---
# System prepended metadata

title: Patho Micro Block Ib

---

# Patho Micro Block Ib
## Lower Urinary Tract & Reproductive System
* 一. PA0088 (72) Clear cell renal cell carcinoma, kidney, 53M（P.3）
    * 有capsule
    * Cytology: 
        * **Abundant clear or granular cytoplasm**
        * variable nuclear atypia
* 二. PA0082 (66) Non invasive papillary urothelial carcinoma, high grade, kidney, 71F（P.15）
    * 像花椰菜
    * ![](https://i.imgur.com/4lwmnhR.jpg)
    * 泌尿上皮 (2-7層、umbrella cell)
    * **fibrovascular core**
    * high grade: nuclear polarity loss (細胞失去排序)、大黑怪 (atypical mitotic urothelial cells)
* 三. PA0219 (161) Invasive urothelial carcinoma, urinary bladder, 83M （P.25）
    * 吃muscularis propria
    * ![](https://i.imgur.com/qvhMXN0.jpg)
* 四. PA0189 (178) Seminoma, testis, 31M （P.32）
    * uniform
    * **細胞膜明顯、細胞質空亮**、細胞核大、核仁跟淋巴球差不多大
    * | ![](https://i.imgur.com/Q3OuV5T.jpg) |
        |-------|
        | ![](https://i.imgur.com/w4FOFh3.jpg) |
    * | GCNIS (Germ cell neoplasia in situ) |
        | -------- | 
        | ![](https://i.imgur.com/1ry4U2H.jpg)     | 

* 五. PA0188 (79) Teratoma, testis, 23M （P.45）
    * ![](https://i.imgur.com/mgCmJBA.jpg)
    * Squamous cell with keratinization
    * ![](https://i.imgur.com/wv2hroP.jpg)
    * Immature stroma cells
    * ![](https://i.imgur.com/PFPVBUR.jpg)
* 六. PA0098 (78) **Adenocarcinoma, prostate**, 57M （P.57）(只有你是prostate)
    * ![](https://i.imgur.com/xqzWf8n.jpg)
    * Infiltrative growth, 單層沒有basal cells
    * ![](https://i.imgur.com/G0pcRFq.jpg)
    * Foamy or amphophilic（藍紫色） cytoplasm
    * 大黑不規則核仁
    * |![](https://i.imgur.com/Eekbuy8.jpg)||
        |---|---|
        |![](https://i.imgur.com/hopCeOF.jpg)|![](https://i.imgur.com/Jyut5lP.jpg)|
        |![](https://i.imgur.com/boEf26u.jpg)|
    * |![](https://i.imgur.com/mxbCj9e.jpg)| ![](https://i.imgur.com/RsVhBV6.jpg)|
        |---|---|

