Long power list

The long power list is a collection of diagnoses based on site and pathologic characteristics. It builds on the short power list.

Site

Breast pathology

Benign - common:

• Normal.
• Fibrocystic change.
• Apocrine metaplasia.
• Columnar cell change.
• Fibroadenoma.
• Phyllodes tumour.
• Intraductal papilloma.
• Florid epithelial hyperplasia.
• Sclerosing adenosis.

Benign - uncommon:

• Flat epithelial atypia.
• Complex sclerosing lesion.
• Breast abscess.
• Breast with fat necrosis.
• Microglandular adenosis.
• Collagenous spherulosis.
• Lactational change.
• Diabetic mastopathy.

Non-invasive:

• ADH.
• DCIS.
  • Subtypes: cribriform, solid, papillary, micropapillary.
• ALH.
• LCIS.

Invasive - epithelial:

• Invasive ductal carcinoma of the breast.
• Invasive lobular carcinoma.
• Papillary carcinoma of the breast.
• Invasive micropapillary carcinoma of the breast.
• Invasive cribriform carcinoma of the breast.
• Tubular carcinoma of the breast.
• Medullary breast carcinoma.
• Mucinous breast carcinoma.
• Metaplastic breast carcinoma.

Invasive - non-epithelial:

• Phyllodes tumour.
• Angiosarcoma.

Invasive - salivary gland-like:

• Adenoid cystic carcinoma of the breast.
• Carcinoma ex pleomorphic adenoma of the breast.

Cardiovascular pathology

General

• Thrombosis (embolism).
• Vasculitis.
  • Large vessel:
    • Giant cell arteritis.
    • Takayasu arteritis.
  • Medium vessel:
    • Polyarteritis nodosa.
    • Kawasaki disease.
  • Small vessel:
    • Microscopic polyangiitis.
    • Wegener granulomatosis.
    • Churg-Strauss syndrome.
    • Leukocytoclastic vasculitis.
• Amyloid deposition.
• Hyperplastic arteriolosclerosis.
• Fibromuscular dysplasia.

Aorta

• Atherosclerosis.
• Aortic dissection.
  • Cystic medial degeneration.
  • Traumatic dissection.
• Mycotic aneurysm.

Cardiac valves

• Infective endocarditis.
• Myxomatous degeneration.
• Papillary fibroelastoma.

Aortic valve

• Calcific aortic stenosis.

Mitral valve

• Rheumatic heart disease.

Tricuspid valve

• Nonbacterial thrombotic endocarditis (NBTE).

Heart

Common - benign:

• Atrial myxoma.

Uncommon - benign:

• Lipoma.
• Rhabdomyoma.

Uncommon - malignant:

• Pleomorphic undifferentiated sarcoma.
• Angiosarcoma.

Endocrine pathology

Thyroid gland

Benign:

• Nodular hyperplasia.
• Lymphocytic thyroiditis.

Malignant:

• Papillary thyroid carcinoma, follicular variant.

Uncommon - malignant:

• Papillary thyroid carcinoma, columnar cell variant.
• Papillary thyroid carcinoma, tall cell variant.
• Medullary thyroid carcinoma.
• Anaplastic thyroid carcinoma.

Adrenal gland

Benign:

• Adrenal cortical adenoma.
• Adrenal myelolipoma.
• Hemorrhagic adrenalitis (Waterhouse-Friderichsen syndrome).

Malignant:

• Adrenal cortical carcinoma.
• Pheochromocytoma.

Femoral head

Benign:

• Osteoarthritis.
• Avascular necrosis of the femoral head.
• Rheumatoid arthritis.

Uncommon - benign (fracture):

• Trauma.
• Osteoporosis.

Uncommon - benign pediatric:

• Slipped femoral capital epiphysis (SFCE).
• Legg–Calvé–Perthes syndrome.

Uncommon - malignant (fracture):

• Metastasis.

Gastrointestinal pathology

Appendix

Benign:

• Appendicitis.
• Periappendicitis.
• Crohn's disease.
• Normal.

Neoplasm:

• Neuroendocrine tumour.
• Low-grade appendiceal mucinous neoplasm (LAMN).

Malignant:

• Mucinous adenocarcinoma.

