Acute Appendicitis

The patient, a 22 year old female, developed midline, colicky abdominal pain which became progressively worse. On examination her temperature was raised (38.5° C) and she had tenderness in the right ileac fassa. An appendectomy was performed.

There are 2 cross-sections and 1 longitudinal section through the tip. The tip is most heavily involved. There are collections of neutrophils in the lumen and mucosa. Some of the glands are shed. Collections of neutrophils are present through the muscle coat and there is heavy involvement of the serosa.


M08

M08
32448 x 34129 @ 20X

Peritonitis (Diaphragm)

This section through the diaphragm shows an inflammatory reaction on both sides, i.e. peritoneum and pleura. There is a fibrinous exudate and a cellular reaction. Some neutrophils are present and cells with fragmented nuclei but the majority are mononuclear cells - macrophages, lymphocytes and plasma cells.

This reaction started as an acute purulent or fibrino-purulent peritonitis. With treatment, including antibiotics, the character of the initial exudate has latered now consisting of mononuclear cells.

The blue staining clumps are deposits of calcium.


M09

M09
46763 x 26000 @ 20X

Nasal Polyp

Male, age 45 yrs, complained of unilateral nasal obstruction and a polyp was surgically removed.

Histologically the surfcae of the polyp is covered by upper respiratory-type epithelium. The stroma is edmeatous and it contains large numbers of eosinophils and smaller numbers of plasma cells and mononuclear cells. An occasional neutrophil can be recognised. This is a type of chronic inflammatory reaction. The large numbers of eosinophils indicate an allergic origin for the inflammatory process. Areas of recent hemorrhage are present which probably occurred during removal.


M10

M10
32448 x 30674 @ 20X

Foreign body granulomatous reaction

The specimen is from a synovium of a knee joint in a 45-yr old female who had a recent arthroplasty.

Numerous multinucleate giant cells are present. These contain clear structures of different shapes and sizes. These structures are birefringent - the material is silicone.


M11

M11
30539 x 24087 @ 20X

Miliary Tuberculosis - Lung

At autopsy this patient was found to have widespread miliary tuberculosis involving lung, liver, kidney, spleen and adrenal.

This is a section of lung. There are small rounded individual lesions consisting of central pink staining necrotic material surrounded by a narrow zone of mononuclear cells. Occasional multinucleate giant cells are seen at the periphery of the lesions. The necrotic material is referred to as "caseous" and the peripheral cells as "epithelioid cells".

In this instance the epithelioid cell layer is not well developed because of the rapidity with which lesions developed.


M12

M12
19087 x 18900 @ 20X