Pathology Core Course
Spring Semester 1999
Duke Universitygraduate student course PTH250
Duke Universitymedical student course PTH200
Web Site designed and coordinated by Laura P. Hale, M.D. Ph.D.
send questions or comments to Dr. Hale at Hale0004@mc.duke.edu
last updated 2/26/99
Image 1 (liver, H&E, x400):
A 2.5 month old infant with a clinical history of immunodeficiency and fever, with negative cultures of urine and blood for bacteria.
Answer, Image 1
Image 2 (gross photograph):
A 38-week gestation infant was born alive after an uncomplicated vaginal delivery. The initial Apgar score was 6 (pulse 1, respirations 2, tone 1, reflex 1, color 1) with a heart rate of 100, which rapidly declined to asystole. Advanced cardiac life support was begun, however cardiac activity was not regained. An autopsy was performed.
Answer, Image 2
Image 3 (gross photograph):
A stillborn infant at 22 weeks gestational age.
Answer, Image 3
Image 4A (lung surface, gross):
Image 4B (lung, H&E, x400):
A 23 year old male with previous history of flank pain and hematuria developed a pleural effusion, respiratory distress, then asystole following treatment for his renal pathology. An autopsy was performed.
Answer, Image 4
Image 5 (soleus muscle, H&E, x400):
A 32 day old male infant with extreme hypotonia and little spontaneous movement.
Answer, Image 5
Image 6 (gross photograph, external abdomen)
A 2 year old child with a clinical history of perforated appendix and poor healing.
Answer, Image 6
Image 7 (gross photograph, umbilical cord at abdominal surface)
Intrauterine fetal death at 28 weeks gestation.
Answer, Image 7
Image 8 (gross photograph):
Twins A and B were stillborn at 17.5 weeks gestational age. Prior to death, Twin A (left) demonstrated polyhydramnios and Twin B (left) demonstrated progressive growth retardation and oligohydramnios.
Answer, Image 8
Image 9 (gross photograph):
A 34 year old male with hematuria and declining renal function.
Answer, Image 9
Image 10 (thymus, H&E, x66):
An infant with cardiac disease undergoing corrective cardiac surgery.
Answer, Image 10
Image 11 (lung, H&E, x33):
A 4 month old infant with acute respiratory distress.
Answer, Image 11
Image 12A (bone marrow, H&E, x33)
Image 12B (bone marrow, H&E, x132)
A 55 year old Middle Eastern male with fever and fatigue.
Answer, Image 12
Image 13A (gross photograph, pleural surface)
Image 13B (pleural lesion, H&E, x66)
A 42 year old woman with metastatic breast cancer underwent high dose chemotherapy with autologous bone marrow support. She subsequently experienced fever, disseminated intravascular coagulation, and respiratory distress leading to death. An autopsy was performed.
Answer, Image 13
Image 14A (peripheral smear, Wright stain, x330)
Image 14B (bone marrow biopsy, H&E, x198)
Image 14C (flow cytometry)
A 45 year old male with anemia and fatigue.
Answer, Image 14
Image 15: (heart, H&E, x33)
A 76 year old woman with a history of hypertension, congestive heart failure, and atrial fibrillation developed hypotension of unknown etiology leading to her death. An autopsy was performed.
Answer, Image 15
Image 16: (heart, H&E, x132)
A 55 year old man developed cardiac arrest after dose nine of high-dose therapy with interleukin-2 for metastatic melanoma.
Answer, Image 16
Image 17A: (gross photograph, hilar lymph nodes)
Image 17B: (gross photograph, spleen)
A 33 year old man developed shortness of breath, which progressed to asystole in the emergency room. A toxicology screen was negative for ethanol, cocaine, and morphine. A full autopsy was performed. Gross examination revealed marked lymphadenopathy involving thoracic, periaortic (abdominal), and omental lymph nodes. The cut surfaces of these lymph nodes were gray-white, soft, and homogeneous ("fish flesh"). The spleen contained diffusely distributed white nodules, 0.2 cm in diameter.
Answer, Image 17
Image 18: (lung, H&E, x198)
An eleven year old girl with myelodysplasia was treated with high dose chemotherapy and umbilical cord blood transplantation. She developed rapidly progressive respiratory failure on day 39 post-transplant, leading to her death on day 43. An autopsy was performed.
Answer, Image 18
Image 19: (bladder, H&E, x66)
An 8 year old boy with acute lymphocytic leukemia in relapse was treated with high dose chemotherapy followed by umbilical cord blood transplantation. He subsequently developed hemorrhagic cystitis and respiratory failure.
Answer, Image 19
Image 20: (heart, H&E, x132)
A 42 year old man with a history of drug abuse was found collapsed at home. An autopsy was performed. The heart was enlarged (weight 796 grams, normal = 346 ± 40 grams), with left ventricular hypertrophy. Toxicology screen revealed cocaine <0.02 mg/L, ecgonine methyl ester 0.14 mg/L, and benzoylecgonine 1.7 mg/L. Ethanol, cocaethylene, codeine, morphine, and 6-monoacetylmorphine were not detected.
Answer, Image 20
Image 21A: (kidney, Masson trichrome, x400)
Image 21B: (kidney, immunofluorescence stain for IgG in green, x400)
Image 21C: (kidney, electron micrograph)
A renal biopsy was obtained from a 23 year old man with hematuria, acute renal failure, and hemoptysis.
Answer, Image 21
Image 22A: (kidney, PAS stain, x400)
Image 22B: (kidney, immunofluorescence stain for IgA in green, x400)
Image 22C: (kidney, electron micrograph)
A renal biopsy was obtained from a 14 year old adolescent male with intermittant hematuria and normal renal function.
Answer, Image 22
Image 23A: (kidney, methenamine silver stain, x400)
Image 23B: (kidney, Masson trichrome stain, x400)
Image 23C: (kidney, immunofluorescence stain for IgG in green, x400)
Image 23D: (kidney, electron micrograph)
A renal biopsy was obtained from a 63 year old woman with nephrotic syndrome (heavy proteinuria, hypoalbuminemia, and edema).
Answer, Image 23
Image 24A: (lung, H&E, x13)
Image 24B: (lung, H&E, x33)
A 75 year old male non-smoking woodworker complained of increasing shortness of breath and a single episode of hemoptysis.
Answer, Image 24
Image 25A: (colon, H&E, x33)
Image 25B: (colon, H&E, x132)
A 55 year old female with recent onset of bleeding with bowel movements and abnormal colonoscopy.
Answer, Image 25