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Anticentromere antibodies
Scleroderma (CREST)
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Antidesmoglein (epithelial) antibodies
Pemphigus vulgaris (blistering)
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Anti-glomerular basement membrane antibodies
Goodpasture's Syndrome (glomerulonephritis and hemoptysis)
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Antihistone antibodies
- Drug-induced SLE
- -hydralazine
- -isoniazid
- -phenytoin
- -procainamide
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Anti-IgG antibodies
Rheumatoid Arthritis
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Antimitochondrial antibodies (AMA)
- Primary biliary cirrhosis
- -female
- -cholestasis
- -portal HTN
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Antineutrophilic cytoplasmic antibodies (ANCAs)
- c-ANCA: Wegener's
- p-ANCA: microscopic polyangiitis, Churg-Strauss
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Antinuclear antibodies (ANAs: anti-smith, anti-dsDNA)
SLE (type III hypersensitivity)
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Antiplatelet antibodies
Idiopathic thrombocytopenic purpura
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Anti-topoisomerase antibodies
diffuse systemic scleroderma
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Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
Celiac disease (diarrhea, distention, weight loss)
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"Apple core" lesion on abdominal x-ray
Colorectal cancer (usually L-sided)
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Azurophilic peroxidase-positive granular inclusions in granulocytes and myeloblasts
- Auer rods
- -AML, especially M3 type
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Bacitracin response
- Sensitive: Group A strep (s. pyogenes)
- Resistant: Group B strep (s. agalactiae)
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"Bamboo spine" on x-ray
Ankylosing Spondylitis
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Basophilic nuclear remnants in RBCs
-Howell-Jolly bodies (splenectomy or non-functional spleen)
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Bloody tap on LP
Subarachnoid hemorrhage
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"Boot shaped" heart on x-ray
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Branching GP rods with sulfur granules
Actinomyces israelii
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Bronchogenic apical lung tumor on imaging
- Pancoast tumor
- -can cause Horner's syndrome
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"Brown" tumor of bone
- -Hyperparathyroidism
- -Osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
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Cardiomegaly with apical atrophy
Chagas' disease
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Cellular crescents in Bowman's Capsule
Rapidly progressive crescentic glomerulonephritis
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"Chocolate cyst" of ovary
Endometriosis (frequently bilateral)
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Circular grouping of dark tumor cells surrounding pale neurofibrils
- Homer-Wright rosettes
- -neuroblastoma
- -medulloblastoma
- -retinoblastoma
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Colonies of mucoid Pseudomonas in lungs
CF
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Decreased AFP in amniotic fluid/maternal serum
Down Syndrome or other chromosomal anomalies
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Degeneration of dorsal column nerves
- -Tabes Dorsalis (tertiary syphilis)
- -Subacute combined degeneration
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Depigmentation of neurons in substantia nigra
Parkinosn's Disease
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Desquamated epithelium casts in sputum
Curschmann's spirals (bronchial asthma, can result in whirled mucus plugs)
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Disarrayed granulosa cells in eosinophlic fluid
Call-Exner bodies (granulosa-theca cell tumor of the ovary)
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Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
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Enlarged cells with intranuclear inclusion bodies
Owl's eye appearance of CMV
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Enlarged thyroid cells with ground-glass nuclei
"Orphan Annie eyes" nuclei (papillary carcinoma of thyroid)
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Eosinophilic cytoplasmic inclusion in liver cell
Mallory body (alcoholic liver disease)
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Eosinophilic cytoplasmic inclusion in nerve cell
Lewy body (Parkinson's Disease)
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Eosinophilic globule in liver
Councilman body (toxic or viral hepatitis, often yellow fever)
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Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Negri body (rabies)
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Extracellular amyloid deposition in gray matter of brain
Senile plaques (alzheimer's)
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Giant B cells with bilobed nuclei with prominent inclusions ("owl's eye")
Reed-Sternberg cells (Hodgkin's lymphoma)
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Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (Yolk Sac Tumor)
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"Hair on end" (crew-cut) appearance on X-ray
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hCG elevated
- -Choriocarcinoma
- -hydatidiform mole
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Heart nodules (granulomatous)
Aschoff bodies (rheumatic fever)
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Heterphile antibodies
Infectious mononucleosis (EBV)
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Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
-
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Hilar lymphadenopathy, peripheral granulomatous lesions in middle or lower lung lobes (can calcify)
Ghon complex (primary TB)
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"Honeycomb" lung on xray or CT
Interstitial pulmonary fibrosis
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Hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau's Syndrome (adenocarcinoma of pancreas or lung)
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Hypersegmented neutrophils
-megaloblastic anemia (B12 deficiency, folate deficiency)
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-Hypertension
-hypokalemia
-metabolic alkalosis
Conn's syndrome
