Hallmark Features - Microscopic

Microscopic stuff…

Anitschlow myocytes : reactive histiocytes

Rheumatic fever

Apple-green bifringence

Amyloidosis

Aschoff bodies : fibrinoid necrosis surrounded by multinucleated giant cells

Rheumatic fever

Asteroid bodies : flower-like spores at end of hyphae

Sporothrix schenckii

Asteroid bodies : stellate inclusions w/I multinucleated giant cells

Noncaseating granuloma

Sarcoidosis

Atypical lymphocytes

Mononucleosis

Phenytoin

Auer rods : cytoplasmic inclusion rods in leukocyte

Acute promyelocytic leukemia (AML)

Basophillic stippling of RBCs

lead poisoning

iron deficiency

Birbeck granules

histocytosis X (eosinophillic granuloma)

Blue dome cyst

fibrocystic disease of the breast

Branching septate hyphae @ 45

Aspergilus

Bread and butter pericarditis

Fibrinous pericarditis; rheumatic, AMI, uremia

Broad based bud

Blastomycosis

Budding yeast w/ pseudohyphae

Candida albicans

Bullet shaped capsid

Rabies

Call-Exnor bodies : rosette-like structure resembling an ovarian follicle

Granulosa cell tumor

Captain's wheel

Paracoccidiomycosis

Catepillar cardiac myocytes in longitudinal section

Rheumatic fever

Charcot-Leyden crystals : refractile crystals seen in eosinophils

bronchial asthma

Chocolate cysts

endometriosis

Cigar shaped budding yeast

Sporothrix schencki

Clue cells : epithelial cells w adherent bacteria

Gardnerella vaginitis

Councilman bodies : eosinophillic inclusions w/i dying hepatocytes

Yellow fever

Crescents in Bowman's capsule

rapidly progressive [crescentic] glomerulonephritis

Darkfield microscopy

Treponemes; syphilis

Dimorphic yeast sperules with endospores

Coccidioides immitis

Dohle bodies : dilated endoplasmic reticulum, appears as gray cytoplasmic inclusion

Seen in activated neutrophils during acute inflammation.

Donovan bodies : organism ladden histiocytes

granuloma inguinale

Epitheloid cells : epithelial looking cells on H&E

activated macrophages as in granulomas

Ferruginous bodies

Asbestosis

Flea bitten kidney

Malignant HTN

Fried egg

Mycoplasma pneumoniae

Oligodendroglioma

Fruiting bodies and branching septate hyphae

Aspergilus

Gaucher's cell : Crinkled paper enlarged cytoplasm

Gaucher's dis.; glucocerebrosidase

Ground glass nuclei

Papillary CA of thyroid

Heavily encapsulated yeast

Cryptococcus neoformans

Heinz bodies : denatured hemoglobin

G6PDH deficiency

Helmit cell : deformed rbc

TTP

Hemolysis - alpha incomplete /green

Strep. pneumoniae

Viridans streptococci

Hemolysis - beta complete /clear

Strep. pyogenes

Strep. agalactiae

Staph. aureus

Listeria monocytogenes

Hemolysis - gamma none

Enterococcus

Peptostreptococcus

Hemolysis - double zone

Clostridium perfringens

Hirano bodies : intracytoplasmic actin inclusions (eosinophilic rods)

Alzheimer's

Homer Wright rosettes : "small cells" surrounded by fibrillary processes

Neuroblastoma

Howell Jolly cells : RBCs w nuclear remnants

Splenectomy

Hgb SS

Hydatid sand : brood capsule full of silicates

Echinococcosis; sheep herder's disease

Hypochromic Microcytic RBCs

iron deficiency anemia

Ito cell : stores vitamin A

Causes fibrosis of liver  cirrhosis

Joint mice

Osteoarthritis

Keratin pearls

Squamous cell carcinome

Kimmelstein-Wilson lesions : peripheral nodules of glomeruli

diabetic nephropathy

Koilocytes : expanded epithelial cells with perinuclear clearing

HPV

Kulchitski cells

APUD tumors; carcinoid tumor, small cell CA

Lewy bodies : eosinophillic inclusions of ubiquinated neurofilaments in substancia nigra cells

Parkinson's

Lines of Zahn

arterial thrombus

Lumpy-bumpy IF glomeruli

poststreptococcal glomerulonephritis

Mallory bodies : intracytoplasmic eosinophillic inclusions of ubiquinated keraitn intermediate filaments

Alcoholic hepatitis

Masson bodies : clumps of Mac digested debris

Bacterial pneumonia

Media - Bordet Gengou agar

bordetella pertussis

Media - Buffered charcoal yeast extract

legionella pneumophila

Media - Campy agar

campylobacter jejuni

Media - charcoal blood agar with cephalexin

bordetella pertussis

Media - chocolate agar w/ V, X

H. influenza

Media - Eaton's agar

Mycoplasma pneumoniae

Media - EMB metallic green sheen

Escherichia coli

Media - Hektoen enteric media

inhibits gram positives

Media - Loffler's coagulated serum media

corynebacterium diptheriae

Media - Lowenstein-Jensen media

mycobacterium tuberculosis

Media - MacConkey [pink colonies]

Escherichia

Klebsiella

Enterobacter

Media - Mannitol salt agar

Staph aureus [ferments]from other staph

Media - Sabouraud's

Fungi

Media - Salmonella-Shigella (bile salt and sodium citrate)

