9 M94003 zx0 G zy1 zy2 UCHC •A coronal section through the frontal lobes and anterior temporal lobes. •The enlarged hemisphere represents a low grade astrocytoma. •Note how the tumor erases the grey-white junction of the cerebral cortex in some areas and enlarges the hemisphere. •It is associated with edema which moves structure toward the opposite hemisphere. | zx1 237 zx2 CNS zx3 7205 zx4 Brain zx5 Glioblastoma Multiforme zx6 Glioblastoma zx7 Malign zx8 TX2000 zx9 M94403 zx0 G zy1 zy2 UCHC •A coronal section through the parietal-occipital junction. •The large variegated mass represents a glioblastoma multiforme - multiform in shape, color, texture and histology. •This is the most malignant of the gliomas. | zx1 238 zx2 CNS zx3 7206 zx4 Brain zx5 Cerebellar hemangioblastoma zx6 Hemangioblastoma zx7 Malign zx8 TX6000 zx9 M91611 zx0 G zy1 zy2 UCHC •A coronal section through the cerebellum and pons •The hemorrhagic areas represent partly the tumor - a hemangioblastoma - as well an attempt to resect the tumor •Note the swelling of the cerebellum and distortion of the pons •The hemangioblastoma is made up of numerous capillaries and larger abnormal blood vessels as well as characteristic small foamy cells. | zx1 239 zx2 CNS zx3 7207 zx4 Brain zx5 Meningioma zx6 Meningioma zx7 Benign zx8 TX1110 zx9 M95300 zx0 G zy1 zy2 UCHC •A coronal section of the brain through the brain at the level of the lenticular nuclei. •A large mass between the hemispheres markedly distorts the brain. •The mass is separatable from the brain parencyma characteristic of the meningioma which arises from the arachnoid cells. •It is the only truely benign tumor of the CNS. | zx1 240 zx2 CNS zx3 7209 zx4 zx5 Acoustic Neurinoma ( Schwannoma) zx6 Schwannoma zx7 Benign zx8 TX0500 zx9 M95600 zx0 G zy1 zy2 UCHC •A coronal section through the cerebellum and pons •The round greyish mass adjacent to the pons is the most common cerebellar-pontine angle tumor - the acoustic neuroma (schwannoma) which arises from the eighth nerve and other sensory nerves | zx1 241 zx2 CNS zx3 7210 zx4 Spinal Cord zx5 Metastatic Carcinoma to Spinal Column zx6 Metastatic_Carcinoma zx7 Malign zx8 TX7410 zx9 M80006 zx0 G zy1 zy2 UCHC •A hemisection of the vertebrae and spinal cord •The whitish tissue in the vertebrae impinging on the spinal cord is a metastatic lung carcinoma •This is a comman place for lung, breast and prostate carcinomas to metastasize to. | zx1 243 zx2 CNS zx3 7208 zx4 Brain zx5 Adenoma zx6 Adenoma zx7 Benign zx8 T91000 zx9 M82700 zx0 G zy1 zy2 UCHC • Base of brain as it is lifted out of the skull with frontal lobes at the left. • A mass is protruding from the sella turcica (at arrows) which is a tan, soft pituitary adenoma. | zx1 244 zx2 CV zx3 7196 zx4 Myocardium zx5 Bundle of His zx6 Bundle_of_His zx7 Normal zx8 T32830 zx9 M00100 zx0 M zy1 zy2 UCHC •This is a Masson trichrome stain marking fibrous tissue blue and muscle light red. •The bundle of His (arrow) is in the membranous portion of interventricular septum, which is part of the cardiac skeleton. The atrial and ventricular septums are on the left and right, respectively. The bundle is modified myocardium. •The loose valve structure below the atrial septum is the tricuspid valve. | zx1 245 zx2 CV zx3 7197 zx4 Myocardium zx5 Subendocardial Posteroseptal Infarct zx6 Infarct_NOS zx7 Degen zx8 T33010 zx9 M54700 zx0 G zy1 zy2 UCHC •Outflow tract of left ventricle. Note: aortic valve; endocardial surface of interventricular septum ( •); posterior papillary muscle arising from posterior wall (1 arrow); anterolateral wall of left ventricle ( • •). •Subendocardial scarring, a healed infarct of posterior wall of left ventricle, and apical portions of anterior wall and interventricular septum (2 arrows). | zx1 246 zx2 GU zx3 7198 zx4 Kidney zx5 Renal Cell Adenocarcinoma zx6 Renal_cell_adenocarcinoma zx7 Malign zx8 T71000 zx9 M83123 zx0 G zy1 zy2 UCHC •Cut section of this kidney shows a renal cell carcinoma (white arrow). The tumor is spherical, well-circumscribed, and has a yellow-tan color. •This tumor measured 2.5 cm in diameter and was peripherally located. It stretched the renal capsule but did not penetrate through it. •A benign cyst is also present (black arrow). | zx1 249 zx2 Resp zx3 7211 zx4 Lung zx5 Normal trachea (medium power) zx6 Normal _Trachea zx7 Normal zx8 T25000 zx9 M00100 zx0 M zy1 zy2 UCHC • This medium power view shows overall architecture of the trachea. • The lining is ciliated respiratory epithelium. • Beneath that is a submucossa containing abundant vessels and resident lymphocytes. • Beneath that is the cartilage, and below the cartilage muscle. | zx1 253 zx2 Endo zx3 7192 zx4 Adrenal zx5 Adrenal ganglioneuroblastoma (External) zx6 Ganglioneuroblastoma zx7 Malign zx8 T93000 zx9 M94903 zx0 G zy1 zy2 UCHC • External view of a ganglioneuroblastoma found in the adrenal gland or sympathetic • Smooth external surface. • No normal adrenal recognizable. | zx1 254 zx2 Endo zx3 7193 zx4 Adrenal zx5 Adrenal Ganglioneuroblastoma (Internal) zx6 Ganglioneuroblastoma zx7 Malign zx8 T93000 zx9 M94903 zx0 G zy1 zy2 UCHC • No recognizable adrenal gland. • Partially cystic neoplasm containing bloody fluid. • Central core of red tan soft tumor. | zx1 255 zx2 Endo zx3 7194 zx4 Adrenal zx5 Adrenal Ganglioneuroblastoma (Composite) zx6 Ganglioneuroblastoma zx7 Malign zx8 T93000 zx9 M94903 zx0 G zy1 zy2 UCHC • Left panel is external view of a smooth surfaced neoplasm completely replacing adrenal gland. • Cut surface shows extensive hemorrhage and cyst formation. | zx1 256 zx2 Resp zx3 7222 zx4 Lung zx5 Bronchogenic Cyst of Lung zx6 Cyst zx7 Con zx8 T28000 zx9 M26500 zx0 G zy1 zy2 UCHC • Portion of lung with normal reddish brown parenchyma. • Lung has been sliced to reveal cyst (arrows). • The lining is smooth and similar in color to the normal lung. | zx1 257 zx2 Resp zx3 7223 zx4 Larynx zx5 Laryngeal Squamous Cell Carcinoma zx6 Squamous_Cell_Carcinoma zx7 Malign zx8 T24100 zx9 M80703 zx0 G zy1 zy2 UCHC • Larynx opened from the posterior side. • Blue arrows point to vocal cords. • Central granular mass above the vocal cords (white arrow) is neoplasm. • Categorized as supraglottic (above cords). | zx1 258 zx2 Resp zx3 7224 zx4 Larynx zx5 Laryngeal Squamous Carcinoma zx6 Squamous_Cell_Carcinoma zx7 Malign zx8 T24100 zx9 M80703 zx0 G zy1 zy2 UCHC • To the left is the uvula; to the right is the trachea. • Specimen opened from the posterior aspect. • Blue arrows point to normal vocal cord (right). • White arrows point to left vocal cord which is distorted by a granular neoplasm. • Categorized as "glottic" in location. | zx1 259 zx2 CV zx3 7226 zx4 Myocardium zx5 Myocarditis zx6 Myocarditis zx7 Inf zx8 T33010 zx9 M40000 zx0 G zy1 zy2 Saint Francis Hospital •View of transverse section of heart from above. Anterior surface faces upwards, thick left ventricle on the left, right ventricle on right. •Note area of myocardial pallor (2 arrows) mostly to the left of the left ventricular cavity involving less than 1/2 of the wall thickness. This is due to a dense interstitial infiltrate of inflammatory cells. •The normal appearing red myocardium elsewhere could also show microscopic infiltrates, which are not dense enough to see grossly. | zx1 260 zx2 CV zx3 7227 zx4 Aorta zx5 Normal Aorta zx6 Normal zx7 Normal zx8 T42000 zx9 M00100 zx0 G zy1 zy2 Saint Francis Hospital •View of a normal aorta opened posteriorly lengthwise, with the bifurcation indicated by the white arrow. •Note: The uniform smooth glistening intimal surface; The longitudinal evenly spaced rows of intercostal artery ostia along the upper and lower cut edges of the thoracic aorta, which appear as faint dots; the upper abdominal aorta marked by the two prominent ostia of the celiac and superior mesenteric arteries (yellow arrow), below which are the barely visible ostia of the renal arteries on the cut edges. | zx1 261 zx2 CV zx3 7228 zx4 Aorta zx5 Abdominal Aortic Aneurysm zx6 Aneurysm zx7 Vasc zx8 T42000 zx9 M32430 zx0 G zy1 zy2 Saint Francis Hospital •Abdominal aortic aneurysm, view of posterior surface. •The next two images are the same specimen, with a complete description with the second of the two images. | zx1 262 zx2 CV zx3 7229 zx4 Aorta zx5 Abdominal Aortic Aneurysm zx6 Aneurysm zx7 Vasc zx8 T42000 zx9 M32430 zx0 G zy1 zy2 Saint Francis Hospital •Same specimen as previous image, opened lengthwise. See following image for complete description. | zx1 263 zx2 CV zx3 7230 zx4 Aorta zx5 Abdominal Aortic Aneurysm zx6 Aneurysm zx7 Vasc zx8 T42000 zx9 M32430 zx0 G zy1 zy2 Saint Francis Hospital •Upper view is of the unopened aorta with a fusiform aneurysm just above the bifurcation (black arrow). •Lower view shows the aorta and common iliac arteries opened longitudunally. •The aneurysmal cavity is almost filled with an unorganized thrombus (white arrow) with a central channel of blood flow having the same diameter as the adjoining intact aorta. •Note that the arteriosclerotic intima lining the upper edge of the opened aneurysm ( •) has been artefactitiously split from the media (blue arrow) | zx1 266 zx2 GYN zx3 7221 zx4 Placenta zx5 Quadruplet Placenta zx6 Triplet_or_Quadruplet zx7 Con zx8 T88100 