color atlas of pediatric pathology - a. husain, j. stocker (demos, 2011)

Color Atlas of Pediatric Pathology Aliya N. Husain J. Thomas Stocker Color Atlas of Pediatric Pathology Aliya N. Husain, MD • J. Thomas Stocker, MD The Color Atlas of Pediatric Pathology covers the broad range of pediatric diseases that a pathologist will likely encounter and is written by well-known leaders in this field. Coverage includes both frequent and less commonly seen cases, and each discussion presents a concise summary of the salient features of the disease along with expertly selected, high-quality color images. The Color Atlas of Pediatric Pathology is a practical working resource for every pathologist who sees pediatric cases as well as the pathology trainee. The atlas features approximately 1,100 high-quality images as well as important staging and prognostic (including molecular) parameters. Features of the Color Atlas of Pediatric Pathology include: n Comprehensive coverage of both common and uncommon diseases in pediatric surgical pathology n Chapters presented by a recognized expert n Practical presentations: concise text highlights diagnostic features making the atlas an outstanding resource for the practitioner n 1,100 full-color images 1. Placenta 2. Congenital Malformation Syndromes 3. Infections 4. The Skin 5. Soft Tissue Lesions 6. Bone and Joints 7. The Heart 8. The Lung and Mediastinum 9. The Kidney 10. Female and Male Reproductive Systems 11. Gastr ointestinal Tract 12. Liver, Biliary Tract, and Pancreas 13. Thyroid, Parathyroid, and Adr enal Glands 14. Bone Marrow, Lymph Nodes, Spleen, and Thymus 15. Central Nervous System and Neuromuscular Diseases A Look Inside the Book 11 W. 42nd Street New York, NY 10036 www.demosmedpub.com Cover Design: Joe Tenerelli Recommended Shelving Category: Pathology About the Editors Aliya N. Husain, MD, Professor of Pathology, University of Chicago, Chicago, Illinois J. Thomas Stocker, MD, Uniformed Services University of the Health Sciences, F. Edward Hébert School of Medicine, Department of Pathology, Bethesda, Maryland Color Atlas of Pediatric Pathology Husain Stocker Color Atlas of Pediatric Pathology Color Atlas of Pediatric Pathology EDITORS Aliya N. Husain, MD Professor of Pathology University of Chicago Chicago, Illinois J. Thomas Stocker, MD Uniformed Services University of the Health Sciences F. Edward Hébert School of Medicine Department of Pathology Bethesda, Maryland NEW YORK Acquisitions Editor: Richard Winters Cover design: Joe Tenerelli Compositor: Absolute Service, Inc. Visit our website at www.demosmedpub.com © 2011 Demos Medical Publishing, LLC. All rights reserved. ISBN 978-1-933864-57-0 eISBN 978-1-935281-40-5 This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. Medicine is an ever-changing science. Research and clinical experience are continually expanding our knowl- edge, in particular our understanding of proper treatment and drug therapy. The authors, editors, and publisher have made every effort to ensure that all information in this book is in accordance with the state of knowledge at the time of production. Nevertheless, the authors, editors, and publisher are not responsible for errors or omis- sions or for any consequences from application of the information in this book and make no warranty, express or implied, with respect to the contents of the publication. Every reader should examine carefully the package inserts accompanying each drug and should carefully check whether the dosage schedules mentioned therein or the contraindications stated by the manufacturer differ from the statements made in this book. Such examination is particularly important with drugs that are either rarely used or have been newly released on the market. Library of Congress Cataloging-in-Publication Data Color atlas of pediatric pathology / editors, Aliya N. Husain, J. Thomas Stocker. p. ; cm. Includes bibliographical references and index. ISBN 978-1-933864-57-0 1. Pediatric pathology—Atlases. I. Husain, Aliya N. II. Stocker, J. Thomas. [DNLM: 1. Pathologic Processes—Atlases. 