Pathology Discussion Forum

31/01/2022

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19/10/2021

Light’s Criteria: Pleural fluid is an exudate if one or more of the following criteria are met:
■ Ratio of pleural fluid protein to serum protein > 0.5
■ Ratio of pleural fluid LDH and serum LDH > 0.6
■ Pleural fluid LDH is > 2/3 normal upper limit for serum (> 200)
■ Pleural fluid protein >30 g/L.

21/09/2021

Role of Hepcidin in iron regulation:
The main regulator of iron absorption is the protein hepcidin, encoded by the HAMP gene and produced and secreted by the liver. Transcription of HAMP is increased by inflammatory cytokines and iron, and decreased by iron deficiency, hypoxia, and erythroferrone, a hormone produced by marrow erythroblasts. These inputs are integrated to regulate the synthesis and plasma levels of hepcidin. Hepcidin binds to the cellular iron efflux channel ferroportin, causing its internalization and proteolysis, thereby inhibiting the release of iron from intestinal cells and macrophages. Due to these activities, an increase in hepcidin lowers plasma iron levels. Conversely, an abnormal deficiency of hepcidin causes iron overload.
Other proteins involved in iron metabolism do so by regulating hepcidin levels. Decreased hepcidin synthesis or activity may be caused by loss of function mutations in the genes HAMP, HJV, TFR2, and HFE, all of which are associated with hereditary forms of hemochromatosis. Deficiencies of hepcidin also occur when erythroferrone levels are chronically elevated, as occurs in disorders marked by ineffective hematopoiesis, such as β-thalassemia and myelodysplastic syndrome.

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20/09/2021

"GROUND GLASS APPEARENCE:
There are some morphologic features that are distinctive for particular subtypes of chronic viral hepatitis. In chronic hepatitis B, the swollen endoplasmic reticulum of hepatocytes are swollen and filled with HBsAg, leading to a “ground-glass” appearance.
Immunostaining for hepatitis B surface and core antigens can confirm the HBV infection.

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20/09/2021

Hepatitis B X protein (HBx), which is not necessary for virus replication, but may act as a transcriptional trans-activator of both viral genes and a subset of host genes.
It has been implicated in the pathogenesis of HBV-related hepatocellular carcinoma.

19/09/2021

PSAMMOMA BODY:
Psammoma bodies (PBs) are concentric lamellated calcified structures, observed most commonly in papillary thyroid carcinoma (PTC), meningioma, and papillary serous cystadenocarcinoma of o***y but have rarely been reported in other neoplasms and nonneoplastic lesions. PBs are said to represent a process of dystrophic calcification. Despite numerous ancillary studies over a span of three and half decades, formation of PBs remains a poorly understood mechanism. Ultrastructural study of PTC has shown that thickening of the base lamina in vascular stalk of neoplastic papillae followed by thrombosis, calcification, and tumor cell necrosis leads to formation of PBs. Studies on serous cystadenocarcinoma of o***y and meningioma, however, revealed that collagen production by neoplastic cells and subsequent calcification was responsible for the formation of PBs. The existence of some precursor forms of PBs was reported in meningiomas and more recently in PTC, which were mostly in the form of extracellular hyaline globules surrounded by well-preserved neoplastic cells or in a smaller number of cases intracytoplasmic bodies liberated from intact tumor cells. Cellular degeneration and necrosis, leading to the disappearance of neoplastic cells, were noticed by us only around PBs but not around the precursor forms. Based on the above findings, it is suggested that rather than being the outcome of dystrophic calcification of dead or dying tissue, PBs may indeed represent an active biologic process ultimately leading to degeneration/death of tumor cells and retardation of growth of the neoplasm. It may also serve as a barrier against the spread of neoplasm.

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19/09/2021

Calcific uremic arteriolopathy (calciphylaxis) is a devastating condition seen almost exclusively in patients with advanced CKD.

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16/09/2021

Flea bitten appearance due to tiny petechial hemorrhage in malignant hypertension.






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15/09/2021

Microscopic findings Presence of hypercellular glomeruli due to leukocytic infiltration, proliferation of endothelial and mesangial cells is characteristic of post streptococcal glomerulonephritis. Immunofluorescence microscopy shows the presence of IgG, IgM and C3 deposits in the mesangium and along the basement membrane giving ‘starry sky’ appearance.

15/09/2021

Causes of renal papillary necrosis: Diabetes (most common), obstructive uropathy, analgesic nephropathy and sickle cell disease.

15/09/2021

Crescent formation (Fibrin + parietal epithelial cells + WBCs) is characteristic of RPGN. Number of crescents also decide the prognosis of the patient.

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