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Hypochromic, microcytic anemia
- -Iron deficiency anemia
- -lead poisoning
- -thalassemia
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Increased AFP in amniotic fluid/maternal serum
- -dating error
- -anencephaly
- -spina bifida (NT defects)
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Increased uric acid levels
- -gout
- -Lesch-Nyhan syndrome
- -tumor lysis syndrome
- -loop and thiazide diuretics
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Intranuclear eosinophilic droplet-like bodies
Cowdry type A vodies (HSV, CMV)
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Iron-containing nodules in alveolar septum
Ferruginous bodies (asbestos)
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Keratin pearls on skin biopsy
Squamous cell carcinoma
-
-Large lysosomal vesicles in phagocytes
-immunodeficiency
Chediak Higashi disease (congenital failure of phagolysosome formation)
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"lead pipe" appearance of colon on barium enema x-ray
Ulcerative colitis
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Linear appearance of IgG deposition on glomerular basement membrane
Goodpasture's Syndrome
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Low serum ceruloplasmin
Wilson's disease
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"Lumpy bumpy" appearance of glomeruli on IF
Poststerptococcal glomerulonephritis (immune complex deposition of IgG and C3b)
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Lytic "hole punch" bone lesions on xray
Multiple myeloma
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Mammary gland "blue-domed" cyst
fibrocystic changes of the breast
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Monoclonal antibody spike
- -multiple myeloma (IgG or IgA)
- -MGUS (normal consequence of aging)
- -Waldenstrom's macroglobulinemia (IgM)
- -Primary amyloidosis
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Mucin-filled cell with peripheral nucleus
Signet ring (gastric carcinoma)
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Narrowing of bowel lumen on barium xray
"string sign" (Crohn's disease)
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Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
- -Wegener's (c-ANCA)
- -Goodpasture's (anti-BM antibodies)
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Needle-shaped, negatively birefringent crystals
Gout (monosodium urate crystals)
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Nodular hyaline deposits in glomeruli
Kimmelsteil-Wilson nodules (diabetic nephropathy)
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Novobiocin response
- Sensitive: S. epidermidis
- Resistant: S. saprophyticus
-
"Nutmeg" appearance of liver
Chronic passive congestion of liver due to right heart failure
-
"Onion skin" periosteal reaction
Ewing's sarcoma
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Optochin response
- Sensitive: S. pneumo
- Resistant: Viridans strep
-
Periosteum raised from bone, creating triangular area
- Codman's triangle
- -osteosarcoma
- -Ewing's sarcoma
- -pyogenic osteomyelitis
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Podocyte fusion or "effacement" on EM
Minimal change disease (child with nephrotic syndrome)
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Polished, "ivory" like appearance of bone at cartilage erosion
Eburnation (osteoarthritis resulting in bony sclerosis)
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Protein aggregates in neurons from hyperphosphorylation of protein tau
- -Neurofibrillary tangles (Alzheimer's)
- -Pick's Bodies (Pick disease)
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Psammoma Bodies
- -Meningiomas
- -Papillary thyroid carcinoma
- -Mesothelioma
- -Papillary serous carcinoma of endometrium and ovary
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Pseudopalisading tumor cells on brain biopsy
Glioblastoma multiforme
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RBC casts in urine
Acute glomerulonephritis
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Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
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Renal epithelial casts in urine
Acute toxic/viral nephrosis
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Rhomboid crystals, positively birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
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Rib notching
Coarctation of the aorta
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Ring-enhancing lesions in AIDS
- -Toxoplasma gondii
- -CNS lymphoma
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Sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages ("starry sky" histology)
Burkitt's Lymphoma (associated with EBV)
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Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick's disease)
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"Soap bubble" in femur or tibia on x-ray
Giant cell tumor of bone (usually benign)
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"spikes" on BM, "dome-like" subepithelial deposits
Membranous glomerulonephritis
-
Stacks of RBCs
- Rouleaux formation
- -high ESR (MM)
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Stippled vaginal epithelial cells
"Clue cells" (Gardenerella vaginalis)
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"Tennis racket" shaped cytoplasmic organelles (EM) in Langerhans cells
- Birbeck granules
- -Langerhans cell histiocytosis
- -Histiocytosis X (eosinophilic granuloma)
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Thrombi made of white/red layers
- Lines of Zahn
- -arterial thrombus, layers of platelets/RBCs
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"Thumb sign" on lateral xray
Epiglotitis (H. flu)
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Thyroid-like appearance of kidney
Chronic bacterial pyelonephritis
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Tram-track appearance of capillary loops of glomerular basement membrane on LM
MPGN
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Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
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"Waxy" casts with very low urine flow
Chronic end stage renal disease
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WBC casts in urine
Acute pyelonephritis
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WBCs that look "smudged"
-CLL (almost always B cell)
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"Wire loop" glomerular capillary appearance on LM
Lupus nephropathy
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Yellowish CSF
Xanthochromia (eg: subarachnoid hemorrhage)
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