zx9 M29070 zx0 G zy1 zy2 UCHC •View from the fetal surface down on the chorionic plate. •Note 4 umbilical cords. •The placental discs are fused. | zx1 267 zx2 Bone zx3 7232 zx4 Bone zx5 Cavernous Hemangioma zx6 Cavernous_Hemangioma zx7 Benign zx8 T1X500 zx9 M91210 zx0 G zy1 zy2 •Cross section of bone •Note the normal looking bone at the edges •The central portion has been replaced by red-purple tissue that represents dilated capillaries of the hemangioma. | zx1 269 zx2 HEM zx3 7225 zx4 Spleen zx5 Congestion zx6 Congestion zx7 Vasc zx8 T07000 zx9 M36100 zx0 G zy1 zy2 Saint Francis Hospital | zx1 270 zx2 CV zx3 6000 zx4 Myocardium zx5 Acute Myocardial Infarct zx6 Infarct_Acute zx7 Degen zx8 T33010 zx9 M54720 zx0 G zy1 zy2 UCHC •Transverse sections positioned such that anterior surfaces face leftward and view is looking down at top of head. •This is an anterolateral infarct touching on the anterior aspect of the interventricular septum. •Note the discrete margins, the light tan focally hemorrhagic coloration, and the transmural extent in the larger section at the junction of the anterior and lateral walls. | zx1 271 zx2 CV zx3 6001 zx4 Myocardium zx5 Acute Myocardial Infarct zx6 Infarct_Acute zx7 Degen zx8 T33010 zx9 M54720 zx0 G zy1 zy2 UCHC •View is of the superior surface of a transverse section of the heart with the anterior surface facing upward, and the IV septum on the right margin. A small bit of the right ventricle and cavity is seen in the right lower corner. •Note the extensive infarct involving the anterior and lateral walls of the left ventricle, and the anterior tip of the IV septum. •Note that the infarct is transmural at the junction of the anterior wall and septum (arrow). | zx1 273 zx2 CV zx3 6003 zx4 Myocardium zx5 Acute Myocardial Infarct with Rupture zx6 Infarct_Acute zx7 Degen zx8 T33010 zx9 M54720 zx0 G zy1 zy2 A93-70 •Transverse section positioned such that the anterior surface faces upward, and the view is of the superior surface of the section. •Note the irregular but distinct margins of the tan lesion which contrasts with the intact bright red myocardium. •The anterior and lateral walls are involved, sparing the posterior wall and interventricular septum. •Note the foci of hemorrage in the anterior wall where the infarct is transmural. These foci mark the tract (arrows) of a rupture through necrotic muscle and epicardium causing a lethal hemopericardium. | zx1 274 zx2 CV zx3 6004 zx4 Myocardium zx5 Acute Myocardial Infarct with Rupture zx6 Infarct_Acute zx7 Degen zx8 T33010 zx9 M54720 zx0 G zy1 zy2 UCHC •The heart is in the anatomical position showing the anterior surface. •There is an acute infarct of the anterior and lateral walls, which has ruptured through a transmural focus in the anterior wall (see CV/6003). •The linear tear in the epicardial serosa (arrow) with hemopericardium results from an expanding epicardial hematoma which simply ruptures the serosa. | zx1 275 zx2 CV zx3 6005 zx4 Coronary Artery zx5 Coronary Artery Thrombosis zx6 Thrombus zx7 Vasc zx8 T41000 zx9 M35100 zx0 G zy1 zy2 UCHC •This is a view of the transected anterior branch of the left coronary artery. •The arrow points at the circular cut surface of the artery, with the media appearing as a uniform yellow ring, and with the lumen occluded by a yellow atheromatous plaque and a superimposed acute thrombus. | zx1 276 zx2 GI zx3 6006 zx4 Liver zx5 Cirrhosis zx6 Cirrhosis zx7 Inf zx8 T56000 zx9 M49500 zx0 G zy1 zy2 UCHC | zx1 277 zx2 GI zx3 6007 zx4 Liver zx5 Cirrhosis zx6 Cirrhosis zx7 Inf zx8 T56000 zx9 M49500 zx0 G zy1 zy2 UCHC | zx1 279 zx2 GI zx3 6009 zx4 Liver zx5 Herpes Infection Involving Liver zx6 Herpes zx7 Inf zx8 T56000 zx9 E3213 zx0 G zy1 zy2 UCHC | zx1 282 zx2 HEM zx3 6012 zx4 Spleen zx5 Splenic Infarct with Chronic Congestion zx6 Infarct zx7 Degen zx8 T07000 zx9 M54700 zx0 G zy1 zy2 UCHC • This is a section of spleen with dark red parenchyma • The wedge shaped lesion with the broad edge beneath the capsule is an area of infarct. • The infarct often stands out from the surrounding parenchyma and may be much firmer. • There is a band of intense hemorrhage around the area of necrotic tissue which is slightly yellow. • The non-necrotic spleen is intensely congested. | zx1 284 zx2 GYN zx3 6014 zx4 Fallopian Tube zx5 Tubal Ectopic Pregnancy zx6 Ectopic zx7 Mech zx8 T86100 zx9 F31100 zx0 G zy1 zy2 HARTFORD HOSPITAL •View of a fallopian tube with an ectopic pregnancy viewed through the fimbriated end. •Arrows highlight the head and back of a very early embryo. •Detected prior to rupture (no hemorrhage). | zx1 285 zx2 RESP zx3 6015 zx4 Lung zx5 Pulmonary Embolus zx6 Embolus zx7 Vasc zx8 T28000 zx9 M35300 zx0 G zy1 zy2 UCHC • Close up view of the interior of one of the pulmonary arteries as it divides into segmental arteries in the hilum of the lung. • White arrows point to edges of pulmonary artery showing a yellow surface. • Black arrows point to large red brown thromboemboli occluding two segmental vessels. | zx1 286 zx2 CV zx3 6016 zx4 Endocardium zx5 Embolus in Right Ventricle zx6 Embolus zx7 Vasc zx8 T32000 zx9 M35300 zx0 G zy1 zy2 UCHC •View of inflow tract of right ventricle, showing right atrium, tricuspid valve, and right ventricle. •Note huge obstructive embolus (arrow) jammed into trabeculae carnae and carnae and folded into the shape of a letter "U". It is 1 cm in diameter and 8 cm in length, corresponding to the size of some leg veins, which can be larger. •The dark space marked ( •) is the opening into the outflow tract leading to the pulmonary valve and trunk. | zx1 287 zx2 CV zx3 6017 zx4 Myocardium zx5 Organizing Myocardial Infarct zx6 Infarct_Acute zx7 Degen zx8 T33010 zx9 M54720 zx0 G zy1 zy2 UCHC •Transverse section of heart with the anterior surface facing upward. The superior surface of the section is shown. •Note the poorly defined irregular gray pink infarcted area (2 arrows) with subendocardial foci of hemorrhage. •The infarct involves both the posterior interventricular septum and the adjoining posterior wall. The hemorrhages probably indicate recent extension. •The gray component of the coloration is characteristic of fibrosis. •Note that the right ventricle is hypertrophied. | zx1 288 zx2 RESP zx3 6018 zx4 Lung zx5 Lung with Aspiration of Gastric Contents zx6 Aspiration zx7 Growth zx8 T26000 zx9 M79000 zx0 G zy1 zy2 UCHC • The bronchial mucosa is a vivid red due to irritation from aspiration of gastric contents. • Adjacent pulmonary parenchyma is also deeply congested. | zx1 289 zx2 GI zx3 6019 zx4 Liver zx5 Metastatic Pancreatic Adenocarcinoma zx6 Metastatic_Adenocarcinoma zx7 Malign zx8 T56000 zx9 M81406 zx0 G zy1 zy2 UCHC | zx1 290 zx2 GI zx3 6020 zx4 Liver zx5 Metastatic Gastric Carcinoma zx6 Metastatic_Adenocarcinoma zx7 Malign zx8 T56000 zx9 M81406 zx0 G zy1 zy2 UCHC | zx1 291 zx2 GI zx3 6021 zx4 Liver zx5 Metastatic Colonic Adenocarcinoma zx6 Metastatic_Adenocarcinoma zx7 Malign zx8 T56000 zx9 M81406 zx0 G zy1 zy2 UCHC | zx1 292 zx2 GU zx3 6022 zx4 Bladder zx5 Cloaca zx6 Cloaca zx7 Con zx8 T74000 zx9 M20000 zx0 G zy1 zy2 UCHC •The dilated sac-like structure in the center of the photograph is a persistent cloaca. There has been failure in early fetal life for the urorectal septum to divide the rectum from the urogenital sinus. •Entering the cloaca included the colon, the right ureter and the left ureter (there was left renal agenesis). The cloaca served as rectum and bladder. The infant had no anus. •The only outlet was a thin narrow urethra. | zx1 293 zx2 GU zx3 6023 zx4 Bladder zx5 Cloaca zx6 Cloaca zx7 Con zx8 T74000 zx9 M20000 zx0 G zy1 zy2 UCHC •The dilated sac-like structure in the center of the photograph is a persistent cloaca. There has been failure in early fetal life for the urorectal septum to divide the rectum from the urogenital sinus. •The photograph is a posterior view. Entering the cloaca included the colon, the right ureter and the left ureter (not shown). The cloaca served as rectum and bladder. There was no left kidney (renal agenesis). The infant had no anus. •The only outlet was a thin narrow urethra. | zx1 294 zx2 GU zx3 6024 zx4 Kidney zx5 Acute Pyelonephritis Secondary to Obstruction zx6 Acute_pyelonephritis zx7 Inf zx8 T71000 zx9 M41000 zx0 G zy1 zy2 UCHC •This is a posterior view of kidneys. The specimen includes metastatic colon carcinoma (T) involving the hilar and proximal peri-ureteral soft tissues on the right. •Although not demonstated by this photograph, the tumor growth in this region has led to secondary hydronephrosis and pyelonephritis of the right kidney. | zx1 295 zx2 GU zx3 6025 zx4 Kidney zx5 Acute Pyelonephritis Secondary To Obstruction zx6 Acute_pyelonephritis zx7 Inf zx8 T71000 zx9 M41000 zx0 G zy1 zy2 UCHC •The photograph shows gross features of hydronephrosis. Note the dilated calyces. •The renal parenchyma has a mottled character. Microscopically the kidney showed areas of acute pyelonephritis. •The urine outflow obstruction was at the level of the proximal ureter due to involvement of the region by metastatic colonic carcinoma. | zx1 296 zx2 GU zx3 6026 zx4 Kidney zx5 Unilateral Hydronephrosis zx6 Hydronephrosis zx7 Inf zx8 T72000 zx9 M33300 zx0 G zy1 zy2 UCHC •The panels