Gallbladder

Benign:

• Cholelithiasis.
• Cholesterolosis.
• Acute cholecystitis.
• Chronic cholecystitis.

Uncommon - pre-malignant:

• Intestinal metaplasia.

Uncommon - malignant:

• Adenocarcinoma.

Gastrointestinal polyp

Benign:

• Normal.
• Hyperplastic polyp.
• Inflammatory pseudopolyp (inflammatory bowel disease).

Pre-malignant:

• Tubular adenoma.
• Villous adenoma.
• Tubulovillous adenoma.
• Sessile serrated adenoma.

Uncommon - pre-malignant:

• Traditional serrated adenoma.

Stomach

Benign:

• Helicobacter pylori gastritis.
• Intestinal metaplasia.
• Chronic gastritis.
• Acute gastritis.

Pre-malignant:

• Gastric dysplasia.

Malignant:

• Adenocarcinoma, intestinal type.
• Signet-ring cell carcinoma.
• GIST.

Duodenum

Benign:

• Normal.
• Celiac disease.

Pre-malignant:

• Tubular adenoma.

Malignant:

• Adenocarcinoma.

Uncommon benign:

• Giardiasis.
• Whipple disease.
• MAI infection.

Liver

Benign:

• Steatosis.
• Steatohepatitis.
• Hepatitis B.
• Hepatitis C.

Malignant:

• Metastatic adenocarcinoma.
• Hepatocellular carcinoma.

Uncommon benign:

• Autoimmune hepatitis.
• Primary sclerosing cholangitis, esp. in the context of UC.
• Primary biliary cirrhosis.
• Wilson's disease.
• Hereditary hemochromatosis.
• Alpha-1 antitrypsin deficiency.

Uncommon malignant:

• Cholangiocarcinoma.

Genitourinary pathology

Tumour kidney

Benign:

• Normal.
• Renal oncocytoma.
• Angiomyolipoma.
• Papillary adenoma.

Malignant:

• Clear cell renal cell carcinoma.
• Papillary renal cell carcinoma.
• Chromophobe renal cell carcinoma.
• Urothelial carcinoma.

Uncommon - benign:

• Xanthogranulomatous pyelonephritis.

Medical kidney

• Diabetic nephropathy.
• Systemic lupus erythematosus.

Prostate gland

Benign:

• Normal.
• Chronic inflammation.
• Acute inflammation.
• Benign prostatic hyperplasia (prostectomy diagnosis only).

Malignant:

• Acinar adenocarcinoma.

Uncommon - malignant:

• Ductal adenocarcinoma.
• Urothelial carcinoma.

Urinary bladder

Benign:

• Inverted urothelial papilloma.
• Cystitis cystica.

Pre-malignant/malignant:

• Urothelial dysplasia.
• Papillary urothelial carcinoma, low grade.
• Papillary urothelial carcinoma, high grade.
• Flat urothelial carcinoma.

Uncommon - benign:

• Malakoplakia.
• Nephrogenic adenoma.

Gynecologic pathology

Uterus

Benign:

• Fibroids.
• Adenomyosis.
• Atrophy.
• Uterine prolapse.
• Proliferative phase endometrium.
• Secretory phase endometrium.

Pre-malignant:

• Complex endometrial hyperplasia.

Malignant:

• Endometrial carcinoma.
  • Endometrioid.
  • Mucinous.
  • Serous.

Uncommon - benign:

• Decidua (change of pregnancy).

Uncommon - malignant:

• Clear cell carcinoma.
• Carcinosarcoma.

Cervix - cytology

Benign:

• Normal.
• Candida.
• Endometrial cells.
• Atrophy.

Pre-malignant/malignant:

• LSIL.
• HSIL.
• Squamous cell carcinoma.
• Adenocarcinoma.

Uncommon - benign:

• HSV changes.
• Trichomonas.

Ovary

Benign:

• Serous cystadenoma.
• Mucinous cystadenoma.
• Mature teratoma.
• Endometriosis.

Malignant:

• Serous carcinoma.
• Endometrioid carcinoma.
• Mucinous carcinoma.

Uncommon - malignant:

• Dysgerminoma.

Fallopian tube

Benign:

• Paratubal cyst.
• Tubo-ovarian abscess.
• Salpingitis.
• Ectopic pregnancy.
• Adenomatoid tumour.

