General

Pathology
EXTRA EDGE INFO

PAGE
1

GRANULOMATOUS INFLAMMATION skin allograft/xenograft and decreased antibody response to T

ƒƒ A granuloma is a focus of chronic inflammation consisting of

dependent antigen.
ƒƒ B cell hyperactivity may be associated with it.
P
a microscopic aggregation of macrophages that are transformed
RHEUMATOID ARTHRITIS
into epithelium-like cells, surrounded by a collar of mononuclear
R

leukocytes, principally lymphocytes and occasionally plasma
cells. Frequently, epithelioid cells fuse to form giant cells. A
granuloma is a cellular attempt to contain an offending agent
that is difficult to eradicate. In this attempt there is often strong
activation of T lymphocytes leading to macrophage activation,
which can cause injury to normal tissues.
FO
ƒƒ Rheumatoid arthritis is a chronic systemic inflammatory disorder
that may affect many tissues and organs—skin, blood vessels,
heart, lungs, and muscles—but principally attacks the joints,
producing a nonsuppurative proliferative and inflammatory
i
synovitis that often progresses to destruction of the articular
M

IN
ƒƒ Histiocytic necrotizing lymphadenitis aka Kikuchi’s disease is a cartilage and ankylosis of the joints. Once an inflammatory
self limiting cause of lymphadenitis. Histologic findings include synovitis has been initiated, an autoimmune reaction—in
proliferative phase, necrotizing phase and xanthomatous phase. which T cells have the pivotal role—is responsible for the
Immunophenotype shows presence of CD4 and CD8 positive T
cells.
chronic destructive nature of rheumatoid arthritis. TH17 cells
are important in the inflammatory reaction because they recruit E
neutrophils and monocytes.
Disease Etiology Description of granuloma
HEPATITIS B VIRAL GENOMES AND CODING
Tuberculosis Mycobacterium
GE
Caseating granuloma(tubercle)
tuberculosis
Genome of HBV Coding S
Leprosy Mycobacterium Acid-fast bacilli in S - Gene HBS Ag (envelop protein)
leprae macrophages;
Noncaseating granuloma C - Gene
(aka Australia Ag)
HBC Ag → Nucleocapsid core Ag
U
ED
Syphilis Treponema Gumma HBe Ag → Nucleocapsid protein with core
pallidum
P - Gene
and precore region
DNA polymerase → having reverse P
Cat-scratch Bartonella Rounded or stellate granuloma transcriptase activity
disease henselae X - Gene HBx protein → development of HCC
P
Sarcoidosis Unknown Noncaseating granulomas. SCHWANNOMA
etiology Sarcoid granulomas often
L
RA

contain star-shaped
structures termed Asteroid
bodies or lamellar structures
termed Schaumann bodies.
NUDE MICE
T
ƒƒ These benign tumors arise from the neural crest–derived Schwann
cell and cause symptoms by local compression of the involved
nerve or adjacent structures (such as brainstem or spinal cord).
ƒƒ On microscopic examination tumors show a mixture of two
growth patterns .
E
ƒƒ (Image B) In the Antoni A pattern of growth, elongated cells
M

with cytoplasmic processes are arranged in fascicles in areas

ƒƒ A nude mouse is a laboratory mouse from a strain with genetic of moderate to high cellularity and scant stromal matrix; the
mutation that causes a deteriorated or absent thymus. These “nuclear-free zones” of processes between the regions of nuclear
EX

mice possess a vestigial thymus which is incapable of producing

mature T cells.
palisading are termed Verocay bodies.
ƒƒ (Image A)In the Antoni B pattern of growth, the tumor is less E
ƒƒ They have impaired T cell function as demonstrated by an dense and consists of a loose meshwork of cells, microcysts and
absence of delayed hypersensitivity reaction, an inability to reject myxoid stroma. Within the cranial vault most schwannomas occur
N
T
These Updates are from Primes Supplement 2018
 General
Pathology
EXTRA EDGE INFO

PAGE
2
at the CP angle (acoustic neuromas), where they are attached to ƒƒ Sign and symptoms include perioral paresthesia, acral paresthesia,
the vestibular branch of the 8th cranial nerve. Affected individuals
often present with tinnitus and hearing loss.
shivering, light headedness, twitching and tremors.
P
PATHWAY ACTIVATED BY PT
CITRATE BASED ANTICOAGULANT
R

FO
ƒƒ Prothrombin time (PT) is used to screen the extrinsic and
ƒƒ Citrate is used as the primary anticoagulant in both donor and common pathways. In this test the clotting of plasma after
therapeutic apheresis addition of an exogenous source of tissue thromboplastin (e.g.,
ƒƒ Citrate infusion can result in symptomatic hypocalcemia in a
donor/patient due to decrease in ionized calcium to levels at
brain extract) and Ca[2]+ ions is measured in seconds.
ƒƒ A prolonged PT can result from deficiency or dysfunction of
i
which the nerne mebrane excitability reaches to the point where factor 5,7,10, prothrombin, or fibrinogen
spontaneous depolarization can occur
M

IN
GE E

S
U
ED
P
P
L
RA

E
M
T
EX

E
N
T
These Updates are from Primes Supplement 2018