2. Pediatrics—Atlases. WS 17] RJ49.C65 2011 618.92’007—dc22 2010052842 11 12 13 14 5 4 3 2 1 Special discounts on bulk quantities of Demos Medical Publishing books are available to corporations, profes- sional associations, pharmaceutical companies, health care organizations, and other qualifying groups. For details, please contact: Special Sales Department Demos Medical Publishing 11 W. 42nd Street, 15th Floor, New York, NY 10036 Phone: 800–532–8663 or 212–683–0072; Fax: 212–941–7842 E-mail: rsantana@demosmedpub.com Printed in the United States of America by Bang Printing For my family, Shaghil, Ameena, Ayesha, and Omar: Balancing work and home would not be possible without your understanding, support, and encouragement. Aliya N. Husain vii Preface ix Contributors xi 1. PLACENTA 1 Raymond W. Redline 2. CONGENITAL MALFORMATION SYNDROMES 29 Nicole A. Cipriani and Aliya N. Husain 3. INFECTIONS 43 David M. Parham 4. THE SKIN 57 Vijaya B. Reddy 5. SOFT TISSUE LESIONS 79 Zhongxin Yu and David M. Parham 6. BONE AND JOINTS 103 Karen S. Thompson 7. THE HEART 123 Bahig M. Shehata and Charlotte K. Steelman 8. THE LUNG AND MEDIASTINUM 147 J. Thomas Stocker and Aliya N. Husain  9. THE KIDNEY 177 Anthony Chang, Neeraja Kambham, and Elizabeth J. Perlman 10. FEMALE AND MALE REPRODUCTIVE SYSTEMS 207 Michael K. Fritsch and Elizabeth J. Perlman 11. GASTROINTESTINAL TRACT 235 J. Thomas Stocker, Haresh Mani, and John Hart 12. LIVER, BILIARY TRACT, AND PANCREAS 265 Haresh Mani and J. Thomas Stocker Contents viii CONTENTS 13. THYROID, PARATHYROID, AND ADRENAL GLANDS 319 John Hicks 14. BONE MARROW, LYMPH NODES, SPLEEN, AND THYMUS 373 Andrea M. Sheehan 15. CENTRAL NERVOUS SYSTEM AND NEUROMUSCULAR DISEASE 401 Peter Pytel Index 419 ix Pediatric pathology is distinct from adult pathology in many ways: types of diseases, genetic and molecular defects, therapies (including side effects and long-term complications), and outcomes. This is not only because of congenital malformations but also because infections and tumors that affect children are not the same as those seen in adults. One example is Wilms tumor, which is relatively com- mon in children but exceedingly rare in adults, with diagnostic and staging parameters distinct from adult renal tumors, and a cure rate of over 95%. Thus, pediatric pathology has been a boarded subspe- cialty in the United States and Canada since 1991. The majority of pediatric pathologists work in chil- dren’s hospitals; however, more than half of the pediatric cases are being seen by “general pathologists” in various practice settings. Thus, there continues to be a need for all pathologists to keep current in their diagnostic skills and knowledge of pediatric pathology and this atlas has been written with those residents, fellows, and general pathologists in mind. It is meant to serve as a handy reference for people who see pediatric cases infrequently and may have no special expertise in the subject. It cannot replace a comprehensive textbook; rather it should be used in addition to one. For years, one of us (JTS) had wanted to use his extensive collection of photographs to illustrate an atlas of pediatric pathology. You may wonder why such a book is needed in this age of “Google pic- tures.” We think there is considerable value to the student as well as the practicing pathologist to see illustrations selected by “experts,” such as the chapter authors in this book. In addition, the accompa- nying text concisely summarizes the pertinent features of each disease. Thus, rather than sifting through the thousands of items brought up in nanoseconds by any of the search engines, one can turn to an atlas such as this when faced with an uncommon or rare diagnostic specimen. The Color Atlas of Pediatric Pathology is organized in a traditional manner with each chapter devoted to a specifi c organ system. The authors for each chapter were chosen for their knowledge, and were asked to cover common as well as selected uncommon diseases that every pathologist would need to know about. Because this is an atlas, the focus is on illustrations with supporting text; only selected references are given. This book brings together the experience and expertise from many institutions, which add to its value. As with any multi-author book, there is some variation in how each chapter is written and illustrated. We hope our readers will fi nd the Color Atlas of Pediatric Pathology to be a valuable resource in their diagnoses of pediatric cases. Acknowledgments: Pictures are from the teaching collections of several pathologists and university hospitals; many are thanks to the diligence of past residents and fellows who are unnamed but not forgotten. Preface [...]