Ditzels

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This article collects ditzels, which are, in the context of pathology, little specimens that are typically one or two slides and usually of little interest.[1]

A list of ditzels

Gastrointestinal

Neuropathology

  • Vertebral disc - see spine.

Pediatric

Orthopaedic

Head and neck pathology

  • Tonsil.

Cardiovascular pathology

Gastrointestinal

Hernia sac

General

  • Hernia repair.
  • Pathologic findings are very usual and if present known to the surgeon.
    • Thus, it has been advocated that one ought not examine 'em.[2][3]

Microscopic

Features:

  • Fibrous tissue.
  • +/-Adipose tissue.
  • +/-Mesothelial cells.

Notes:

  • One should not see vas deferens.
  • Things worthy of some comment: granulation tissue, inflammation.

Stoma

See: Colon and Small intestine.

General

  • Reversal of ileostomy or colostomy.

Microscopic

Features:

  • Colonic-type or small intestinal-type bowel wall.
    • Lymphoid hyperplasia (abundant lymphocytes) - very common.
    • +/-Fibromuscular hyperplasia of the lamina propria and submucosa.
  • Skin.

Notes:

Pediatric

Bands of Ladd

General

  • Associated with intestinal malrotation.
  • Removed by Ladd's procedure.

Microscopic

Features:

  • Benign fibrous tissue.

Cholesteatoma

General

  • Squamous epithelium in the middle ear - leading to accumulation of keratinaceous debris.[4]
    • Keratosis obturans - accumulation in the external ear canal - is considered to be a different process;[5] though some consider it a synonym.[6]

Microscopic

Features:[7]

  • Keratinaceous debris - key feature.
  • Squamous epithelium.
  • Macrophages +/- giant cell (containing keratinceous debris).
  • Chronic inflammation (lymphocytes).

DDx:

  • Cholesterol granuloma.[8]

Genitourinary pathology

Foreskin

Main article: Penis

General

Indications:

  • Phimosis.

Main considerations:

Microscopic

Features:

  • Usu. fibrotic dermis.
  • +/-Inflammation.

DDx:

Paraurethral cyst

General

  • Rare.
  • Benign.

Clinical:[9]

  • Presentation: mass lesion, dyspareunia or dysuria.
  • Multipareous.

Microscopic

Features:

  • Cystic space with epithelial lining - diagnosis based on epithelial lining.

Subclassification:[10][11]

Head and neck pathology

Tonsillitis

General

  • Commonly removed (tonsillectomy) when enlarged.

Microscopic

Features:

  • Follicular hyperplasia.

Note:

  • Signed-out as reactive lymphoid hyperplasia.

Cardiovascular pathology

Leg amputation

General

Comes in two basic flavours:

  • Above the knee ampuation.
  • Below the knee ampuation.

Sections:

  • Resection margin (check for viability).
  • Gangrenous area.
  • Blood vessels.
  • Bone (check for osteomyelitis).

Microscopic

Features:

See also

References

  1. ↑ Weedman Molavi, Diana (2008). The Practice of Surgical Pathology: A Beginner's Guide to the Diagnostic Process (1st ed.). Springer. pp. 37. ISBN 978-0387744858.
  2. ↑ Siddiqui K, Nazir Z, Ali SS, Pervaiz S (February 2004). "Is routine histological evaluation of pediatric hernial sac necessary?". Pediatr. Surg. Int. 20 (2): 133–5. doi:10.1007/s00383-003-1106-2. PMID 14986035.
  3. ↑ Partrick DA, Bensard DD, Karrer FM, Ruyle SZ (July 1998). "Is routine pathological evaluation of pediatric hernia sacs justified?". J. Pediatr. Surg. 33 (7): 1090–2; discussion 1093–4. PMID 9694100.
  4. ↑ URL: http://www.harrisonspractice.com/practice/ub/view/Harrisons%20Practice/141015/all/otitis_media_and_mastoiditis. Accessed on: 16 March 2011.
  5. ↑ Piepergerdes MC, Kramer BM, Behnke EE (March 1980). "Keratosis obturans and external auditory canal cholesteatoma". Laryngoscope 90 (3): 383–91. PMID 7359960.
  6. ↑ Shire JR, Donegan JO (September 1986). "Cholesteatoma of the external auditory canal and keratosis obturans". Am J Otol 7 (5): 361–4. PMID 3538893.
  7. ↑ Iino Y, Toriyama M, Ohmi S, Kanegasaki S (1990). "Activation of peritoneal macrophages with human cholesteatoma debris and alpha-keratin". Acta Otolaryngol. 109 (5-6): 444–9. PMID 1694387.
  8. ↑ URL: http://path.upmc.edu/cases/case273/dx.html. Accessed on: 14 January 2012.
  9. ↑ Isen, K.; Utku, V.; Atilgan, I.; Kutun, Y. (Aug 2008). "Experience with the diagnosis and management of paraurethral cysts in adult women.". Can J Urol 15 (4): 4169-73. PMID 18706145.
  10. ↑ Satani, H.; Yoshimura, N.; Hayashi, N.; Arima, K.; Yanagawa, M.; Kawamura, J. (Mar 2000). "[A case of female paraurethral cyst diagnosed as epithelial inclusion cyst].". Hinyokika Kiyo 46 (3): 205-7. PMID 10806582.
  11. ↑ Das, SP. (Jul 1981). "Paraurethral cysts in women.". J Urol 126 (1): 41-3. PMID 7195943.
  12. ↑ URL: http://webpathology.com/image.asp?n=3&Case=540. Accessed on: 5 February 2012.
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