Malignant:

• Serous carcinoma.

Uncommon - benign:

• Salpingitis isthmica nodosa.

Head and neck

General

Benign:

• Sinonasal papilloma.
• Vocal cord nodule.

Malignant:

• Squamous cell carcinoma.
• Nasopharyngeal carcinoma.

Uncommon - malignant:

• Paraganglioma (carotid body tumour).

Salivary gland

Benign:

• Pleomorphic adenoma.
• Warthin tumour.

Malignant:

• Mucoepidermoid carcinoma.
• Adenoid cystic carcinoma.

Uncommon benign:

• Benign lymphoepithelial cyst.
• Basal cell adenoma.
• Canalicular adenoma.
• Oncocytoma.

Uncommon malignant:

• Acinic cell carcinoma.
• Polymorphous low grade adenocarcinoma.
• Carcinoma ex pleomorphic adenoma.
• Salivary duct carcinoma.
• Hyalinizing clear cell carcinoma.

Lymph node

Benign:

• Normal/resting.
• Follicular hyperplasia.

Malignant:

• Metastasis, esp. carcinoma.
• Follicular lymphoma.
• Diffuse large B cell lymphoma.
• Nodular sclerosis Hodgkin lymphoma.
• Mixed cellularity Hodgkin lymphoma.
• MALT lymphoma.

Pulmonary pathology

Benign:

• Normal.

Malignant:

• Adenocarcinoma.
• Squamous carcinoma.
• Small cell carcinoma.

Uncommon - benign:

• Tuberculosis.
• Sarcoidosis.
• Usual interstitial pneumonia.
• Solitary fibrous tumour - esp. pleural.

Uncommon - malignant:

• Mesothelioma.

Spleen

Benign:

• Trauma.
• Normal.
• Enlargement due to cirrhosis.

Malignant:

• Hairy cell leukemia.

Pathologic characteristics

Non-skin tumours with skin

• Salivary gland tumours.
• Breast tumours.

Nuclear features

Pseudostratified nuclei

Tumours that commonly have pseudostratified nuclei:

• Colorectal carcinoma.
• Endometrioid endometrial carcinoma.

Pseudoinclusions

Main article: Nuclear pseudoinclusions

Cytoplasmic features

Eosinophilic cytoplasm

• Squamous cell carcinoma.
• Oncocytoma/Oncocytic tumours.
• Apocrine tumours.

Clear cytoplasm

Main article: Clear cell tumours

Cells

Tumours with lymphocytes

• Seminoma.
• Acinic cell carcinoma.
• Nasopharyngeal carcinoma.
• Lymphoepithelioma-like carcinoma.
• Medullary breast carcinoma.

Giant cells

Main article: Giant cell lesions

Many eosinophils

• Infection.
• Inflammatory fibroid polyp.
• Hodgkin lymphoma.
• Churg-Strauss syndrome.
• Langerhans cell histiocytosis.
• Kimura disease.

Site specific:

• Eosinophilic esophagitis.
• Pulmonary Langerhans cell histiocytosis.
• Angiolymphoid hyperplasia with eosinophilia (ALHE) - skin.

Structures

Psammoma bodies

Main article: Psammoma bodies

Myxoid lesions

Main article: Myxoid lesions

Architecture

Classically nested

• Paraganglioma.
• Meningioma.
• Brenner tumour.
• SCTAT.

Stroma rich tumours

• Cholangiocarcinoma.
• Fibrolamellar hepatocellular carcinoma.
• Mesothelioma - lung.
• Hyalinizing trabecular tumour - thyroid.
• Hyalinizing clear cell carcinoma - salivary gland.

Spindle cell lesions

Main article: Spindle cell lesions

Neuropathology

• Schwannoma.
• Gliosarcoma.

Frustration list

If the pathology isn't apparent...

• Angiosarcoma.
• Amyloidosis.
• Neurofibroma.
• Granular cell tumour.
• Pheochromocytoma.
• Plasma cell neoplasm.
• Adenomatoid tumour.

For CNS specimens:

• Meningioma.

Head & neck:

• Myoepithelioma.

See also

• Short power list.
• Diagnoses.