show the right and left kidneys of a patient. Note the dilated pelvis and calyces on the right compared to the left. •Autopsy showed metastatic colonic carcinoma involving the right hilar and peri-ureteral soft tissues. The tumor in this area has caused outflow obstruction on the right, resulting in hydronephrosis and acute pyelonephritis | zx1 297 zx2 GU zx3 6027 zx4 Kidney zx5 Normal zx6 Normal_kidney zx7 Normal zx8 T71000 zx9 M00100 zx0 G zy1 zy2 UCHC •No specific gross abnormalities are demonstrated in this photograph. | zx1 298 zx2 CV zx3 6028 zx4 Endocardium zx5 Thrombus in Left Atrium zx6 Thrombus zx7 Vasc zx8 T32310 zx9 M35130 zx0 G zy1 zy2 UCHC •View of the inflow tract of the left ventricle showing a big left atrium, a stenotic mitral valve, and the upper left ventricle showing the anterior and posterior papillary muscles. •Note the severe mitral stenosis due to a healed rheumatic valvulitis with thickened valve cusps and chordae tendinae. The large cusp with thick chordae tendinae attached to the posterior papillary muscle is the anterior valvular leaflet. •The huge thrombus (2 arrows), which shows outer older light tan layers is arising out of the auricular appendage. | zx1 299 zx2 Endo zx3 6029 zx4 Adrenal zx5 Metastatic Adenocarcinoma zx6 Adenocarcinoma zx7 Malign zx8 T93000 zx9 M81406 zx0 G zy1 zy2 UCHC • The gray white nodule which obliterates normal architecture is the metastatic neoplasm. • Yellow tissue is normal cortex; brown gray normal medulla. | zx1 300 zx2 CV zx3 6030 zx4 Aorta zx5 Severe aortic athersclerosis zx6 Atherosclerosis zx7 Degen zx8 T42000 zx9 M52110 zx0 G zy1 zy2 Saint Francis Hospital •View of inner surface of aorta and bifurcaton, opened lengthwise along the posterior midline. •Note: irregular variegated lining due to diffuse disease, with red thrombi (black arrow); ostia of celiac and superior mesenteric arteries and right renal artery (white arrows); deceptive narrower calibre of abdominal aorta below celiac artery due to rigidity of calcified atheroma in the typically more severely diseased lower aorta, which maintains its shape after being cut. | zx1 306 zx2 CV zx3 6035 zx4 Coronary Artery zx5 coronary artery thrombosis zx6 Thrombus zx7 Vasc zx8 T41000 zx9 M35100 zx0 G zy1 zy2 Saint Francis Hospital •Note the occlusion of the distended artery by a dark red thrombus. No lines of Zahn are present.The initial occlusion was probably a fibrinous platelet thrombus where a plaque ruptured or hemorrhaged, and this view is of a stasis thrombus formed proximal to the initial occlusion. | zx1 309 zx2 RESP zx3 6038 zx4 Lung zx5 Normal Lung zx6 Normal_Lung zx7 Normal zx8 T28000 zx9 M00100 zx0 G zy1 zy2 Saint Francis Hospital • External surface of a normal right lung. • Initials identify upper (U), middle (M), and lower (L) lobes. • Carbon pigment trapped in subpleural lymphatics creates the lines of black on the external surface (arrows). | zx1 310 zx2 RESP zx3 6039 zx4 Lung zx5 Pulmonary Congestion (External View) zx6 Congestion zx7 Vasc zx8 T28000 zx9 M36142 zx0 G zy1 zy2 Saint Francis Hospital • View of the left lung with lobes identified by letter U (upper) and L (lower). • The lower lobe is much deeper red consistent with congestion of the pulmonary vessels. | zx1 311 zx2 RESP zx3 6040 zx4 Lung zx5 Pulmonary Adenocarcinoma (External View) zx6 Adenocarcinoma zx7 Malign zx8 T28000 zx9 M81403 zx0 G zy1 zy2 Saint Francis Hospital •This is the pleural surface of the lung. •Note the puckering of the pleural surface with surrounding hemorrhage at the arrow. •The carcinoma cannot be identified in this picture but lies directly beneath the puckered area. | zx1 312 zx2 RESP zx3 6041 zx4 Lung zx5 Bronchopneumonia zx6 Bronchopneumonia zx7 Inf zx8 T28000 zx9 M40000 zx0 G zy1 zy2 Saint Francis Hospital • The photo is of a slice of pulmonary parenchyma. • The lung is congested. • A barely visible nodularity which is easier palpated indicates bronchopneumonia. • Arrows point to examples of nodules. | zx1 315 zx2 GI zx3 6044 zx4 Stomach zx5 Normal stomach zx6 Normal zx7 Normal zx8 T63000 zx9 M00100 zx0 G zy1 zy2 Saint Francis Hospital •Esophageal-gastric junction(black arrow) •Cardia(white arrow) is poorly defined zone 1.0-1.5cm below esophageal-gastric junction •Antrum is triangular area occupying distal third of stomach(green arrows) •Fundus is remainder of stomach shown here with prominent rugal folds | zx1 316 zx2 Bone zx3 6045 zx4 Bone zx5 Parosteal Osteosarcoma zx6 Osteosarcoma,_Parosteal zx7 Malign zx8 T1X500 zx9 M91903 zx0 G zy1 zy2 UCHC ¥Tumor (yellow arrows) arises from the periosteum. ¥Note the eccentric location of the tumor. ¥Note central area of necrosis and hemorrhage. | zx1 317 zx2 Bone zx3 6046 zx4 Bone zx5 Metastatic Renal Cell Carcinoma to Scapula zx6 Metastatic_adenocarcinoma zx7 Malign zx8 T1X500 zx9 M81406 zx0 G zy1 zy2 UCHC •Large yellow-tan mass surrounded by white arrows is the tumor. •Yellow nodules are normal fat around shoulder. •Tumor has undergone central necrosis as indicted by the dark arrow near the center. | zx1 318 zx2 Bone zx3 6047 zx4 Bone zx5 Giant Cell Tumor - head of femur zx6 Giant_Cell_Tumor zx7 Benign zx8 T1X500 zx9 M92501 zx0 G zy1 zy2 UCHC •Large central lesion surrounded by white arrows is tumor. •Note areas of hemorrhage. This is a common feature in giant cell tumors. | zx1 319 zx2 Bone zx3 6048 zx4 Bone zx5 Metastatic Carcinoma from breast in spinal column zx6 Metastatic_adenocarcinoma zx7 Malign zx8 T1X500 zx9 M81406 zx0 G zy1 zy2 UCHC •Section showing three adjacent vertebral bodies •The two left are relatively normal. •Note that the one on the right has been almost completely replaced by a white mass. •This is the metastatic tumor destroying bone. | zx1 320 zx2 Bone zx3 6049 zx4 Bone zx5 Normal Vertebrae zx6 Normal_Bone zx7 Normal zx8 T1X500 zx9 M00100 zx0 G zy1 zy2 UCHC •Two and a half adjacent vertebral bodies in section. •The two black arrows flank an inter-vertebral disk. •The bone of the vertebral body is the pink material, with flecks of white within. •The pink material is bone marrow and the white flecks are cancellous bone spicules. | zx1 321 zx2 Bone zx3 6050 zx4 Bone zx5 Multiple Myeloma Involving Skull zx6 Multiple_myeloma zx7 Malign zx8 T1X500 zx9 M97303 zx0 G zy1 zy2 UCHC •This is a view of the skull from above, after the scalp has been removed. •Note the "punched out" circular, hemorrhagic lesions (some indicated by arrows). These are the tumor deposits in the bones of the skull. | zx1 322 zx2 Bone zx3 6051 zx4 Bone zx5 Multiple myeloma in a rib zx6 Multiple_myeloma zx7 Malign zx8 T1X500 zx9 M97303 zx0 G zy1 zy2 UCHC •Sections of vertebrae and ribs from a patient with myeloma. •Note the tan-white lesion indicated by the two white arrows in the middle piece of bone. •Note the typical, sharply demarcated appearance of this lesion. •This is a single focus of myeloma in the rib of a patient. | zx1 323 zx2 Bone zx3 6052 zx4 Bone zx5 Myelofibrosis - spinal column zx6 Myelofibrosis zx7 Inf zx8 T10510 zx9 M49000 zx0 G zy1 zy2 UCHC •The specimen is of 4.5 adjacent vertebral bodies in section. •The two black arrows flank an intervertebral disk. •Note that the bones in this specimen do not have the pink appearance with white specks characteristic of normal vertebral bodies (see image # 6049). •This is because the marrow has been replaced by fibrous tissue. | zx1 324 zx2 Bone zx3 6053 zx4 Joint zx5 Osteosarcoma involving epiphysis zx6 Osteosarcoma zx7 Malign zx8 T1X500 zx9 M91803 zx0 G zy1 zy2 UCHC •Specimen is a section though a joint. The two bones involved are on the left and right. •The epiphysis of the bone on the right is seen at the black arrow. •The epiphysis of the bone on the left has been completely replaced by the mass which distends the joint capsule to the top of the specimen. The tumor is indicated by the white arrows. | zx1 326 zx2 Bone zx3 6055 zx4 Bone zx5 Parosteal osteosarcoma zx6 Osteosarcoma,_Parosteal zx7 Malign zx8 T1X500 zx9 M91903 zx0 G zy1 zy2 UCHC •Specimen is a longitudinal section of the proximal end of a long bone. •The tumor (indicated by the arrows) arises from the periosteum, explaining its eccentric appearance. •The tumor has grown into the soft tissues around the joint. | zx1 327 zx2 Bone zx3 6056 zx4 Bone zx5 Osteosarcoma eroding through epiphysis zx6 Osteosarcoma zx7 Malign zx8 T1X500 zx9 M91803 zx0 G zy1 zy2 UCHC •Specimen of end of long bone •There is extensive destruction of bone by the tumor (shown by the white arrows). •Note erosion of epiphysis by the tumor (black arrow). This is uncommon. | zx1 329 zx2 CNS zx3 6057 zx4 Brain zx5 Recent Infarct zx6 Cerebral_Infarct,_Acute zx7 Degen zx8 TX2000 zx9 M54720 zx0 G zy1 zy2 Saint Francis Hospital •Coronal section of brain through the corpus striatum •Shows recent cerebral infarct (1st 24 hours) with edema, discoloration of the cortex and widening of the white matter •This is a middle cerebral or internal carotid artery distribution infarct •Since the infarct is pale it is probably due to a thrombosis. | zx1 330 zx2 CNS zx3 6058 zx4 Brain zx5 Meningioma zx6 Meningioma zx7 Benign zx8 TX1110 zx9 M95300 zx0 G zy1 zy2 Saint Francis Hospital •A portion of dura and falx showing a nodule which is a