## Female Genital System（1）
    排卵後製造分泌物在basal side (pseudostratified nuclei with mitosis)
* 一. PA0103 （84） Adenomyosis, uterus, 49F（P.20）
    * **Myometrium**中見到endometrial stroma (長長的核)或glands
    * ![](https://i.imgur.com/bw5WM50.jpg)
    * ![](https://i.imgur.com/DWHq0gF.jpg)
    * Myometrium增厚
* 二. PA0105 （86） Endometrioid adenocarcinoma, uterus, 61F（P.33）
    * Architecture: **Gland/Stroma高**，gland最厚那種，back-to-back（沒有stroma混在裡面）
    * 柱狀上皮、subnuclear vacuoles
    * |cribiform pattern|back-to-back glands|
        |---|---|
        |![](https://i.imgur.com/64bGFgI.jpg)|![](https://i.imgur.com/y1LpLVb.jpg)|
    * |Squamous/poorly differentiated glands|
      |---|
      |![](https://i.imgur.com/MIghi7K.jpg)|
      |![](https://i.imgur.com/vVbVVyW.jpg)|
* 三. PA0108 （89） Endometriosis, ovary, 37F（P.56）
    * Endometrial glands & endometrial stroma長到外面去
    * Hemorrhage
    * <details>
          <summary><b>Ovarian stroma (spindle/wavy)</b></summary>
          <img src=https://i.imgur.com/iQedmLE.jpg></img>
          <img src=https://i.imgur.com/rgUkSwx.jpg></img>
          <pre><code>圖</code></pre>
      </details>
    * ![](https://i.imgur.com/uIOj37Y.png)
    * ![](https://i.imgur.com/Y7AZWrt.png)
## Female Genital System（2）
* 一. PA0110 （91） High-grade serous carcinoma, ovary, 49F （P.4）
    * Solid: **slit-like spaces (裂開的洞洞)**
    * ![](https://i.imgur.com/gzwoXX7.jpg)
    * ![](https://i.imgur.com/N5Mc1ya.jpg)
    * Papillary: fibrovascular core
    * pleomorphism明顯
* 二. PA0114 （94） Mucinous cystadenoma, ovary, 52F（P.20）
    * ovarian stroma
    * Cysts上皮為單層柱狀（良性、偶爾papillary）、核在底部、apical mucin
    * ![](https://i.imgur.com/NOKE8KF.jpg)
* 三. PA0115 （95） Clear cell carcinoma, ovary, 51F （P.34）
    * ![](https://i.imgur.com/YEiRZx2.jpg)
    * Architecture: 
        * **Tubulocystic, micropapillary (單層)** 跟mucinous/serous cystadenome又不太一樣
        * stroma較一般ovarian stroma粉紅
    * **Hobnail cells**: apical hyperchromatic nuclei
    * ![](https://i.imgur.com/rgxYgUv.jpg)
    * **Clear/Eosinophilic cytoplasm**
    * Hyaline globules
## Female Genital System（3） 
* 一. PA0111 （92） Dysgerminoma, ovary, 32F（P.4）
    * Primary site tumor necrosis: 淡粉紅
    * **Fibrous septa**
    * 一整片大細胞，無特別排列
    * <details>
          <summary><b>圖</b></summary>
          <img src=https://i.imgur.com/Ki9BYBR.jpg></img>
          <img src=https://i.imgur.com/rNalAze.jpg></img>
          <pre><code>圖</code></pre>
      </details>
* 二. PA0252 （93） Yolk sac tumor, ovary（P.15）
    * <details>
          <summary><b>低倍圖</b></summary>
          <img src=https://i.imgur.com/GOG63a3.jpg></img>
          <pre><code>低倍</code></pre>
      </details>
    * Architecture: microcystic & macrocystic
    * Reticular (lace-like)
    * **Schiller-Duval (endodermal sinus) bodies**: 長的像glomerulus
    * hyaline globules
    * <details>
          <summary><b>Tumor排列</b></summary>
          <img src=https://i.imgur.com/ZzI3GvO.jpg></img>
          <pre><code>圖</code></pre>
      </details>
* 三. PA0221 （163） Immature teratoma, grade III, ovary, 11F（P.30）
    * immature: **primitive neuroepithelial cell** (tubule/rosette, 細胞多、核質比大), cartilage, stroma cell
    * <details>
          <summary><b>Grading</b></summary>
          <img src=https://i.imgur.com/8hcO8Yp.png></img>
          <pre><code>圖</code></pre>
      </details>
    * <details>
          <summary><b>低倍</b></summary>
          <img src=https://i.imgur.com/W07vqJM.jpg></img>
          <pre><code>圖</code></pre>
      </details>
    * <details>
          <summary>Ganglion cell</summary>
          <img src=https://i.imgur.com/tZYWR7M.jpg></img>
          <pre><code>圖</code></pre>
      </details>
* 四. PA0109 （90） Adult granulosa cell tumor, ovary, 68F（P.41）
    * Stroma部份顏色淺、病變部份顏色深紅
    * <details>
        <summary>Microfollicular pattern: <b>Call-Exner body</b> (咖啡豆 (nuclear grooving) 周圍細胞核) cell</summary>
          <img src=https://i.imgur.com/CVPqXPu.jpg></img>
          <pre><code>圖</code></pre>
      </details>
## Female Genital system（4）
* 一. PA0253 （87） Tubal pregnancy, fallopian tube（P.3）