Media - Skirrow agar

campylobacter jejuni

Media - Tellurite agar

corynebacterium diptheriae

Media - Thayer-Martin chocolate agar

neisseria

Metachromatic granules

Corynebacteria diptheria

Michaelis-Gutmann bodies : sheroidal structures of calcium phosphate

Malakoplakia

Motility on wet prep pear-shaped organisms

Trichomonas

Motility, Swarming

Proteus mirabilis

Motility, Tumbling

Listeria

Mucoid capsule

Klebsiella

Multinucleated squamous cells w intranuclear inclusion

HSV

Negri bodies : eosinophilic, cytoplasmic inclusions in neurons

Rabies

Neuritic plaques

Alzheimer's

Neurofibrillary tangles : intracytoplasmic microtubule inclusions

Alzheimer's

Nissl bodies

rough ER [in neurons]

Nutmeg liver

Congestive Heart Failure

Orphan Annie nuclei : hypochromatic nuclei

Papillary carcinoma of thyroid

Owl's eye cardiac myocytes in cross section

Rheumatic fever

Owl's eye inclusions : nuclear inclusion surrounded by a halo

CMV

Peripheral Blood Smear - anucleate, biconcave

rbc

Peripheral Blood Smear - clock face chromatin

Plasma cell

Peripheral Blood Smear - frosted glass cytoplasm w/ kidney shaped nucleus

Monocyte

Peripheral Blood Smear - granules w/ bilobate nucleus

Eosinophil, Basophil

Peripheral Blood Smear - granules w/ multilobulated nucleus

Neutrophil

Peripheral Blood Smear - Hypersegmented neutrophils

Megaloblastic anemia; B12 or folate deficiency

Peripheral Blood Smear - scant cytoplasm w/ round dense nucleus

Lymphocyte

Pick's bodies : round intracytoplasmic inclusions of neurofilaments

Pick's disease

Pigment - Anthracotic (coal dust)

Black.

Nml in alveolar macrophages.

Pigment - bilirubin

Breakdown of Hb.

Hemolytic anemia, hepatitis, gall stone.

Pigment - Hematin

Black, crystalline ferric Hb.

Malaria, autoimmune hemolytic anemia.

Pigment - Hemosideron

Packets of ferritin.

Hemochromatosis, hemosiderosis, left heart failure, anemia of chronic disease.

Pigment - homogentisate

Black. Found in joints, cartilage, urine. Alcaptonuria.

Pigment - lipofuscin

Yellow-brown granular pigment of "wear-n-tear".

Nml aging, free radical damage.

Pigment - Melanin

 ACTH overproduction (Addison's), Nevi, Malignant melanoma.

 Albinism, Vitiligo, seen in PKU

Pigment production

Yellow - gold

Blue-green

Red

Staph. aureus

Pseudomonas aeruginosa

Serratia marcescens

Polygonal clear cells

Renal cell carcinoma

Psammoma bodies : calcified necrotic tumor cells

Papillary adenocarcinoma of thyroid

Serous papillary cystadenocarcinoma

Meningioma

Mesothelioma

Pseudopalisades

Glioblastoma multiforme

Red inclusions in endocervical cells

Chlamydia

Red snappers on acid fast staining

Tuberculosis

Reed-Sternberg cells : binucleat cells w prominate inclusion like nucleoli

Hodgkin's Disease

Reid Index [increased]

chronic bronchitis

Reinke crystals

Leydig cell tumor

Rouleaux formation : RBCs stacked as poker chips

Multiple Myeloma

Schiller Duval bodies : papillary infoldings into cysts

Yolk sac tumor

Schistocyte

TTP

School of fish appearance on gram stain

Hemophilus ducreyi

Shaumann bodies : laminated calcifications w/I multinucleated giant cells

Noncaseating granuloma

Sarcoidosis

Signet ring cells : mucinous tumor cell

Stomach cancer

Krukenberd tumor

Smudge cell : fragile lymphocyte disrupted during slide prep.

CLL

Spaghetti and meatballs

Malassezia furfur

Spike and Dome IF glomeruli

Membranous glomerulonephritis

Spindle cells

Leiomyoma aka fibroid

Giant cell tumor

Fibrosarcoma

Synovial sarcoma

Spores

Fungi

Bacillus anthracis

Clostridium perfringens

Clostridium tetani

Stains - Acid fast

Mycobacteria

Stains - Giemsa

chromosomes (karyotyping)

Stains - H&E; blue [basic]

protein, nucleic acid, GAG, extracellular matrix, ergastoplasm

Stains - H&E; pink [acidic]

electrostatic charge, cytoplasm, collagen, reticular fibers, elastic fibers, basement membrane, decalcified bone

Stains - India Ink

Cryptococcus neoformans

Stains - Mallory's trichrome

collagen, cytoplasm, rbc

Stains - Nissl

Oligodendroglia

Stains - Osmium; black

lipids, phospholipids

Stains - PAS; magenta

carbohydrates, mucus, glycogen, basement membrane

Stains - Prussian blue

Hemosideron

Stains - Resorcin-Fuschin; dark

elastic material

Stains - Silver; black

reticular, basement membrane, Legionella

Starry sky

Burkitt's lymphoma [EBV]

Stomatocytes : RBCs w mouth

Alcoholism

Sulfur granules

Actinomycosis [A. israelii]

Target cells : mis-shapen RBCs

Thalassemia

Alcoholism

Liver disease

Tennis rackets

Histiocytosis X

Clostridium tetani

Tram-Track IF glomeruli

Membranoproliferative glomerulonephritis

Tzanck prep

Herpes family of viruses

Warthin-Finkeldey Giant cells

Measles

WBC casts

pyelonephritis

Weibel Palade bodies : granules contain vWF, adhesion molecules

nml in endothelial cells

Wire Loop IF glomeruli

Lupus nephropathy, type IV

Yeast w/ capsular halo

Cryptococcus neoformans