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Pathology gallery 2

Invasive ductal carcinoma This slide shows invasive ductal carcinoma of the breast.  Ductal carcinoma is the commonest form of breast cancer accounting for 80% of all invasive tumours.  About half of all women have axillary nodal metastases at presentation.  Risk factors include age, age of menarche and menopause and parity. Spread is via the lymphatics to lung, liver and bone. The most important prognostic factors include tumour size, tumour grade and nodal status. 

Multiple myeloma This slide shows a bone marrow smear from a patient presenting with hypercalcaemia and bone pain.  The large cells are plasma cells and the diagnosis is multiple myeloma.  Myeloma is a monoclonal proliferation of bone marrow plasma cells.  Its associated with a plasma paraproteinaemia and Bence Jones (BJ) proteinuria.  About 15% of patients have BJ protein in their urine without a paraproteinaemia.  BJ proteinuria results from free IgG light chains.  The median survival for patients with myeloma is two years.

Hashimoto's thyroiditis This slide shows a diffuse lymphocytic and plasma cell infiltrate around the follicular structures of the thyroid gland.  The appearances are those of Hashimoto's thyroiditis.  This is an autoimmune disease which produces a diffuse goitre.  Serum anti-thyroglobulin and anti-microsomal antibodies are raised.  The natural history of the disease results in diffused fibrosis and hypothyroidism.  The risk of thyroid lymphoma is increased

Transitional cell carcinoma This slide shows a papillary lesion biopsied from the wall of the bladder.  The epithelium is clearly transitional in nature and the appearances are those of a transitional cell carcinoma. TCCs can occur at any site within the urinary tract.  They are often the result of filed changes within the epithelium.  Well defined carcinogens have been identified including beta-naphthylamine.  



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