Cook R.A., Stewart B. Colour Atlas of Anatomical Pathology
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LYMPH
NODES
AND
SPLEEN
2
LYMPH
NODES
AND
SPLEEN
Fig.
2.3
Fig.
2.4
Fig.
2.1
Diffuse
malignant
lymphoma. M/73. This inguinal
lymph node shows complete obliteration
of its
normal
architecture
by
fleshy, homogeneous tumour tissue.
Fig.
2.2
Nodular
malignant
lymphoma. F/33. This axillary
lymph node
has its
normal architecture replaced
by
tumour tissue
showing
a
nodular pattern.
The
exact diagnosis
of
malignant
lymphomas must
be
made
by
microscopic examination.
Fig.
2.3
Burkitt's
lymphoma.
M/8
from Papua
New
Guinea.
This
lymphoma
is a
common tumour
in
children
in
Central Africa
and in
children
in
Papua
New
Guinea,
where
it is
associated with
the
presence
of
Epstein-Barr virus
in
tissue culture
of the
tumour
cells.
It
occurs less frequently
in
other parts
of the
world,
and
then
it is not
associated with
the
presence
of
Epstein-Barr
virus.
Fig.
2.4
Secondary
tumour
in a
lymph
node.
F/43.
The
node
is
replaced
by
black tumour tissue. Diagnosis
of the
type
of
secondary tumour depends
on
microscopic examination,
but
when
the
tumour
is
black
it is
very
likely
to be a
secondary
melanoma,
as
this
one
was.
Fig.
2.5
Spleen
in
malignant
lymphoma. F/70.
The
normal
architecture
of the
spleen
has
been replaced
by a
homogeneous
infiltration.
The
normal malpighian follicles cannot
be
seen. This
appearance
is
identical
for
both malignant lymphoma
and
leukaemia.
Fig.
2.6
Multiple
infarcts
in a
spleen
greatly
enlarged
by
malignant
lymphoma. F/61.
The
multiple areas
of
infarction
are
well
demarcated.
Fig.
2.7
Spleen
in
Hodgkin's
disease.
M/34. This spleen
was
removed during
a
laparotomy
for
staging
of
Hodgkin's
disease.
One
rounded deposit
was
found.
The
splenic deposits
of
Hodgkin's disease tend
to be
discrete
and
round, rather than
a
diffuse infiltration
as is
seen
in
non-Hodgkin's lymphomas.
Fig.
2.8
Spleen
in
Hodgkin's
disease.
A
more advanced
Hodgkin's disease than that
in
Figure 2.7. F/55.
There
are
multiple rounded, creamy, nodular deposits.
32
Fig.
2.1
Fig.
2.2
LYMPH
NODES
AND
SPLEEN
Fig.
2.5
Fig.
2.6
Fig.
2.7
Fig.
2.8
33
LYMPH
NODES
AND
SPLEEN
Fig.
2.9
Fig. 2.10
Fig.
2.9
Ruptured
spleen.
F/16. This
was a
result
of a
motor
traffic
accident. There
are
multiple
tears
in the
spleen, which
was
removed
to
stop
the
haemorrhage. Rupture
of a
spleen
of
normal
size
requires considerable force,
as in
this case.
In
countries where malaria
is
endemic,
splenomegaly (often
very
gross enlargement)
is
common. These spleens
are not
protected
by
the
ribcage
and
rupture occurs with relatively
little
trauma
to
the
abdomen. Spleens enlarged
as a
result
of
infectious
mononucleosis
and
leukaemia also rupture
as a
result
of
minor
trauma.
Fig. 2.10
Simple
cysts
in the
spleen.
F/61. These multiple
benign cysts were
an
incidental postmortem finding
and
caused
no
clinical symptoms.
Fig. 2.11
Perisplenitis.
M/71.
The
splenic capsule
is
covered
by
thick, white, fibrous plaques. This
is a
fairly
frequent
incidental postmortem finding.
Its
cause
is not
known.
Fig.
2.11
34
RESPIRATORY
SYSTEM
3
RESPIRATORY
SYSTEM
Fig.
3.3
Fig.
3.1
Acute
tracheobronchitis.
M/68.
The
mucosa
of the
trachea
is
reddened
and
streaked with pus.
The
patient died
from
the
respiratory infection.
Fig.
3.2
Acute
tracheitis
associated
with
the
presence
of
a
tracheostomy
tube.
F/56.
