1

Gross Specimen of the Spleen

The lesions seen in this specimen are infarcts, which are areas of ischaemic
necrosis due to loss of blood supply.
Describe the lesions.
Pale yellow ,wedge shape, at base of capsular of spleen
A

Gross Specimen (Cut Surface) of a Kidney showing 2 Infarcts (A)

1. Describe the lesions labeled A.

Lesion is a pale yellow , wedge shape located at capsule of kidney/near edge of kidney
2. State the morphological type of necrosis of these lesions.
Coagulative necrosis

A
B
Gross Specimen of the Heart (Cross Section)
The heart is from a patient who died from a heart attack.

1. Describe the abnormalities indicated A and B.

A)Hyperemia(conjestion of blood) region adjacent to pale lesion.
B)Pale area replacing normal cardiac muscle.
2. What is the most likely cause of the abnormalities seen in the heart?
Infarction.Loss of blood supply

Normal
Myocardium

Histological Section of the Heart - Very Low Power

Normal
Myocardium

Histological Section of the Heart - Low Power

1. Describe the abnormality indicated by A on the very low power

section of the heart.
A) Brighter red/pinkish color
2. Examine the areas marked by the arrow heads (corresponding to A in
the very low power view). Describe the abnormalities seen.
Homogenous cell with pink color compared to normal myocardium/loss of myocardium cellular
nucleus 3. Based on the gross and microscopic findings, what is the pathological
diagnosis?
Coagulative necrosis/myocardial cell necrosis

Gross Cut Specimen of the Brain

The lesion seen in the brain section is due to cerebral infarction (loss of blood
supply).

1. Describe the lesion.

yellow/discoloration,wedge shape/cheesy like,loss of normal architecture ,cystic space between lesion
2. What morphological type of necrosis does cerebral infarction cause?
Liquefactive necrosis
3. Name two other morphological types of necrosis.
Coagulative necrosis
Caseous necrosis

Gross Cut Section of the Lung

1. Describe the abnormalities seen in the upper and middle lobes of the lung.
Yellow color, cheese like lesion at upper and middle lobe of lung and some area with cystic
space in between
Histological examination of the affected lung tissue as well as microbiological
investigations showed that the patient suffered from pulmonary tuberculosis.
2. What type of necrosis is typical of tuberculosis?
Caseous necrosis

Specimen of an Amputated Foot

1. Describe the appearance of the foot.

Black discoloration of foot, ulcer at ankle of foot , sole of front part and toes on the foot
2. What is the diagnosis?
Dry gangrene
3. What is the aetiology of this condition?
Loss of blood supply to foot

Gross Specimen of the Liver - Cut Surface

The liver is from a 45 year old man who died in a motor vehicle accident. Post mortem
investigations confirmed that the deceased was drunk when the accident occurred and
chronic alcoholic intake was confirmed by the family.
Describe the gross appearance of the liver. Use the image of the normal liver (given
below) for comparison.
Orange yellow discoloration compared to normal.

Image of Normal Liver

Portal triad

Portal vein

Bile Duct
Histological Section of the Liver - Low Power

Histological Section of the Liver - Medium Power

1. What part (or structure) of the liver does A (circled) represent? Name the component
structures that can you identify within A?
Refer picture
2. Describe the main abnormality seen in the histological section of the liver.
Hepatocyte contain cytoplasmic vacuole
3. State the pathological diagnosis.
Fatty change

Gross Specimen of Lung showing the Pleural Surface

The lung specimen is from a 60-year-old coal miner who died from a heart attack.
1. Describe the abnormality seen in the lung.
Black streak between lobule of lung beneath pleura surface
2. What is the likely cause of the abnormality?
Accumulation of carbon/deposition of carbon

Histological Section of a Lymph Node - Medium Power

The histological section is that of a hilar lymph node obtained from the same
patient.
Describe the abnormality seen in the lymph node.

Massive infiltration of macrophages containing black and dark pigment.

Submucosa

Mucosa

Histological Section of the Wall of the Stomach - Medium Power

The section of the stomach is stained by hematoxylin and eosin. Describe the abnormality
seen in the submucosa and blood vessel wall (arrowed) of the stomach.
Pink : cytoplasm blue: nucleus

Histological Section of the Liver (H & E)

The histological specimen is from a 38-year-old man who presented with enlarged liver,
abdominal pain and abnormal skin pigmentation in the sun-exposed areas. Biochemical
testing showed that he has diabetes mellitus. A liver biopsy was performed as part of the
investigation.

Describe the microscopic changes in the section of the liver.

Deposition of granular brown (excess iron) pigment present within hepatocyte

10

Gross Specimen of Brain

Arachnoid
mater

Pia mater

Cerebral Cortex

Histological Section of the Brain - Low Power

The brain specimen is from a 55-year-old patient who died of bacterial meningitis.
1. Describe the abnormality seen in the gross specimen of the brain.
Large area of brain surface covered by pale yellow exudate
2. Describe the abnormalities seen in the histological section.
Infiltration of inflammatory cell in brain.Neutrophil infiltration.
3. State the morphological type of inflammation typically seen in bacterial meningitis.
Suppurative inflammation

11

Photograph of a Thumb

Low Power View of Cross Section of the Skin Lesion

The skin lesion on the thumb is due to scalding.

1. Identify the lesion.

Blister
2. Describe the microscopic abnormality of the skin.
Separation of epidermis from dermis
3. What is the abnormality due to?
Accumulation of serous fluid under epidermis layer

12

Normal
Lung Tissue
Consolidation

Gross Cut Section of Lung

Histological Section of the Lung - Low Power

Histological Section of the Lung - High Power

The lung specimen is from a patient who had pneumonia. The upper lobe of the lung is
normal while the lower lobe lung is consolidated due to the pneumonia.