... MD, DDS, MS, PhD Professor of Pathology Texas Children’s Hospital and Baylor College of Medicine Houston, Texas Aliya N Husain, MD Professor of Pathology University of Chicago Chicago, Illinois Neeraja Kambham, MD Associate Professor of Pathology Co-Director, Renal Pathology Laboratory Stanford University Medical Center Stanford, California Haresh Mani, MD Assistant Professor of Pathology Penn State... Department of Pathology University of Chicago Medical Center Chicago, Illinois Vijaya B Reddy, MD Professor of Pathology Rush University Medical Center Chicago, Illinois Raymond W Redline, MD Department of Pathology Case Western Reserve University Cleveland, Ohio Andrea M Sheehan, MD Assistant Professor of Pathology and Immunology Assistant Professor of Pediatrics, Section of Hematology-Oncology Texas... Associate Professor of Pathology University of Chicago Medical Center Chicago, Illinois Nicole A Cipriani, MD Department of Pathology University of Chicago Medical Center Chicago, Illinois Michael K Fritsch, MD, PhD Associate Professor of Pathology Northwestern University Feinberg School of Medicine Children’s Memorial Hospital Chicago, Illinois John Hart, MD Professor of Pathology The University of Chicago... and Penn State College of Medicine Hershey, Pennsylvania David M Parham, Pediatric MD Professor Department of Pathology University of Oklahoma Health Science Center Oklahoma City, Oklahoma Elizabeth J Perlman, MD Head, Pathology and Laboratory Medicine Arthur C King Professor of Pathology and Laboratory Medicine Professor of Pathology Northwestern University Feinberg School of Medicine Children’s Memorial... Baylor College of Medicine Houston, Texas Bahig M Shehata, MD Professor of Pathology and Pediatrics Emory University School of Medicine Department of Pathology Children’s Healthcare of Atlanta Atlanta, Georgia xi xiiâ•… Contributors Charlotte K Steelman, BS Emory University School of Medicine Children’s Healthcare of Atlanta Atlanta, Georgia J Thomas Stocker, MD Uniformed Services University of the Health... Sciences F Edward Hébert School of Medicine Department of Pathology Bethesda, Maryland Karen S Thompson, MD Associate Professor of Pathology John A Burns School of Medicine, University of €Hawaii Pediatric Pathologist, Pan Pacific Pathologists, LLC Kapiolani Medical Center for Women and Children Honolulu, Hawaii Zhongxin Yu, MD Assistant Professor Department of Pathology University of Oklahoma Health Science... development over a 3-week period in association with accelerating maternal hypertension (40) Localized PVF plaques have no known clinical significance (41) MATERNAL VASCULAR LESIONSâ•… Pathology Gross: Diagnosis of massive PVF deposition requires documentation of consolidation affecting at least 20% of the villous parenchyma and/or thickening of 50% of the basal plate The majority of placentas are small... vacuolated pigment-laden macrophages in the dense fibrous connective tissue of the chorionic plate 21 22â•… Placenta Microscopic: Abundant pigment-laden macrophages are seen in the dense fibrous stroma of the chorionic plate (Figure 1.31) Macrophages may also be observed in the wall of large chorionic plate vessels There is often extensive perivascular condensation of the loose connective tissue of Wharton’s... abutting the basal plate Infarcts of less than 1- to 2-day duration are dark red Those that are more remote, pale yellow Centrally hemorrhagic villous infarcts need to be distinguished from intervillous thrombi (IVT) by microscopy Microscopic: The hallmarks of villous infarction are collapse of the intervillous space with widespread agglutination of villi and evidence of ischemic necrosis in the trophoblastic... presence of ill-defined aggregates of intervillous fibrin Clinical presentation: MMP is the most common cause of FGR and an important cause of idiopathic preterm delivery (33) It is commonly seen in association with preeclampsia, especially in preterm placentas, and is a nonspecific finding in some chromosomal abnormalities Pathology Gross: Placentas with villous changes consistent with MMP are often . Color Atlas of Pediatric Pathology Aliya N. Husain J. Thomas Stocker Color Atlas of Pediatric Pathology Aliya N. Husain, MD • J. Thomas Stocker, MD The Color Atlas of Pediatric Pathology. Edward Hébert School of Medicine, Department of Pathology, Bethesda, Maryland Color Atlas of Pediatric Pathology Husain Stocker Color Atlas of Pediatric Pathology Color Atlas of Pediatric Pathology EDITORS Aliya. Cataloging-in-Publication Data Color atlas of pediatric pathology / editors, Aliya N. Husain, J. Thomas Stocker. p. ; cm. Includes bibliographical references and index. ISBN 97 8-1 -9 3386 4-5 7-0 1. Pediatric pathology Atlases.