The
tracheal mucosa
is
reddened
and
there
is
mucosal ulceration adjacent
to the
vertical
tracheostomy opening.
The
ulceration
was
caused
by
irritation
from
the
inflated
bulb
of the
tracheostomy
tube.
Fig.
3.3
Candidiasis
of the
epiglottis.
M/19.
The
epiglottis
is
reddened from
the
acute inflammation
and at its tip
there
is a
green
membrane, which consisted
of
purulent exudate plus
the
hyphal forms
of
Candida.
The
patient died from acute leukaemia.
Fig.
3.4
Acute
epiglottitis.
M/4. This child
had a
sudden
onset
of
stridor leading quickly
to
respiratory obstruction
and
death.
The
epiglottis
is
acutely inflamed
and
swollen,
but no
other abnormality
was
found
at
postmortem. This condition
probably
has a
viral aetiology.
36
Fig.
3.1
Fig.
3.2
Fig.
3.4
RESPIRATORY
SYSTEM
Fig.
3.7
Fig.
3.5
Rhinoscleroma.
M/30. Patient from Papua
New
Guinea.
An
inflammatory tumour mass caused
by
Klebsiella
rhinoscleromatis
is
protruding
from
the
left
nostril.
The
nose
is
expanded
by the
tumour, which also filled
the
nasopharynx.
Fig.
3.6
Acute
pulmonary
oedema.
M/21.
The
trachea
is
filled with frothy oedema
fluid.
Both lungs were heavy,
and
similar fluid could
be
squeezed from their
cut
surfaces.
Fig.
3.7
Tracheopathia
osteoplastica.
M/70. There
are
multiple hard nodules
on the
mucosal surface
of the
trachea.
Microscopically, these consisted
of
cartilage.
Fig.
3.8
Nasal
polyps. F/10. These
two
polyps were removed
from
the
left nasal cavity. Such
polyps
are
fairly common
at all
ages
and are
inflammatory
in
origin.
37
Fig.
3.5
Fig.
3.6
Fig.
3.8
RESPIRATORY
SYSTEM
Fig.
3.9
Squamous
cell
carcinoma
of the
hypopharynx.
F/65.
Fig. 3.10 Squamous
cell
carcinoma
of the
larynx. M/71.
The
subglottic tumour
can be
seen
in the
laryngectomy
specimen.
The
patient presented with hoarseness.
Fig. 3.11 Squamous
cell
carcinoma
of the
larynx. M/64.
This
was
primarily
an
extrinsic carcinoma
of the
larynx arising
in
the
hypopharynx
and
compressing
the
larynx. There
is a
patch
of
leukoplakia adjacent
to the
tumour. Laryngectomy specimen.
Fig. 3.12 Pseudosarcoma
of the
larynx. M/44. This large,
polypoid tumour with
a
smooth surface
is
almost completely
obstructing
the
larynx.
Fig.
3.11
Fig.
3.12
38
Fig.
3.10
Fig.
3.9
RESPIRATORY
SYSTEM
Fig. 3.13
Fig.
3.14
Fig. 3.15
Fig. 3.13
Foreign
body (tablet) lodged
in the
hilum
of the
right
lung,
obstructing
the
middle
and
lower lobe bronchi. M/84. This
is
the
commonest site
for an
inhaled foreign body
to
become
impacted because
of the
anatomy
of the
bronchial tree. Inhaled
foreign
bodies
are
most frequently encountered
in
children about
the age of 2
years.
Fig. 3.14
Unusual
inhaled
foreign
body. M/2. This child
was
found
by his
parents covered
in his
mother's talcum powder.
Within
a few
hours
he
developed acute respiratory difficulty
and
died
3
hours later.
The
whole
of the
bronchial tree
was
filled with
thick,
semisolid material which
could
be
squeezed
out as
demonstrated.
The
powder contained silica,
and the
irritant
effect
of
this must have stimulated
the
secretion
of
mucus which
in
turn mixed with
the
powder
to
cause complete blockage
of
the
airways. This gross appearance
is
similar
to
that seen
in
chronic
bronchitis (Figure 3.27)
and
asthma (Figure 3.28).
Fig. 3.15
Inhalation
of
vomitus.
M/70.
The
trachea
and
bronchial tubes
are
filled with vomitus. This
was the
final cause
of
death
in a
debilitated
old
man.
39
RESPIRATORY
SYSTEM
Fig. 3.16
Fig. 3.17
Fig. 3.18
0 cm 1
40