meningioma •Meningioma are benign tumors which frequently arise from the dura and compress but do not invade the brain | zx1 332 zx2 CNS zx3 6059 zx4 Brain zx5 Hydrocephalus zx6 Hydrocephalus zx7 Con zx8 TX2000 zx9 M33320 zx0 G zy1 zy2 UCHC •Hydrocephalus is due to an accumulation of cerebrospinal fluid in the ventricles when flow out of ventricles or subarachnoid space is blocked. •In infants with their pliable skulls develop enlarged heads when hydrocephalus occurs. | zx1 333 zx2 GI zx3 6060 zx4 Stomach zx5 Acute benign Gastric Ulcer zx6 Ulcer zx7 Inf zx8 T63000 zx9 M38000 zx0 G zy1 zy2 UCHC •A benign ulcer is present in the lesser curvature(arrow) •Margins are typically smooth, and the edge is flat as opposed to many malignant gastric ulcers which have a raised firm border •Remainder of the stomach has a normal well preserved rugal pattern | zx1 334 zx2 GI zx3 6061 zx4 Stomach zx5 Benign Acute Gastric Ulcer zx6 Ulcer zx7 Inf zx8 T63000 zx9 M38000 zx0 G zy1 zy2 UCHC •Benign peptic ulcer(arrow) has a round to oval punched out appearance with a necrotic hemorrhagic base •Margins are smooth and the adjoining intact tissue is not elevated as is commonly seen in malignant gastric ulcers •The adjoining rugal folds appear normal | zx1 335 zx2 EAE zx3 6062 zx4 Ear zx5 Malformation of external ear zx6 Malformation zx7 Con zx8 TXY100 zx9 M20000 zx0 G zy1 zy2 UCHC | zx1 336 zx2 Bone zx3 6063 zx4 Bone zx5 Syndactyly zx6 Syndactyly zx7 Con zx8 T11500 zx9 M20000 zx0 G zy1 zy2 UCHC •Note the fused middle and ring fingers on right hand. •This congential malformation is called syndactyly. •Fusion of these two digits is the most common form of this congenital anomaly. | zx1 337 zx2 CNS zx3 6064 zx4 Brain zx5 Hydrocephalus zx6 Hydrocephalus zx7 Con zx8 TX2000 zx9 M33320 zx0 G zy1 zy2 •A coronal section of the brain through the corpus striatum •Note the markedly enlarged lateral ventricles with thinning of the white matter which is characteristic of hydrocephalus due to obstruction of CSF pathways with increased cerebral spinal fluid pressure in the ventricles. | zx1 339 zx2 CNS zx3 6066 zx4 Brain zx5 Germinal Plate Hemorrhage zx6 Hemorrhage,_Germinal_Plate zx7 Vasc zx8 TX1615 zx9 M37000 zx0 G zy1 zy2 •Premature infant brain with bilateral subependymal hemorrhages in the germinal plate with rupture into the lateral and third ventricles. Probably caused the death of the infant. •The germinal plate is the area where neuroblasts and glioblasts form and from which they migrate. It has thinwalled, large caliber blood vessels with little matrix around them which are easily ruptured when there is increased blood flow as in transient hypertension. | zx1 340 zx2 CNS zx3 6067 zx4 Brain zx5 Cyclops / Holoprosencephaly zx6 Holoprosencephaly zx7 Con zx8 TX2000 zx9 M20100 zx0 G zy1 zy2 •A cyclops with one central abnormal eye, a probocis above it and an abnormal mouthlike structure below it. •Usually associated with the most severe form of holoproscencephaly. •Often seen in trisomy 13 but can be seen with normal chromosomes. | zx1 341 zx2 CNS zx3 6068 zx4 Brain zx5 Hydrocephalus zx6 Hydrocephalus zx7 Con zx8 TX2000 zx9 M33320 zx0 G zy1 zy2 •Horizontal section of brain looking down into the markedly dilated lateral ventricles - hydrocephalus. •Note the markedly narrowed white and grey matter compressed by the increased cerebral spinal fluid pressure from blockage of outflow. •The choroid plexus continues to make CSF in spite of the increased intraventricular pressure. | zx1 342 zx2 GYN zx3 6069 zx4 Placenta zx5 Quadruplet Placenta zx6 Triplet_or_Quadruplet zx7 Con zx8 T88100 zx9 M29070 zx0 G zy1 zy2 UCHC •View from the fetal surface. •Four umbilical cords. •Membranes obscure the chorionic plate. | zx1 345 zx2 GU zx3 6072 zx4 Bladder zx5 Leiomyosarcoma_of_bladder_neck zx6 Leiomyosarcoma zx7 Malign zx8 T74000 zx9 M88903 zx0 G zy1 zy2 UCHC •The photograph shows the cut section of a leiomyosarcoma removed from the region of the bladder neck and prostate gland. •The external contour is irregularly lobulated but for the most part smooth. There are peripheral regions however, showing necrosis and contour irregularities. •The viable central region is light tan and fairly homogenous. | zx1 347 zx2 GU zx3 6074 zx4 Kidney zx5 Cystic_renal_dysplasia zx6 Cystic_renal_dysplasia zx7 Con zx8 T71000 zx9 M23070 zx0 G zy1 zy2 UCHC •The photograph shows the amputated upper pole of a kidney removed for segmental cystic dysplasia. •The upper pole of this kidney had its own ureter which is seen here as a dilated and tortuous structure. •The equatorial and lower pole of the kidney was drained by a second ureter that was normal in caliber and continuous to the bladder. | zx1 350 zx2 GU zx3 6077 zx4 Kidney zx5 Cystic Renal Dysplasia zx6 Cystic_renal_dysplasia zx7 Con zx8 T71000 zx9 M23070 zx0 G zy1 zy2 UCHC •The photograph shows the upper pole of a kidney amputated for renal dysplasia. The pelvis has been opened to show a dilated pelvis with a trabeculated luminal surface. •The renal parenchyma shows multiple cysts (arrows). •This upper pole was associated with a duplicated ureter that was tortuous, dilated and obstructed at the uretero- vesicle junction (not shown). The remainder of the kidney was normal with a separate ureter and left in the patient. | zx1 351 zx2 HEM zx3 6078 zx4 Spleen zx5 Granuloma of spleen zx6 Granuloma zx7 Inf zx8 T07000 zx9 M44000 zx0 G zy1 zy2 UCHC | zx1 352 zx2 GI zx3 6079 zx4 Colon zx5 Ulcerative Colitis - opened colon zx6 Ulcerative_Colitis zx7 Inf zx8 T67000 zx9 D6255 zx0 G zy1 zy2 UCHC •Mucosa has red granular appearance •Lumen of proximal colon(arrow) is dilated | zx1 353 zx2 GI zx3 6080 zx4 Colon zx5 Ulcerative Colitis zx6 Ulcerative_Colitis zx7 Inf zx8 T67000 zx9 D6255 zx0 G zy1 zy2 UCHC •Numerous punctate mucosal hemorrhages •Dilated colon without thickening of wall | zx1 354 zx2 GI zx3 6081 zx4 Colon zx5 Ulcerative Colitis zx6 Ulcerative_Colitis zx7 Inf zx8 T67000 zx9 D6255 zx0 G zy1 zy2 UCHC •Diffuse and punctate mucosal hemorrhage •Swollen granular mucosa •Thickened wall(arrow) is not characteristic of ulcerative colitis | zx1 355 zx2 GI zx3 6082 zx4 Colon zx5 Perforated Diverticulitis - serosa zx6 Diverticulitis zx7 Inf zx8 T67000 zx9 M46420 zx0 G zy1 zy2 Hartford Hospital •Serosal surface of colon is focally covered with yellow green inflammatory exudate(arrow) •The perforation site is not seen, and is probably beneath the plaque of exudate | zx1 356 zx2 GI zx3 6083 zx4 Colon zx5 Diverticulosis of Colon zx6 Diverticulosis zx7 Mech zx8 T67000 zx9 M32710 zx0 G zy1 zy2 Hartford Hospital •The opened colon shows the dilated openings(white arrow) of several diverticuli •The wall(green arrow) is not thickened and the pericolic fat show no evidence of inflammation | zx1 357 zx2 GI zx3 6084 zx4 Colon zx5 Diverticulosis zx6 Diverticulosis zx7 Mech zx8 T67000 zx9 M32710 zx0 G zy1 zy2 Hartford Hospital •Multiple dilated openings of diverticuli (arrows) •Adjoining mucosa is normal | zx1 358 zx2 GYN zx3 5085 zx4 Uterus zx5 Squamous Dysplasia of Endocervical Cleft zx6 Squamous_Carcinoma_in_situ_of_Cervix zx7 Growth zx8 T83000 zx9 M74008 zx0 M zy1 zy2 UCHC •This is a view of an endocervical cleft. •At the bottom (yellow arrows) is normal endocervical epithelium. •Growing down from the surface is squamous epithelium. •Squamous mucosa shows no maturation except at the very top. | zx1 359 zx2 GU zx3 6086 zx4 Renal Pelvis zx5 Transitional Cell Carcinoma zx6 Transitional_cell_carcinoma zx7 Malign zx8 T72000 zx9 M81303 zx0 G zy1 zy2 Hartford Hospital •The photograph shows a tumor mass involving the upper pole calyceal system (arrow). •The gross feature of the tumor indicates that the tumor growth is largely intraluminal. | zx1 360 zx2 GU zx3 6087 zx4 Renal Pelvis zx5 Transitional Cell Carcinoma zx6 Transitional_cell_carcinoma zx7 Malign zx8 T72000 zx9 M81303 zx0 G zy1 zy2 Hartford Hospital •Shown in the photograph is a calyx of the upper pole with transitional cell carcinoma (T). The tumor appears as a markedly thickened mucosal lesion. The tumor growth appears luminal rather than parenchymal invasive. •Adjacent areas of the mucosa appear irregularly thickened (arrows). These areas were also histologically transitional cell carcinoma. | zx1 362 zx2 CNS zx3 6089 zx4 Brain zx5 Anencephaly zx6 Anencephaly zx7 Con zx8 TX2000 zx9 M21000 zx0 G zy1 zy2 Hartford Hospital •Also note the cleft lip and palate and scoliosis. •Infant missing skull and cerebral hemispheres - anencephaly •These infants have been a source of controversy in the news as to whether they should be used as organ donors. | zx1 363 zx2 CNS zx3 6091 zx4 Brain zx5 Anencephaly with iniencephaly zx6 Anencephaly zx7 Con zx8 TX2000 zx9 M21000 zx0 G zy1 zy2 Hartford Hospital •This is a posterior view of the anencephalic infant which shows fusion of the head with the cervical spinal column and a cervical meningomyelocoele called iniencephaly. •The scoliosis is more prominant on this view. | zx1 366 zx2 GU zx3 6094 zx4 Kidney zx5 Renal Cell Adenocarcinoma zx6 Renal_cell_adenocarcinoma zx7 Malign zx8 T71000 zx9 M83123 zx0 G zy1 zy2 Hartford Hospital •Shown is the cut surface of a bivalved kidney. •There is a ovoid tumor mass occupying the