Long questions 2010 (5)

1. Common techniques in pathology (2010)

1. Immunohistochemistry
2. Fluorescent In Situ Hybridization (FISH)
3. Array comparative genomic hybridization,
4. PCR,
5. DNA sequencing

2. Pathological changes in Burkitt’s lymphoma (2010)

1. Origin: central B cell
2. Clinical features : mainly in children and young adult
3. Extranodal site : jaw, kidney, breast, ovaries
4. Morphology :
• medium size lymphoid cells
• “Starry-sky” appearance
• high mitotic activity
5. Immunophenotype : IgM CD19 CD20 CD10

3. Pathological features of myelin lesions (2010,2011,2012)

1. Demyelination: an 'attack' by the immune system on the myelin covering the nerves, causing the
myelin sheath damaged. ( guillain-barre syndrome, DM, Chronic inflammatory demyelination
polyneuropathy)
2. Hyper myelination: It is pathologically characterized by focal myelin thickenings and abnormal
folding, known as “tomacula” due to their sausage-like shape.
3. Hypo myelination : Myelin is abnormally thin or incomplete compaction of the outermost
myelin lamellae
4. Schwann cell proliferation: Result of proliferation of Schwann cells and of basement membrane
deposits arranged concentrically around a relatively intact axon “onion bulbs”.

4. Cytopathology (2010)
It is a branch of pathology. Widely of morphological study and diagnosis on the cellular level.
Narrowly, diagnostic techniques, used to examine cells from various body sites to determine the
causer nature of the disease

5. Staging of endometrial carcinoma (2010,2011,2012)

Grading 1 No more than 5% of the tumor is composed of solid masses

Grading 2 6-50% of the tumor is composed of solid masses
Grading 3 More than 51% of the tumor is composed of solid masses
Long Questions 2011 (6)
1. Advantages and disadvantages of frozen section processing (2011,2012)
• Advantages
− Rapid processing time
− Less equipment requirement
− Less need for ventilation in the laboratory
• Disadvantages
− The poor quality of the final slide
− High demanding to the diagnostic skill of pathologists.

2. Principle of Immunohistochemistry (2011) The localization of antigens or proteins in tissue or cell

sections by the use of labelled antibodies as specific reagents through antigen-antibody interactions
that are visualized by a marker such as fluorescent dye, enzyme, radioactive element or colloidal gold.

3. Pathological changes of Diffuse Large B Cell Lymphoma (2011)

• A diffuse proliferation of large neoplastic B lymphoid cells with nuclear size equal to or
exceeding normal macrophage nuclei or more than twice the size of normal lymphocyte.
• A rapidly enlarging, often symptomatic mass at a single nodal or extranodal site.

4. Reactive hyperplasia vs. lymphoma (2011,2012)

• Immune phenotype and genetics: polyclonal reactive processes vs. monoclonal neoplasms
• Proliferation cell phenotype: T, B, Histiocyte
• Gene rearrangement
• B cell: monoclonal light chain (λ,κ)/heavy chain gene rearrangement
• T cell : monoclonal T cell receptor (TCR) gene(α/β/γ) rearrangement

Long Questions 2012 (6)

5. GIST ( gastrointestinal stromal tumor) (2012)

• Definition: The most common primary non-epithelial tumor of the GI tract, maybe benign or
malignant. Immunohistochemically positive for KIT. Can occur anywhere in the GI tract. But
most common in the stomach (60%).
• Gross Features: Most are found in the submucosa or the muscularis propria.
The cut surface is typically granular and often shows hemorrhage, necrosis, or cystic change.
• Microscopic Features: Histological patterns among spindle cell GISTs include
1. Sclerosing type
2. Palisaded-vacuolated type
3. Hypercellular pattern
4. Sarcomatoid type
 6. Advantages and Disadvantages of cytology (2012)
Advantages:
• Rapid diagnosis-Inexpensive-Simplen
• It is better in evaluating the infectious diseases.
• Supplement or replace frozen section or biopsy
• Little injury to tissue allowing repeated sampling
• Cover a wider surface than that involved in surgical biopsy, more effective for diagnosing
superficial lumps
Disadvantages:
• Interpretation of the morphological cellular changes is based only on individual cell
observation.
• Not always final diagnosis, so it is confirmed by histopathology in some cases.
• Not determine the size and type of lesion in some cases.