1. The low power histological section of the lung is taken from the area of consolidation.
Describe the abnormality seen.
Compare to normal alveoli space, affected area loss of normal architecture , completely
filled with inflammatory cell
2. Describe the abnormalities seen in the high power image.
Massive infiltration of acute inflammatory cell.Alveoli wall has dilated, capillary filled with RBC
3. What morphological type of inflammation does this condition illustrate?
Suppurative inflammation

13

Exhibit A

Exhibit B

Gross Specimen of the Appendix

Histological Section of the Appendix

Normal Appendix
The appendix shown in Exhibit A is removed at surgery from a second year medical
student with right iliac fossa pain, fever and nausea. Examination of the gross and
microscopic specimens (Exhibit B) confirmed the diagnosis of acute appendicitis.

1. Describe the gross appearance of the appendix. Use the photograph of the normal
appendix for comparison.
Enlarged , appear congested
2. What type of inflammatory cells do you expect to find on the histological section?
Neutrophil due to acute appendictis
3. Name the complications that can occur in acute appendicitis.
Abscess formation/gangrene/rupture of appendix

14

Gross Specimen of Lung - Cut Surface

The lung specimen is from a patient who died from extensive tuberculosis. The cut
specimen shows multiple caseating granulomas which appear as rounded, irregularly
sized, tan coloured nodules. Some of the larger nodules appear to be necrotic.

Histological Section of the Abnormal Lung Tissue - Low Power

Histological Section of the Abnormal Lung Tissue - Medium Power

1. Describe the abnormalities in the low power image of the lung.

Multiple granuloma are present
2. Describe the lesion (circled) shown in the low power image of the lung.
Loss of normal architecture.
Surrounding necrotic area has multinucleated giant cell , massive infiltration of mononuclear
cell,epitheloid cell.

A
B

Histological Section of the Abnormal Lung Tissue - High Power

1. Identify the cells labeled A and B.

A:epitheloid cell B:giant cell
2. What is the origin of the cells labeled A?
Macrophages

15

Photograph of a Swelling on the Back

A Representative Histological Section of the Swelling

A 55-year-old man, who is a known diabetic, complained of a painful swelling on his
back. On examination, a large swelling (circled) was found.

1. Describe the findings on the histological section of the swelling.

Infiltration of inflammatory cell
2. What is the diagnosis?
Abscess which is localised collection of pus.Pus has neutrophil,dead cell,inflammatory exudate and bacteria
3. What is the most common cause of this condition?
Pyrogenic bacteria infection
4. If you are to examine the swelling, what features of the acute inflammatory reaction
would you find?
Redness , warm , pain

16

Gross Cut Section of the Lung

Histological Section of one of the Lesions Arrowed

The lung specimen is from a patient who died of pneumonia. Multiple abscesses are
present in the gross specimen of the lung.
1. What is an abscess?
Localised collection of pus/purulent inflammatory exudate
2. Describe the microscopic features of the abscess.
Numerous neutrophil, inflammatory polymorph surrounded by congested blood vessel.Intense
inflammatory exudate.

17

Lower Limb of a Diabetic Patient

This patient had diabetes mellitus for many years. This disease leads to marked
atherosclerosis with narrowing of the arteries with resultant ischaemia. When this
involves peripheral arteries to the legs, ischemia of soft tissues and bone occurs. In this
condition, minor trauma leads to ulceration that heals poorly and often becomes
secondarily infected. A transmetatarsal amputation has already been performed in this
patient because of the severity of peripheral vascular disease.
1. What is an ulcer?
Ulcer:local defect/excavation of surface of organ
2. Name two other locations/organs where ulcers most commonly occur.
Mouth , stomach , Gastrointestinal tract

18

Photograph of a Wound

Histological Section of the Wound

The photograph shows the gross appearance of a wound in the process of healing.
Histological features of the healing wound are demonstrated in the photomicrograph.

1. Identify and name the different cells seen in the histological section.
Granulation of tissue composed of inflammatory cell & fibroblast & edema & some RBC
2. Name the characteristic histological features of granulation tissue.
Component of granulation tissue : fibroblast , newly formed blood vessel , inflammatory cell
3. Name the stages of healing.
Secondary union heal by fibrosis
1) Formation of new blood vessels (angiogenesis)
2) 2) Migration and proliferation of fibroblasts
3) 3) Deposition of ECM (scar formation)
4) 4) Maturation and recognization of fibrous tissue (remodeling)
4. List the local conditions that can delay the process of wound healing
Infection , presence of foreign body , poor blood supply , ulceration

19
Photomicrograph A: Heart - Recent Infarct

Myocardium

Acute
inflammatory cells

Photomicrograph B: Heart - Healed infarct

Myocardium

Healed infarct comprising

fibrous tissue

A 59-year-old business man was brought-in dead to the Emergency Unit after suffering
from a severe left-sided chest pain. At autopsy the heart was found to be enlarged and the
left descending coronary artery was blocked. Sections through the left ventricle wall in
two different areas are shown.

1. Based on the history and pathological findings at autopsy, what is the most likely
cause of death in the patient?
Heart attack
2. Explain the pathogenesis of this condition.
Obstruction of blood vessel leading to necrosis of myocardiac cell
3. What microscopic features support the histological diagnosis of a healed infarct in
photomicrograph B
Scarring tissue

20
Photograph of a Skin Lesion

Histological Section of the Lesion

1. What is the lesion shown in the photograph?

Keloid
2. Describe the microscopic feature of the lesion.
Excessive formation of collagen tissue/fibroblast/fibrous tissue
3. What type of injury is this lesion commonly associated with?
Skin trauma , thermal injury