equatorial region of the renal parenchyma. •The tumor is well circumscribed and partially bulges into the renal sinus. •The tumor has a variegated cut surface. | zx1 367 zx2 GU zx3 6095 zx4 Kidney zx5 Renal Cell Adenocarcinoma zx6 Renal_cell_adenocarcinoma zx7 Malign zx8 T71000 zx9 M83123 zx0 G zy1 zy2 Hartford Hospital •The photograph is a close up view of the hilar region of a nephrectomy specimen. •The tumor is a renal cell carcinoma with extension as a tumor thrombus (T) into the renal vein (arrow). | zx1 369 zx2 Endo zx3 6097 zx4 Adrenal zx5 Adrenal Adenoma (Composite view) zx6 Adenoma zx7 Benign zx8 T93000 zx9 M81400 zx0 G zy1 zy2 Hartford Hospital • Left panel shows smooth surfaced external view of adenoma. • Right panel shows large, vividly yellow mass with focal hemorrhage. | zx1 371 zx2 Endo zx3 6099 zx4 Adrenal zx5 Adrenal Adenoma (Cut section) zx6 Adenoma zx7 Benign zx8 T93000 zx9 M81400 zx0 G zy1 zy2 Hartford Hospital • View of yellow cortical adenoma with focal hemorrhage. • No recognizable normal cortex or medulla. • Smooth external contour of the neoplasm. | zx1 372 zx2 GU zx3 6100 zx4 Kidney zx5 Xanthogranulomatous Pyelonephritis zx6 Xanthogranulomatous_pyelonephritis zx7 Inf zx8 T71000 zx9 M44040 zx0 G zy1 zy2 Hartford Hospital •Xanthogranulomatous pyelonephritis is a type of chronic pyelonephritis. •A significant number of the inflammatory cells are lipid laden histiocytes and account for the yellow appearance of the gross specimen. •Cut section of this specimen shows irregular yellowish areas of renal parenchyma that are related to the calyces. •The calyces are are dilated and are lined by irregular necrotic tissue. •There is a renal calculus lodged in the renal pelvis at the botton of the photograph. | zx1 373 zx2 GYN zx3 6101 zx4 Placenta zx5 Circumvallate Insertion of Membranes zx6 Circumvallate zx7 Vasc zx8 T88100 zx9 M29280 zx0 G zy1 zy2 Hartford Hospital •View of the placenta from the fetal surface. •Yellow arrows point to the insertion of the membranes. •White arrows point to the margin of the placental disc. •Normally white and yellow arrows should point to the same location. | zx1 374 zx2 GYN zx3 6102 zx4 Vulva zx5 Squamous Carcinoma of Vulva zx6 Squamous_Cell_Carcinoma zx7 Malign zx8 T80100 zx9 M80703 zx0 G zy1 zy2 Hartford Hospital •View of a vulvectomy specimen. •White arrow points to the right labia minora. •Black arrows point to the site of the carcinoma replacing the left labia minora. | zx1 375 zx2 RESP zx3 6103 zx4 Lung zx5 Thromboemboli from Pulmonary Arteries zx6 Embolus zx7 Vasc zx8 T28000 zx9 M35300 zx0 zy1 zy2 Hartford Hospital • Two portions of thrombus removed from segmental pulmonary arteries. • Note the shaggy external surfaces. | zx1 377 zx2 GI zx3 6105 zx4 Small Intestine zx5 Gastrointestinal Stromal Tumor zx6 Leiomyosarcoma zx7 Malign zx8 T64000 zx9 M88903 zx0 G zy1 zy2 Hartford Hospital •The tumor which has originated in the muscularis propria has an intact overlying mucosa (white arrow) with a portion showing mucosal ulceration (black arrow) •The gross appearance of this specimen does not allow a diagnosis of malignancy | zx1 378 zx2 GYN zx3 6106 zx4 Uterus zx5 Uterus Didelphys (Double uterus) zx6 Didelphys zx7 Con zx8 T82000 zx9 M20000 zx0 G zy1 zy2 Hartford Hospital •Hysterectomy specimen of a double uterus. •Uterine funduses marked by red arrows. •Cervical ostia marked by yellow arrows. •Uterus on right opened (black arrow on myometrium). | zx1 379 zx2 GYN zx3 6107 zx4 Uterus zx5 Uterus Didelphys (Double Uterus) zx6 Didelphys zx7 Con zx8 T82000 zx9 M20000 zx0 G zy1 zy2 Hartford Hospital •Lateral view of uterus didelphys. •Left side unopened. •Right side opened to show endometrial cavity (em) and endocervical canal (ec). | zx1 380 zx2 GYN zx3 6108 zx4 Ovary zx5 Dermoid Cyst of Ovary (composite) zx6 Dermoid zx7 Benign zx8 T87000 zx9 M90840 zx0 G zy1 zy2 Hartford Hospital •On the left is the smooth external surface. •On the right is the cyst lined by smooth and granular tissue. | zx1 381 zx2 GYN zx3 6109 zx4 Ovary zx5 Dermoid Cyst of Ovary (External View) zx6 Dermoid zx7 Benign zx8 T87000 zx9 M90840 zx0 G zy1 zy2 Hartford Hospital •Smooth external surface of ovary. •No recognizable normal ovary or fallopian tube. | zx1 382 zx2 GYN zx3 6110 zx4 Ovary zx5 Dermoid Cyst of Ovary (Interior) zx6 Dermoid zx7 Benign zx8 T87000 zx9 M90840 zx0 G zy1 zy2 Hartford Hospital •This opened cyst shows no normal ovary. •Granular, yellow material consisting of keratin (arrows). •No hair or teeth. | zx1 383 zx2 GYN zx3 6111 zx4 Ovary zx5 Torsion of Ovary Mass (Composite View) zx6 Torsion zx7 Mech zx8 T87000 zx9 M34210 zx0 G zy1 zy2 Hartford Hospital •On the left is the bluish external surface of an ovary. •On the right is the cut surface which is extremely hemorrhagic. •Frequently cannot tell what the pathology of the mass is because of infarct and hemorrhage. •Arrows point to fallopian tubes. | zx1 384 zx2 GYN zx3 6112 zx4 Ovary zx5 Ovarian Mass with Torsion zx6 Torsion zx7 Mech zx8 T87000 zx9 M34210 zx0 G zy1 zy2 Hartford Hospital •External surface of an ovary which has undergone torsion. •Enlarged ovary twists around the broad ligament. •Infarcted mass often cannot be definitely classified. •Arrow points to fallopian tube. | zx1 385 zx2 GYN zx3 6113 zx4 Ovary zx5 Ovarian Mass with Torsion (Interior) zx6 Torsion zx7 Mech zx8 T87000 zx9 M34210 zx0 G zy1 zy2 Hartford Hospital •Completely infarcted ovarian mass. •Extensive hemorrhage into necrotic tissue. •Arrow points to fallopian tube. | zx1 386 zx2 CV zx3 6114 zx4 Myocardium zx5 Sarcoma of heart zx6 Sarcoma zx7 Malign zx8 T32100 zx9 M89003 zx0 G zy1 zy2 Hartford Hospital •This is a sarcomatous neoplasm resected from the heart. The arrow points to attached myocardial tissue. •The smooth and glistening lobulated asymetrical form is consistent with a malignant tumor. The histology is as variable as all soft tissue tumors, but angiosarcomas, rhabdomyosarcomas, and fibrsarcomas are most typical. •Sarcomas are difficult to cure surgically because of extensive grossly inapparent infiltration of adjoining tissues beyond widest possible margins of resection. | zx1 387 zx2 RESP zx3 6115 zx4 Larynx zx5 Squamous Carcinoma of the Larynx zx6 Squamous_Cell_Carcinoma zx7 Malign zx8 T24100 zx9 M80703 zx0 G zy1 zy2 Hartford Hospital • View of a larynx which has been opened along the posterior aspect. • Yellow arrows point to vocal cords. • White arrow points to granular red brown carcinoma located just beneath the vocal cords. | zx1 391 zx2 GI zx3 6119 zx4 Colon zx5 Gastrointestinal Stromal Tumor zx6 Leiomyosarcoma zx7 Malign zx8 T67000 zx9 M88903 zx0 G zy1 zy2 Hartford Hospital •The white rubbery cut surface is typical of a GIST tumor (Gastrointestinal Stromal Tumor) •The large size of this tumor suggests malignant potential, but is not as accurate as mitotic counts as an aid in classifying these tumors as benign or malignant •Necrosis and hemorrhage are found in malignant tumors, but in GIST tumors are related to the size of the tumor and are not an independant predictor of malgnanant potential | zx1 392 zx2 GI zx3 6120 zx4 Colon zx5 Adenocarcinoma of Colon zx6 Adenocarcinoma zx7 Malign zx8 T67000 zx9 M81403 zx0 G zy1 zy2 Hartford Hospital •Tumor has well defined margins •The center is depressed due to tumor necrosis •The thin margin of intact tumor is raised(arrow) •Adjoing mucosa is normal with delicate mucosal folds | zx1 393 zx2 GI zx3 6121 zx4 Colon zx5 Adenocarcinoma of Colon - high power zx6 Adenocarcinoma zx7 Malign zx8 T67000 zx9 M81403 zx0 G zy1 zy2 Hartford Hospital •Colon has been opened revealing a flat carcinoma that is only partly circumferential •Edges of the lesion have raised rolled white well demarcated margins •Center has brown granular necrotic tumor •Adjoining mucosa is delicate | zx1 394 zx2 Breast zx3 6122 zx4 Breast zx5 Infiltrating Duct Carcinoma of breast zx6 Ductal_Carcinoma zx7 Malign zx8 T04000 zx9 M85003 zx0 G zy1 zy2 Hartford Hospital • This is a photograph of a right mastectomy specimen. • The axillary tail is identified (AX). • The locally advanced carcinoma has grown through the skin and completely destroyed the nipple | zx1 395 zx2 Breast zx3 6123 zx4 Breast zx5 Infiltrating Duct Carcinoma (Closer View) zx6 Ductal_Carcinoma zx7 Malign zx8 T04000 zx9 M85003 zx0 G zy1 zy2 Hartford Hospital • This is a close view of a right mastectomy specimen with axillary tail (AX). • The extremely large carcinoma has destroyed the entire central portion of the breast including the nipple. • Although most breast carcinomas are identified earlier in their course some patients do not reach medical attention until very late in the progression of local disease. | zx1 396 zx2 Endo zx3 6124 zx4 Thyroid zx5 Graves Disease of Thyroid zx6 Graves zx7 Growth zx8 T96000 zx9 D2193 zx0 G zy1 zy2 Hartford Hospital • Diffusely enlarged red tan thyroid gland. • Slight lobulation but no large cyst formed. | zx1 397 zx2 GU zx3 6125 zx4 Kidney zx5 Renal Cell Adenocarcinoma zx6 Renal_cell_adenocarcinoma zx7 Malign zx8 T71000 zx9 M83123 zx0 G zy1 zy2 Hartford Hospital •Cut surface of the kidney shows a tumor replacing one pole and much of the equatorial region. •The tumor involves the soft