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Pontine Lesion

Pontine Lesion, large cystic lesion filled with grumous material within the right basis pontis
  This middle-aged patient presented with left-sided upper and lower extremity weakness. MRI demonstrated a 2.5 cm cystic ring-enhancing lesion in the pons. The patient’s condition deteriorated and they expired.  An autopsy was performed.   Which of the following would best complete the following sentence based on the gross (Figure #1) and microscopic (Figures #2 and #3 ) findings?  The patient has a history of ______. A. Bacterial sepsis B. Large hilar lung mass C. Multiple sclerosis D. Eating raw pork   Answer: Large hilar lung mass Figure #1 shows large cystic lesion filled with grumous material within the right...

Mycobacterial Infection

Mycobacterial Infection
Hematoxylin and eosin FFPE 100x original magnification Hematoxylin and eosin FFPE 100x original magnification   Acid Fast Stain (Kinyoun) FFPE 1000x oil immersion   This 45-year-old patient presented to the emergency department with left thigh and buttock pain of four months’ duration, and two weeks of fever (105oF) and chills. The patient's past medical history is significant for autoantibody-positive rheumatoid arthritis treated with mycophenolate mofetil and steroid, and recent findings of focal central disc herniation at L5-S1. The patient is reported to have traveled to Asia and India. Chest X-ray showed mild bibasilar atelectasis. MRI showed avascular necrosis of the...


ANCA-Associated Vasculitis, anti-neutrophil-cytoplasmic antibodies (ANCA) testing
Hematoxylin and eosin; 200x and 400x original magnifications   This 60-year-old patient presented with fevers and bilateral leg myalgias of one month’s duration. Laboratory studies demonstrate elevated ESR (120) and normal CPK. On physical examination, the patient had pain upon palpation of both calf muscles. Muscle biopsy was performed. Given the clinical history and features seen in the image, what additional laboratory test results would be best to request? A. ANCA B. Stool ova and parasites C. C-reactive protein D. RPR   Answer: ANCA The image shows the circumferential presence of mononuclear histiocytes within the wall of a small artery...

Oh baby!

oh baby, Arkana Tot, Nicki's baby shower
Oh baby, another Arkana Tot is on the way!  We showered our mom-to-be, Nicki, with all of the bows and diapers for baby Saylor. We can't wait to meet her!  

Node of Ranvier

Node of Ranvier, Neuro Notes, neuropathology
The patient is a 70-year-old male with recent bilateral foot drop. Laboratory studies showed normal/negative pANCA, cANCA, and MPO. His symptoms partially responded to treatment with prednisone. Nerve biopsy was performed to evaluate for vasculitis. What is the structure indicated by the arrow in the image? A. Internode B. Myelin incisure C. Traction artifact D. Node of Ranvier   Answer: Node of Ranvier Peripheral nerve “nodes of Ranvier” are small gaps between adjacent segments of myelin sheath formed by individual Schwann cells. The specialized regions are rich in voltage-gated sodium ion channels and act as “booster stations” for the rapid...

Dr. Rachelle Gietzen Finishes Her Renal Path Rotation

Dr. Rachelle Gietzen finishes her renal pathology rotation
Dr. Rachelle Gietzen has officially finished her renal path rotation at Arkana!   We were so thrilled to immerse her in the world of kidney pathology this past month. As the winner of the Arkana Renal Rotation Award, she’s headed home with a certificate of completion of her training, a cash award of $1000, and a gift of a renal pathology book. And of course, a new love of kidney pathology.   Interested in applying to our rotation? Find more info here -