7. Cytopathology methods of retrieving cell (extra)

• Exfoliative cytology: Spontaneously shed cells in body fluids, natural covering epithelium (skin,
urinary tract, vagina, and cervix)
− Urine
− Cerebrospinal fluid (CSF)
− Sputum
− Effusions in body cavities (pleura, pericardium, peritoneum)

• Abrasive cytology: Dislodges cells from body surfaces

− Imprint
− Scraping from cervix, vagina, oral cavity, and skin
− Endoscopic brushing of mucosal surfaces eg.bronchi, urinary tract
− Washing of mucosal or serosal surfaces
− Swab

• Fine-needle aspiration cytology (FNAC): A diagnostic procedure used to investigate superficial

lumps or masses or deep lesions under imaging guidance. In this technique, a thin, hollow needle
is inserted into the mass for sampling of cells that, after being stained, will be examined under a
microscope.

Definitions (2012 except 1,2)

1. Pathology: a main medical specialty that is concerned with the diagnosis of human disease. It is also
known as diagnostic or surgical pathology, which is performed by the clinical pathologists, with the
aim of offering the diagnostic, prognostic or therapeutic information of patients for clinical treatment.

2. Lymphomas: Clonal tumors of mature and immature lymphocyte including B-cells, T-cells and
Natural Killer (NK) cells. It is a malignant tumor of immune system.

3. Reid Sternberg Cell: Is a cell that can be found typically in Hodgkin Lymphoma. It has the
characteristic that is similar to owl eye. It is seen on a light microscope.

4. LSIL (low grade squamous intraepithelial lesion): means that the cervical cells show changes that
are mildly abnormal. LSIL usually is caused by an HPV infection that often goes away on its own. It
is found with Cervical Intraepithelial Neoplasia I (CIN I).
 5. DCIS (ductal carcinoma in situ): is the presence of abnormal cells inside a milk duct which is a
precursor of beast carcinoma. It is non-invasive and can be categorized into 2 types high grade and
low grade.

6. Endoscopic mucosal resection: The use of a liquid cushion to expand the submucosa and minimize
cautery damage is a principal component of endoscopic mucosal resection (EMR). This technique is
commonly used to resect premalignant and malignant lesions confined to the mucosa.
Endoscopic pinch biopsy: Pinch biopsy, performed with the use of a biopsy forceps during
endoscopy, is the most frequent form of tissue sampling. The biopsy site is usually fully visualized at
the time of sampling.
Endoscopic snare polypectomy: During endoscopy, a loop of wire may be placed around a polyp
lesion for the purpose of removing. Polyps throughout the GI tract may be excised in this manner.

7. Wallerian degeneration: Wallerian degeneration is a process that results when a nerve fiber is cut or
crushed, in which the part of the axon separated from the neuron's cell body degenerates distal to the
injury.

8. FNAC
9. Diffuse large B-cell Lymphoma
10. Cytopathology

Fill in the blank/MCQ (2011)

1. Size of the slide for microscope is within …………………………………..

2. The proper interpretation of biopsy
1. type I refers to that a definite pathological diagnosis can be given,
2. type II is defined as a certain disease being suspicious of without a definite pathological
diagnosis given,
3. type III is that the diagnosis cannot be made and only objective descriptions are given,
4. type IV is defined as that the materials are not sufficient to make the diagnosis, because of
the tiny, partial or destroyed specimens.
3. Fixation in the paraffin in the …………………………………
4. ABC for pathology : ………, ………., …………
5. Compact myelin contains ………, ……….. and …………..
Non-compact myelin contains ………., ……….., ………….. and ………...
6. Paraffin embedded tissue processing: ………….., ……………., ………………
7. Common techniques in pathology :

8. Impulses jump from one node to the next ---…………………………..

9. What nerve is usually used in neuro tests because it’s both superficial and sensory: ………………
10. 4 Periods of pathology development………………………………………………