tissues of the renal sinus. •In this case tumor was also present in the renal vein. •The cut surface of the tumor is mottled and hemorrhagic. | zx1 398 zx2 RESP zx3 6126 zx4 Lung zx5 Carcinoid Tumor of the Lung zx6 Carcinoid zx7 Benign zx8 T28000 zx9 M82401 zx0 G zy1 zy2 Hartford Hospital • View is of a segmental bronchus (outlined in yellow). • Within the bronchus (white arrow) is a tan neoplasm filling up the lumen. • Distal lung lobe is out of focus. | zx1 399 zx2 HEM zx3 6127 zx4 Spleen zx5 Laceration zx6 Trauma zx7 Trauma zx8 T07000 zx9 M14400 zx0 G zy1 zy2 Hartford Hospital | zx1 400 zx2 GYN zx3 6128 zx4 Ovary zx5 Ovarian Fibrothecoma (External view) zx6 Fibrothecoma zx7 Benign zx8 T87000 zx9 M86000 zx0 G zy1 zy2 Hartford Hospital •External surface of an ovary. •Distorted by a yellow-tan mass which has been incised (white arrows). •Small remnant of normal ovary (yellow arrow). •Fallopian tube (red arrow). | zx1 401 zx2 GYN zx3 6129 zx4 Ovary zx5 Ovarian Fibrothecoma (cut surface) zx6 Fibrothecoma zx7 Benign zx8 T87000 zx9 M86000 zx0 G zy1 zy2 Hartford Hospital •No recognizable normal ovary. •Yellow tinge due to cholesterol in theca cells. •Little hemorrhage or necrosis. | zx1 403 zx2 GYN zx3 6131 zx4 Vulva zx5 Melanoma of vulva zx6 Melanoma zx7 Malign zx8 T80100 zx9 M87203 zx0 G zy1 zy2 Hartford Hospital | zx1 404 zx2 GYN zx3 6132 zx4 Vulva zx5 Vulvar Melanoma zx6 Melanoma zx7 Malign zx8 T80100 zx9 M87203 zx0 G zy1 zy2 Hartford Hospital •View of a partial vulvectomy. •Inferior margin is composed of the right and left labia minora (LM) •Neoplasm has nodular (N) portion that has destroyed the clitoris and flat darkly pigmented region (P). •Black staining around edge of specimen (I) is ink used to mark margin of specimen. | zx1 405 zx2 GYN zx3 6133 zx4 Placenta zx5 True Knot of Umbilical Cord zx6 Knot zx7 Mech zx8 T88800 zx9 M29700 zx0 G zy1 zy2 Hartford Hospital •Most of the photograph shows an umbilical cord. •There is a knot in the center of the cord. •There is no swelling or hemorrhage in the cord indicating that the knot did not compress blood vessels. | zx1 408 zx2 Bone zx3 6136 zx4 Soft Tissue zx5 Soft tissue sarcoma - infiltrating muscle zx6 Sarcoma zx7 Malign zx8 T1X100 zx9 M90403 zx0 G zy1 zy2 Hartford Hospital •This is a cross section of a leg. •The yellow tissue is subcutaneous fat. •The red-brown tissue is skeletal muscle. •Note the bone in cross section in the right center. •The tumor is the tan-gray mass diffusely infiltrating the muscle (white arrows). | zx1 409 zx2 Bone zx3 6137 zx4 Soft Tissue zx5 Soft tissue sarcoma of thigh - infiltrating muscle zx6 Sarcoma zx7 Malign zx8 T1X100 zx9 M90403 zx0 G zy1 zy2 Hartford Hospital •This is a cross section of a thigh. •Note the yellow subcutaeous fat, the cross section of the femur and the red-brown skeletal muscle. •The tumor (white arrows) is the tan-gray mass extending from the bone and infiltrating into the muscle. | zx1 410 zx2 Bone zx3 6138 zx4 Soft Tissue zx5 Close up view of soft tissue sarcoma of thigh. zx6 Sarcoma zx7 Malign zx8 T1X100 zx9 M90403 zx0 G zy1 zy2 Hartford Hospital •This is a cross section of a thigh. •Note the yellow subcutaneous fat, the femur in cross section and the red-brown muscle of the thigh. •The tumor (white arrows) is the tan- grey tissue infiltrating muscle and fascia. | zx1 411 zx2 Bone zx3 6139 zx4 Soft Tissue zx5 Close up view of soft tissue sarcoma of the thigh zx6 Sarcoma zx7 Malign zx8 T1X100 zx9 M90403 zx0 G zy1 zy2 Hartford Hospital •This is a cross section of a thigh. •Note the yellow subcutaneous fat, the femur in cross section and the red-brown muscle of the thigh. •The tumor (white arrows) is the tan- grey tissue infiltrating muscle and fascia. Here it is seen mainly in the fascial plane separating muscle bundles. | zx1 412 zx2 RESP zx3 6140 zx4 Lung zx5 Bronchopneuomia (External view of Lung) zx6 Bronchopneumonia zx7 Inf zx8 T28000 zx9 M40000 zx0 G zy1 zy2 Hartford Hospital • This is the external view of a right lung. • The lobes are identified as (U)pper, (M)iddle, and (L)ower. • The arrows point to regions of deep red discoloration overlying bronchopneumonia. • This may be contrasted with a lobar pattern of pneumonia in which the affected lobe(s) would be altered throughout. | zx1 414 zx2 RESP zx3 6142 zx4 Lung zx5 Bronchopneumonia (Cut surfaces) zx6 Bronchopneumonia zx7 Inf zx8 T28000 zx9 M40000 zx0 G zy1 zy2 Hartford Hospital • This is a view of the sliced surface of the right lung with lobes identified as (U)pper, (M)iddle, and (L)ower. • The pale tan regions of parenchyma are normal. • The reddish brown regions of parenchyma are consolidated and contain hemorrhage and neutrophils. • The patchy distribution is characteristic of broncho- pneumonia as opposed to diffuse involvement of the lobe in lobar pneumonia. | zx1 415 zx2 GYN zx3 6143 zx4 Ovary zx5 Struma Ovarii zx6 Struma_Ovarii zx7 Benign zx8 T87000 zx9 M90900 zx0 G zy1 zy2 Hartford Hospital •Ovary completely replaced by a cyst which has been opened. •Center is an area that resembles normal thyroid (arrow). •Thyroid component is rubbery and red brown. | zx1 416 zx2 GYN zx3 6144 zx4 Ovary zx5 Struma Ovarii (Close up) zx6 Struma_Ovarii zx7 Benign zx8 T87000 zx9 M90900 zx0 G zy1 zy2 Hartford Hospital •Thyroid tissue in the center (arrow). •Red brown and firm. •Surrounded by a cyst with delicate lining. | zx1 417 zx2 Skin zx3 6145 zx4 Skin zx5 Ulcer zx6 Ulcer zx7 Degen zx8 T01000 zx9 M38120 zx0 G zy1 zy2 Hartford Hospital | zx1 418 zx2 Bone zx3 6146 zx4 Soft Tissue zx5 Exterior and cut surfaces of an osteochondroma zx6 Osteochondroma zx7 Benign zx8 T1X000 zx9 M92100 zx0 G zy1 zy2 Hartford Hospital •The image is of two surfaces of an osteochondroma. To the left is the exterior surface; to the right is the cut surface. •The tumor manifests two components •The whiter part (best seen on the cut surface (white arrow) is the cartilagenous "cap". •The darker portion is the bone with marrow spaces, accounting for the dark red-brown color. | zx1 419 zx2 Bone zx3 6147 zx4 Soft Tissue zx5 Exterior surface of an osteochondroma zx6 Osteochondroma zx7 Benign zx8 T1X000 zx9 M92100 zx0 G zy1 zy2 Hartford Hospital •This is the exterior (uncut) surface of an osteochondroma. •The surface looks shiny and glistening because the tumor is composed on the outside of cartilage. In this uncut surface, we are looking at the cartilagenous surface. •Note the furrows that create the bosselated appearance. This is typical of an osteochondroma. | zx1 420 zx2 Bone zx3 6148 zx4 Soft Tissue zx5 Attachment surface of an osteochondroma zx6 Osteochondroma zx7 Benign zx8 T1X000 zx9 M92100 zx0 G zy1 zy2 Hartford Hospital •This is the surface through which the osteochondroma is attached to the bone of origin. •Note the central area of red (hemorrage) due to the resection of the tumor. •To the periphery is the cartilagenous covering of the tumor. Note the typical furrowed appearance. | zx1 421 zx2 Bone zx3 6149 zx4 Soft Tissue zx5 Osteochondroma - bisected zx6 Osteochondroma zx7 Benign zx8 T1X000 zx9 M92100 zx0 G zy1 zy2 Hartford Hospital •Cross section of an osteochondroma. •The white areas is this tumor represent the cartilagenous portions. •The white arrows flank an area of bone. •The bone is fully developed with the red bone marrow spaces and the brown-white spicules of bone. | zx1 422 zx2 Endo zx3 6150 zx4 Adrenal zx5 Adrenal Pheochromocytoma (Cut Surface) zx6 Pheochromocytoma zx7 Benign zx8 T93000 zx9 M87000 zx0 G zy1 zy2 Hartford Hospital •Arrows point to normal adrenal gland on each side of large neoplasm. •Gray tan surface with areas of brown red hemorrhage is typical. | zx1 423 zx2 Endo zx3 6151 zx4 Adrenal zx5 Adrenal Pheochromocytoma zx6 Pheochromocytoma zx7 Benign zx8 T93000 zx9 M87000 zx0 G zy1 zy2 Hartford Hospital • Mottled brown tan mass is the neoplasm filling up the adrenal medulla. • Blue arrow points to residual normal medulla. • Yellow arrows point to golden yellow adrenal cortex. • Black discoloration around the specimen is india ink applied to assess the margins of the specimen. | zx1 424 zx2 Breast zx3 6152 zx4 Breast zx5 Schwannoma of breast zx6 Schwannoma zx7 Benign zx8 T04000 zx9 M95600 zx0 G zy1 zy2 Hartford Hospital • This is a close view of a portion of breast tissue. • Outer perimeter is inked to demonstrate the margins of resection. • The neoplasm is tan, homogeneous, and sharply demarcated from the adjacent breast tissue. | zx1 427 zx2 GYN zx3 6156 zx4 Ovary zx5 Ovarian Teratoma (External view) zx6 Dermoid zx7 Benign zx8 T87000 zx9 M90840 zx0 G zy1 zy2 Hartford Hospital •External view of an ovary replaced by a large solid mass. •Arrow on fallopian tube. •Black sutures scattered across the specimen. | zx1 428 zx2 GYN zx3 6157 zx4 Ovary zx5 Ovarian Teratoma (Cut surface) zx6 Dermoid zx7 Benign zx8 T87000 zx9 M90840 zx0 G zy1 zy2 Hartford Hospital •Ovary replaced with predominantly solid, white firm tissue. •Small cystic areas. •No hair or teeth. •Not typical dermoid cyst. | zx1 429 zx2 GYN zx3 6155 zx4 Ovary zx5 Ovarian Teratoma (composite view) zx6 Dermoid zx7 Benign zx8 T87000 zx9 M90840 zx0 G zy1 zy2 Hartford Hospital •On the left is the external view of a predominantly solid neoplasm replacing