    * ![](https://i.imgur.com/d3JTViI.jpg)
    * <details>
        <summary><b>Trophoblast</b></summary>
          <img src=https://i.imgur.com/2b1ooX9.jpg></img>
          <img src=https://i.imgur.com/XdM7szx.jpg></img>intermediate trophoblast (villous IT) 長在villi之間
          <pre><code>圖</code></pre>
      </details>
    * syncytiotrophoblast knot
* 二. PA0119 （98） Complete hydatidiform mole, uterus, 45F （P.20）
    * **Hydropic chorionic villi**: cistern, scalloped
    * ![](https://i.imgur.com/HwUDsjc.jpg)
    * trophoblastic proliferation
    * <details><summary>decidual change: 像荷包蛋，圓胖紅胞質多。Polygonal, Eosinophilic, Endometrial gland atrophy （不要和villous IT搞混）</summary><img src=https://i.imgur.com/16X2a17.jpg></img></details>
    * <details>
        <summary>Arias-Stella reaction: 子宮內膜腺核大黑atypia、<b>hobnail</b></summary>
          <img src=https://i.imgur.com/SrPc0yU.jpg></img>
          <pre><code>圖</code></pre>
      </details>
* 三. PA0116 （96） Invasive hydatidiform mole （invasive mole）, uterus, 48F （P.37）
    * Chorionic Villi侵犯子宮肌肉層或血管
* **四. PA0117 （97） （1） Choriocarcinoma; （2）Adenomyosis, uterus, 38F （P.48）**
    * **沒有chorionic villi**，trimorphic proliferation, atypia (核黑大)
        * cytotrophoblast
        * **syncytiotrophoblast**
        * intermediate trophoblast
## Breast
* 一. PA0268（103）舊片PA0125, Fibrocystic change, breast, 47F P.7
    * foamy histiocyte
    * microcalcification
* 二. PA0267（101）舊片PA0122, Fibroadenoma, breast, 27F P. 17
    * **TDLU被擠壓成細長狀**
    * intralobular stroma **spindle** cell增生
* 三. PA0124（102）P.25
    * 1. Invasive carcinoma of no special type （NST）, breast
        * infiltrative glands with **desmoplasia** (仍有duct，c.f. indian file)
    * 2. Ductal carcinoma in situ (DCIS), breast
        * 管壁**表皮增生** (round duct with intraluminal epithelial hyperplasia)
* **四. PA0120（99）P.46**
    * **1. Invasive lobular carcinoma (ILC), breast**
        * Discohesive / **Indian file**
        * 沒有desmoplasic change
    * **2. Lobular carcinoma in situ (LCIS), breast**
        * **塞滿lumen**，像signet ring cell
        * 沒有desmoplasic change
* 五. PA0121（100）Paget’s disease, breast, 56F P.60
    * lactiferous duct中DCIS
    * **Paget's cell** 細胞核大核仁明顯**細胞質空亮**，在epidermis
    * ![](https://i.imgur.com/c4eTojm.jpg)
## Kidney（1）
* • PA0187 （70） Multicystic renal dysplasia, kidney, 4mF （P.25）
    * **hyaline cartilage** 
    * cyst
    * <details><summary><b>fetal type glomerulus: 緊密</b></summary><img src=https://i.imgur.com/9FpFbEP.jpg></img></details>
* • PA0087 （71） Adult polycystic kidney disease, kidney, 47M （P.39） 
    * Cyst
* • PA0095 （75） Autosomal recessive （childhood） polycystic kidney disease （P. 49）
    * radiating cylindrical cyst
* <span style="color:lightgrey">• PA0089 （73） Chronic pyelonephritis, kidney, 60F（P. 56）
## Kidney（2）
* <span style="color:lightgrey">一. PA0246（184）Acute glomerulonephritis, kidney（p3）</span>
    * <span style="color:lightgrey">glomeruli異常大、有neutrophils</span></br>
* 二. PA0242（183）Focal segmental glomerulosclerosis, kidney （p15）
    * **Synechia** (腎絲球包氏小體黏在一起)
    * segmental sclerosis
* <span style="color:lightgrey">三. PA0083（67）Membranous nephropathy with segmental sclerosis, kidney, 69M（p26）</span>
* 四. PA0239（180）Diabetic nephropathy, kidney（p44）
    * Nodular glomerulosclerosis
## Kidney（3）
* <span style="color:lightgrey">一. PA0238 （179） Lupus nephritis, class IV, kidney（p.5）
    * endocapillary hypercellularity
    * wire loop lesion (hyaline)
* <span style="color:lightgrey">二. PA0241 （182） Lupus nephritis, class IV, with crescent（p.32）
    * Bowman's space被細胞佔滿</span></br>
* 三. PA0240 （181） Malignant nephrosclerosis, kidney（p.53）
    * Bowman's space大空
    * finrinoid necrosis: 不均質
    * hyaline arteriolosclerosis：均質
    * Hyperplastic arteriolitis（onion-skinning）：血管堵起來了
## Miscellaneous
* Serous cystadenoma: ciliated tubal-like cell
    * ![](https://i.imgur.com/EXLaprT.jpg)
* MGN, Acute GN, *lupus*不考
* 猜題：
    * Hydatidiform mole
    * Choriocarcinoma, Adenomyosis
    * ILC/LCIS