the ovary. •Arrow on fallopian tube. •Black spots represent sutures. •Right side shows predominantly solid mass with focal cysts. | zx1 430 zx2 GYN zx3 6158 zx4 Placenta zx5 Velamentous Insertion of Umbilical Cord zx6 Velamentous zx7 Con zx8 T88800 zx9 M29650 zx0 G zy1 zy2 Hartford Hospital •Twin placenta. •Umbilical cord "A" inserts normally into one side of the placental disc. •Umbilical cord "B" inserts into the membranes. •The arteries and veins leaving and entering "B" travel through the membranes, unsupported by the disc. | zx1 431 zx2 GYN zx3 6159 zx4 Placenta zx5 Amnion Band of Placenta zx6 Amnion_Band zx7 Mech zx8 T88100 zx9 M29470 zx0 G zy1 zy2 Hartford Hospital •Close up view of the membranes, umbilical cord and chorionic plate of the placental disc. •A band of amnion drapes around the cord (arrow). | zx1 432 zx2 GYN zx3 6160 zx4 Placenta zx5 Abruptio Placentae (close-up) zx6 Abruption zx7 Vasc zx8 T88100 zx9 M29360 zx0 G zy1 zy2 Hartford Hospital •This is a close-up view of a cut section of the placenta. •Yellow arrows point to hemorrhage separating the placenta from the basal endometrium. •Blue arrows point to necrotic villi. | zx1 433 zx2 GYN zx3 6161 zx4 Uterus zx5 Uterine Sarcoma - not otherwise specified zx6 Sarcoma zx7 Malign zx8 T84000 zx9 M89303 zx0 G zy1 zy2 Hartford Hospital •This is a uterus which has been opened to show a neoplasm replacing the posterior endometrium and myometrium. •Yellow tan, focally necrotic sarcoma. •Endocervix and cervix (arrows) normal. | zx1 434 zx2 GYN zx3 6162 zx4 Uterus zx5 Uterine Sarcoma (Close up) zx6 Sarcoma zx7 Malign zx8 T84000 zx9 M89303 zx0 G zy1 zy2 Hartford Hospital •Enormous sarcoma with focal hemorrhage and necrosis. •Destroyed endometrium and myometrium. •Arrow point to normal endocervix. | zx1 435 zx2 GYN zx3 6163 zx4 Uterus zx5 Multiple Nabothian Cysts of Cervix zx6 Endocervical_Cyst zx7 Mech zx8 T83300 zx9 M33400 zx0 G zy1 zy2 •This is a uterus with the fundus to the left and the cervix is to the right. •It has been opened to show the interior with the endometrial cavity (em) and the endocervix (ec). •Cervix has many mucus filled Nabothian cysts (arrows). | zx1 436 zx2 GYN zx3 6164 zx4 Uterus zx5 Nabothian Cysts of Cervix (Close up) zx6 Endocervical_Cyst zx7 Mech zx8 T83300 zx9 M33400 zx0 G zy1 zy2 Hartford Hospital •Numerous thin walled cysts are present (arrows) contianing mucinous, white material. •Endometrium at top of picture (em). | zx1 437 zx2 GYN zx3 6165 zx4 Ovary zx5 Endometrioid Carcinoma of Ovary zx6 Endometrioid_Carcinoma zx7 Malign zx8 T87000 zx9 M83803 zx0 G zy1 zy2 Hartford Hospital •Cut surface of an ovary replaced by large tan mass. •Neoplasm is predominantly solid and fleshy. •No normal tube or ovary seen. | zx1 438 zx2 GYN zx3 6166 zx4 Placenta zx5 Complete Hydatidiform Mole (close up) zx6 Mole zx7 Benign zx8 T88100 zx9 M91000 zx0 G zy1 zy2 Hartford Hospital •Photograph of massively dilated villi. •Resemble vesicles or "grapes" filled with clear fluid. •No fetal parts identified. | zx1 439 zx2 GYN zx3 6167 zx4 Placenta zx5 Complete Hydatidiform Mole zx6 Mole zx7 Benign zx8 T88100 zx9 M91000 zx0 G zy1 zy2 Hartford Hospital •Placental tissue transformed into mass of enlarged villi. •Arrows point to enormous individual villi. | zx1 440 zx2 CNS zx3 6168 zx4 Brain zx5 Anencephaly zx6 Anencephaly zx7 Con zx8 TX2000 zx9 M21000 zx0 G zy1 zy2 Hartford Hospital •Anencephaly - lack of brain except for a rudimentary brainstem and absence of overlying skull. •Due to a failure of closure of the anterior neural tube - a neural tube defect. •These infants rarely live past a month of age. | zx1 441 zx2 CNS zx3 6169 zx4 Brain zx5 Anencephaly zx6 Anencephaly zx7 Con zx8 TX2000 zx9 M21000 zx0 G zy1 zy2 Hartford Hospital •Shows lack of cerebral hemispheres and overlying skull as well as characteristic bulging eyes. •Usually associated with facial and other malformations. •Occur in 1:1000 births, however, if a woman has one infant with a neural tube defect the chance of occurrence of another is l:50 and if she has two such infants the chance of another is 1:25. | zx1 442 zx2 CNS zx3 6170 zx4 Brain zx5 Anencephaly zx6 Anencephaly zx7 Con zx8 TX2000 zx9 M21000 zx0 G zy1 zy2 Hartford Hospital •Looking at the back of an anencephalic head showing the cerebral vasculosa, a mixture of blood vessel, glial tissue, rudimentary leptomeninges etc which takes the place of the cerebral hemispheres. •A rudimentary brainstem and part of a cerebellum may be present. | zx1 443 zx2 Skin zx3 6171 zx4 Skin zx5 Squamous Cell Carcinoma zx6 Squamous_Cell_Carcinoma zx7 Malign zx8 T01000 zx9 M80703 zx0 G zy1 zy2 Hartford Hospital | zx1 446 zx2 HEM zx3 6174 zx4 Thymus zx5 Thymoma zx6 Thymoma_Benign zx7 Benign zx8 T98000 zx9 M85800 zx0 G zy1 zy2 Hartford Hospital | zx1 447 zx2 CV zx3 6175 zx4 Myocardium zx5 Atrial Myxoma zx6 Myxoma zx7 Benign zx8 T32100 zx9 M88400 zx0 G zy1 zy2 Hartford Hospital •This is a bisected myxoma measuring 4-5 cm in greatest diameter. The relatively smooth but nodular variegated surface is seen on the left, and the cut surface on the right. The cut surface has a mucoid glistening variegated appearence characteristic of myxomatous tumors. •This is a solid mass lesion, but some cardiac myxomas have a delicate papillary form similar to a sea anemone. The individual papillae can break off, embolize, and thereby call attention to the possible presence of a cardiac myxoma, among other possibilities. | zx1 451 zx2 GI zx3 6179 zx4 Colon zx5 Chrohns Disease zx6 Crohns zx7 Inf zx8 T67000 zx9 D6216 zx0 G zy1 zy2 Hartford Hospital •Linear Longitudinal ulcers(black arrows) •Areas of normal mucosa are seen(green arrow) | zx1 452 zx2 GI zx3 6180 zx4 Small Intestine zx5 Foreign Body (Bone) with perforation zx6 Perforation zx7 Mech zx8 T64000 zx9 M30400 zx0 G zy1 zy2 Hartford Hospital •Foreign body(bone)with white arrow at point of mucosal perforation •Serosal surface contains grey-yellow plaque of exudate(green arrow) indicating peritonitis secondary to the perforation | zx1 453 zx2 GU zx3 6181 zx4 Kidney zx5 Transitional Cell Carcinoma of Kidney zx6 Transitional_cell_carcinoma zx7 Malign zx8 T71000 zx9 M81303 zx0 zy1 zy2 Hartford Hospital | zx1 454 zx2 GU zx3 6182 zx4 Kidney zx5 Transitional Cell Carcinoma of kidney zx6 Transitional_cell_carcinoma zx7 Malign zx8 T71000 zx9 M81303 zx0 zy1 zy2 Hartford Hospital | zx1 455 zx2 Endo zx3 6183 zx4 Thyroid zx5 Multinodular Goiter (Composite View) zx6 Multinodular_Goiter zx7 Growth zx8 T96000 zx9 M71620 zx0 G zy1 zy2 Hartford Hospital • Left panel shows thyroid gland with nodular enlargement of the gland, more prominent on the left. • Cut surface (on right) shows varied appearance from normal red tan to yellow to hemorrhagic. | zx1 456 zx2 Endo zx3 6184 zx4 Thyroid zx5 Multinodular Goiter (External view) zx6 Multinodular_Goiter zx7 Growth zx8 T96000 zx9 M71620 zx0 G zy1 zy2 Hartford Hospital • Enlarged thyroid with more enlargement on left. • Left lobe also shows multiple nodules. | zx1 457 zx2 Endo zx3 6185 zx4 Thyroid zx5 Multinodular Goiter (Cut Surface) zx6 Multinodular_Goiter zx7 Growth zx8 T96000 zx9 M71620 zx0 G zy1 zy2 Hartford Hospital • Cut surface of one lobe of thyroid gland showing ill defined nodules. • Focus of cystic degeneration seen (blue arrow). • Some hemorrhage (red arrow) and some scarring. | zx1 458 zx2 Bone zx3 6186 zx4 Bone zx5 Giant Cell Tumor of Bone zx6 Giant_Cell_Tumor zx7 Benign zx8 T1X500 zx9 M92501 zx0 G zy1 zy2 Hartford Hospital •A resected, bisected giant cell tumor of bone. •Notice the typical browish color of this lesion, due to the repeated hemorrhage and accumulation of hemosiderin pigment. | zx1 459 zx2 GU zx3 6187 zx4 Testis zx5 Seminoma zx6 Seminoma zx7 Malign zx8 T78000 zx9 M90613 zx0 G zy1 zy2 Hartford Hospital •The photograph shows the cut surface of a testis tumor. •The tumor is fleshy and replaces the testis. •The cut surface is fairly homogenous in character, with only a limited area of hemorrhage and necrosis. •The attached elongate structure is the spermatic cord. | zx1 460 zx2 Endo zx3 6188 zx4 Adrenal zx5 Adrenal Ganglioneuroblastoma zx6 Ganglioneuroblastoma zx7 Malign zx8 T93000 zx9 M94903 zx0 G zy1 zy2 Hartford Hospital • Left panel shows smooth external surface of organ markedly distorted by n eoplasm. • Cut surface shows gray fleshy with small focal hemorrhage. | zx1 461 zx2 Endo zx3 6189 zx4 Adrenal zx5 Ganglioneuroblastoma zx6 Ganglioneuroblastoma zx7 Malign zx8 T93000 zx9 M94903 zx0 G zy1 zy2 Hartford Hospital • Adrenal gland distorted by large mass. • Relatively smooth external surface. | zx1 462 zx2 Endo zx3 6190 zx4 Adrenal zx5 Adrenal Ganglioneuroblastoma zx6 Ganglioneuroblastoma zx7 Malign zx8 T93000 zx9 M94903 zx0 G zy1 zy2 Hartford Hospital • No normal adrenal gland can be seen. • Neoplasm shows some fleshy gray areas and other areas with hemorrhage. • Mature and immature neurons are scattered throughout and cannot be identified in separate areas grossly. | zx1 463 zx2 GYN zx3 6191 zx4 Ovary zx5 Papillary Serous Cystadenocarcinoma zx6 Cystadenocarcinoma_Serous zx7 Malign zx8 T87000 zx9 M84413 zx0 G zy1 zy2 Hartford Hospital •Bivalved ovary with attached fallopian tube (ft). •Surface of the ovary still identifiable (white arrows). •Interior shows papillary excrescences (black arrows). | zx1 464 zx2 Endo zx3 6192 zx4 Parathyroid zx5 Parathyroid Adenoma zx6 Adenoma zx7 Benign zx8 T97000 zx9 M81400 zx0 G zy1 zy2 Hartford Hospital • Cut surfaces of a parathyroid which is enlarged. • Smooth external contour is characteristic of benign parathyroid enlargement. • Small area of hemorrhage. • Compressed normal parathyroid can not be identified grossly. | zx1 465 zx2 Endo zx3 6193 zx4 Thyroid zx5 Papillary Carcinoma of the Thyroid zx6 Carcinoma zx7 Malign zx8 T96000 zx9 M80503 zx0 G zy1 zy2 Hartford Hospital • On the left is the external surface of a thyroid gland, massively distorted by carcinoma. • The surface is irregular with many adhesions. • Cut surface on the right is partly red brown (normal) • Large yellow-tan nodules are carcinoma. | zx1 466 zx2 Endo zx3 6194 zx4 Thyroid zx5 Papillary Carcinoma of the Thyroid zx6 Papillary_Carcinoma zx7 Malign zx8 T96000 zx9 M80503 zx0 G zy1 zy2 Hartford Hospital • The thyroid is massively distorted by a multinodular growth. • Shaggy external surface due to difficulty in dissecting organ from other structures, a feature which suggests malignancy. | zx1 467 zx2 Endo zx3 6195 zx4 Thyroid zx5 Thyroid Papillary Carcinoma (Sectioned) zx6 Papillary_Carcinoma zx7 Malign zx8 T96000 zx9 M80503 zx0 G zy1 zy2 Hartford Hospital • The dark reddish brown tissue is characteristic of normal thyroid. • The large tan nodules represent carcinoma. • No large areas of hemorrhage and necrosis are seen. | zx1 468 zx2 GU zx3 6196 zx4 Kidney zx5 Chronic Pyelonephritis zx6 Chronic_pyelonephritis zx7 Inf zx8 T71000 zx9 M43000 zx0 G zy1 zy2 Hartford Hospital •There are marked abnormalities involving the kidney, somewhat sparing the lower pole. •The cystic appearing structures are actually dilated calyces, reflecting hydronephrosis. •The renal parenchyma between the dilated calyces show reduction in tissue when compared to the more normal renal parenchyma of the lower pole. | zx1 469 zx2 GYN zx3 6197 zx4 Ovary zx5 Ovarian Fibroma (composite view) zx6 Fibroma zx7 Benign zx8 T87000 zx9 M88100 zx0 G zy1 zy2 Hartford Hospital •Upper image is external surface of ovary. •Smooth glistening intact surface. •Fallopian tube across surface (red arrow) •Lower image is tan firm cut surface with some holes which are degenerative. | zx1 470 zx2 GYN zx3 6198 zx4 Ovary zx5 Ovarian Fibroma (external view only) zx6 Fibroma zx7 Benign zx8 T87000 zx9 M88100 zx0 G zy1 zy2 Hartford Hospital •Ovary replaced by neoplasm. •External surface is smooth, bulging, and firm. •Fallopian tube (red arrow) stretches across surface. •No recognizable normal ovary. | zx1 471 zx2 GYN zx3 6199 zx4 Ovary zx5 Ovarian Fibroma (internal view only) zx6 Fibroma zx7 Benign zx8 T87000 zx9 M88100 zx0 G zy1 zy2 Hartford Hospital •Cut surface of ovary showing no remaining normal tisue. •Homogeneous tan with few degenerating areas (holes). •No hemorrhage. | zx1 472 zx2 GYN zx3 6200 zx4 Uterus zx5 Uterine Leiomyoma zx6 Leiomyoma zx7 Benign zx8 T85000 zx9 M88900 zx0 G zy1 zy2 Hartford Hospital •This is a section through the fundus of the uterus. •White arrow on small intramural leiomyoma. •"EM" on endometrial cavity. •Large intramural leiomyoma (black arrow). | zx1 473 zx2 GYN zx3 6201 zx4 Uterus zx5 Uterine Leiomyoma (close up cut surface) zx6 Leiomyoma zx7 Benign zx8 T85000 zx9 M88900 zx0 G zy1 zy2 Hartford Hospital •Close up of an unusual uterine leiomyoma. •Not usual white, whorling pattern. •More cellular microscopically than typical leimoyoma. | zx1 474 zx2 GYN zx3 6202 zx4 Placenta zx5 Velamentous Insertion of Umbilical Cord zx6 Velamentous zx7 Con zx8 T88800 zx9 M29650 zx0 G zy1 zy2 Hartford Hospital •View of placenta from fetal surface. •Umbilical cord inserts into membranes (arrow at point of insertion). •Cord runs within the membranes to the chorionic plate which is surface of disc. | zx1 475 zx2 GYN zx3 6203 zx4 Ovary zx5 Struma Ovarii zx6 Struma_Ovarii zx7 Benign zx8 T87000 zx9 M90900 zx0 G zy1 zy2 Hartford Hospital •Arrows highlight reddish-brown, glistening surfaces. •Resemble normal thyroid, which may be functional. •No residual normal ovary seen. | zx1 476 zx2 CNS zx3 6204 zx4 Brain zx5 Encephalocele zx6 Encephalocele zx7 Con zx8 TX2000 zx9 M21660 zx0 G zy1 zy2 Hartford Hospital •An infant with a portion of brain protruding out from his occipital region in a skin covered sac - called an encephalocele. •An encephalocele is a neural tube defect of lesser severity then anencephaly. | zx1 477 zx2 RESP zx3 6205 zx4 Lung zx5 Pulmonary Hemangioma (External View) zx6 Hemangioma zx7 Benign zx8 T28000 zx9 M91200 zx0 G zy1 zy2 Hartford Hospital • View of the pleural surfaces of the lung. • Arrows highlight a deep red brown region which is a hemangioma. • Remainder of the lung is pink and normal in appearance. | zx1 478 zx2 Bone zx3 6206 zx4 Soft Tissue zx5 Malignant Fibrous Histiocytoma zx6 Histiocytoma zx7 Malign zx8 T1X000 zx9 M88303 zx0 G zy1 zy2 Hartford Hospital •A malignant fibrous histiocytoma removed from the subcutaneous tissue. •The large dark brown tissue occupying the left half of the specimen is normal skeletal muscle. •The yellow arrows encircle the tumor. •The yellow lobulated tissue lying to the right of the tumor is normal, subcutaneous fat. •The black discoloration at the right top of this image is due to carbon pigment (India ink) used by the pathology resident to mark the surgical of resection of this specimen. | zx1 479 zx2 Bone zx3 6207 zx4 Soft Tissue zx5 Malignant Fibrous Histiocytoma zx6 Histiocytoma zx7 Malign zx8 T1X000 zx9 M88303 zx0 G zy1 zy2 Hartford Hospital •Close-up view of the malignant fibrous histiocytoma in subcutaneous tissue. •The multiple yellow arrows flank the subcutaneous tumor in this specimen. •Above the tumor is the lobulated yellowish subcutaneous fat. •The india ink used for marking the surgical line of resection is to the right top edge of this image. | zx1 483 zx2 GU zx3 6211 zx4 Kidney zx5 Hydronephrosis zx6 Congenital_hydronephrosis zx7 Con zx8 T71000 zx9 M23050 zx0 G zy1 zy2 Hartford Hospital •Cut surface shows markedly dilated renal pelvis and proximal ureter. •This is a case of congenital hydronephrosis. | zx1 484 zx2 GU zx3 6212 zx4 Kidney zx5 Renal Cell Adenocarcinoma zx6 Renal_cell_adenocarcinoma zx7 Malign zx8 T71000 zx9 M83123 zx0 G zy1 zy2 Hartford Hospital •The tumor is seen involving one of the poles of the kidney. •Its expansile growth has distorted the renal sinus and hilus. | zx1 486 zx2 GU zx3 6214 zx4 Kidney zx5 Renal Cell Adenocarcinoma zx6 Renal_cell_adenocarcinoma zx7 Malign zx8 T71000 zx9 M83123 zx0 G zy1 zy2 Hartford Hospital •The tumor is seen to the right of the photograph. •There is an eccentric region showing cystic and hemorrhagic necrosis. •This renal cell carcinoma is relatively small and has not grossly distorted the external contour of the kidney. | zx1 488 zx2 GU zx3 6216 zx4 Kidney zx5 Renal Cell Adenocarcinoma zx6 Renal_cell_adenocarcinoma zx7 Malign zx8 T71000 zx9 M83123 zx0 G zy1 zy2 Hartford Hospital •The photograph shows multiple seemingly discontinuous yellowish nodules. •These nodules represent renal cell carcinoma (clear cell type) which has extensively permeated the venous channels of the kidney. •The lower portion of the specimen shows tumor thrombus in the renal vein. •In this particular case, tumor showed continuous intravenous growth to the inferior vena cava. | zx1 489 zx2 GI zx3 6217 zx4 Colon zx5 Polyposis Coli zx6 Polyposis zx7 Benign zx8 T67000 zx9 M82210 zx0 G zy1 zy2 Hartford Hospital •Opened colon displays a mucosal surface covered with numerous small to medium sized polyps •The absence of a large mass lesion does not guarentee that carcinoma is not present | zx1 490 zx2 GI zx3 6218 zx4 Colon zx5 Polyposis Coli zx6 Polyposis zx7 Benign zx8 T67000 zx9 M82210 zx0 G zy1 zy2 Hartford Hospital •The opened colon contains a myriad of smooth raised polypoid mucosal lesions varying in size from 1 to 10 mm. •None of these is obviously malignant but histologic examination would be required to confirm this | zx1 491 zx2 GI zx3 6219 zx4 Colon zx5 Polyposis Coli zx6 Polyposis zx7 Benign zx8 T67000 zx9 M82210 zx0 G zy1 zy2 Hartford Hospital •The polyps range in size from less than a mm to several cm | zx1 492 zx2 GI zx3 6220 zx4 Small Intestine zx5 Hemorrhagic intestinal infarction zx6 Infarct zx7 Degen zx8 T64000 zx9 M54700 zx0 G zy1 zy2 Hartford Hospital •Note Meckel's diverticulum(arrow) •Diffuse violacious red appearance is characteristic of transmural hemorrhagic intestinal infarction | zx1 494 zx2 GI zx3 6222 zx4 Small Intestine zx5 Atresia of Intestine zx6 Atresia zx7 Con zx8 T64000 zx9 M20400 zx0 G zy1 zy2 Hartford Hospital •The intestine ends in as a blind smooth surfaced pouch which in this case is complete(arrow) | zx1 495 zx2 GI zx3 6223 zx4 Liver zx5 Adenoma of liver zx6 Adenoma zx7 Benign zx8 T56000 zx9 M81400 zx0 G zy1 zy2 Hartford Hospital | zx1 496 zx2 GI zx3 6224 zx4 Liver zx5 Adenoma of liver zx6 Adenoma zx7 Benign zx8 T56000 zx9 M81400 zx0 G zy1 zy2 Hartford Hospital | zx1 497 zx2 GI zx3 6225 zx4 Small Intestine zx5 Gastrointestinal Stromal Tumor(GIST) zx6 Leiomyosarcoma zx7 Malign zx