UNIVERSITY OF NOVI SAD FACULTY OF MEDICINE

A PRACTICAL
HANDBOOK OF
MACROSCOPIC
EXAMINATION IN
PATHOLOGY
Milana Panjković
AUTHORS

Prof.dr Živka Eri

Prof.dr Zdravko Kosjerina
Prof.dr Nada Vučković
Prof.dr Dejan Vučković
Prof.dr Slavica Knežević Ušaj
Assoc. Prof. dr Milana Panjković
Assist. Prof dr Tatjana Ivković Kapicl
Assist Prof. dr Sandra Trivunić
Assist. Prof. dr Mirjana Živojinov
Assist. Prof. dr Zoran Nikin
Asist.dr.Aleksandra Lovrenski (PhD)
Asist.dr Dragana Tegeltija
Asist.dr Nenad Šolajić
Asist.dr Golub Samardžija
Asist. dr Tanja Lakić

Proofreader

Prof. dr Tibor Tot MD, PhD, Falun Sweden

Lector

Stanka Matejašev

CONTENT

2
1. Abscessus cerebri, Brain abscess (7)…………………………………………..7
2. Adenocarcinoma renis, Renal adenocarcinoma (35)………………………...8
3. Amyloidosis lienis, Amyloidosis of the spleen (6)……………………………..9
4. Aneurysma arteriae basilaris cerebri, Aneurism of basilar artery of the brain
(78)………………………………………………………………………..10
5. Anthracosis lymphonodorum bronchopulmonalium et pulmonis,
Anthracosis of the lung and bronchopulmonary lymph nodes (11)………..11
6. Atherosclerosis arteriarum baseos cerebri, Atherosclerosis of the arteries at
the base of the brain (10)……………………………………………………...12
7. Atrophia e comressione hepatis, Atrophy of the liver due to compression (1)
…………………………………………………………………………….…13
8. Bronchectasiae cylindricae lobi inferioris pulmonis sinistri, Cylindrical
bronchiectasis in lower lobe of left lung (51)………………………………...14
9. Carcinoma bronchi lobi superioris pulmonis infiltrans mediastini,
Bronchial carcinoma of upper pulmonary lobe with infiltration of
mediastinum (90)……………………………………………………………...15
10. Carcinoma exophyticum intestine crassi, Exophyting carcinoma of the large
intestine (91)…………………………………………………………………….16
11. Carcinoma exulceratum mammae, Ulcerating breast carcinoma (34)…….17
12. Carcinoma exulceratum ventriculi, Ulcerated gastric carcinoma (75)…..…18
13. Carcinoma glandulae thyreoideae, Carcinoma of the thyroid gland (38)…19
14. Carcinoma metastaticum corporis vertebrae thoracalis, Metastatic
carcinoma of thoracic vertebral bodies (42)…………………………………20
15. Carcinoma papillare renis, Papillary carcinoma of the kidney (64)…….....21
16. Carcinoma stenosans intestine crassi, Stenosing carcinoma of the large
intestine (76)……………………………………………………………...……..22
17. Cicatrix cutis, Skin scar (17)……………………………………………….…23
18. Cirrhosis micro- et macronodularis hepatis, Micro- and macronodular liver
cirrhosis (72)………………………………………………………………..…..24
19. Complexus primaries tuberculosis pulomonis, Primary complex of
pulmonary tuberculosis (23)………………………………………………….25
20. Contentum sanguineum vesicae urinariae, Hemorrhagic content of the
urinary bladder (62)………………………………………………….……….26
21. Cystes congenitalis ovarii bilateralis, Congenital bilateral ovarian cysts (96)
………………………………………………………………………….…..27
22. Cystes retentions renis, Retention cysts of the kidney (57)…………………28
23. Cystis hydatidosa lienis; Atrophia e compressione lienis, Hydatid cyst of the
spleen; Atrophy of the spleen due to compression (2)………………………29
24. Diverticulosis intestini tenuis, Diverticulosis of the small intestine (70)……30

3
25. Diverticulum Meckeli intestine tenuis, Meckel's diverticulum of the small
intestine (69)……………………………………………………………….......31
26. Embolia thrombotica recens trunci pulmonalis et arteriarum pulmonalium,
Recent thromboembolism of pulmonary trunk and pulmonary arteries (14)
……………………………………………………………………………...32
27. Endocarditis bacterialis, Bacterial endocarditis (54)……………………….33
28. Epicarditis, fibrinosa acuta, Acute fibrous epicarditis- Cor villosum (56)..34
29. Fibroma pendulans, Pendular fibroma (27)…………………………………35
30. Foramen ovale apertum (53)…………………………………………………36
31. Haematocephalus internus, Internal hematocephalus (79)……………...…37
32. Haemorrhagia recens cerebri, Recent cerebral hemorrhage (15)………….38
33. Hyalinosis pleurae parietalis, Hyalinosis of the parietal pleura (7)……..…39
34. Hypertrophia myocardii et dilatation ventriculorum cordis- Cor bovinum,
Myocardial hypertrophy and ventricular dilatation of the heart (3)…..….40
35. Hypertrophia prostatae; Hypertrophia trabecularis vesicae urinariae;
Hypertrophy of the prostate; Trabecular hypertrophy of the urinary
bladder (4)…………………………………………………………………..…41
36. Hypoplasia renis, Hypoplasia of the kidney (18)……………………………42
37. Infarctus anaemicus lienis, Anemic infarct of the spleen (13)……………...43
38. Laryndotracheobronchitis pseudomembranacea, Pseudomembranous
laryngotracheobronchitis (22)……………………………………………..…44
39. Leiomyomata subserosa et intramuralis uteri, Subserosal and intramural
leiomyomas of the uterus (66)……………………………………………...…45
40. Lymphoma lienis, Splenic lymphoma (41)……………………………….….46

41. Melanoma metastaticum cordis, Metastatic melanoma of the heart (46)…47

42. Meningeoma lobi frontalis haemisphaeri dextri cerebri, Meningioma in the
frontal region of the right cerebral hemisphere (82)……………………..….48
43. Mesothelioma pleurae, Pleural mesothelioma (52)……………………….....49
44. Myeloma multiplex (plasmacytoma) calvariae, Multiple myeloma
(plasmacytoma) of the skull (40)…………………………………………..…50
45. Myxoma (pseudomyxoma) atria sinistri cordis, Myxoma (pseudomyxoma)
of the left cardiac atrium (33)………………………………………………...51
46. Naevus pigmentosus verrucosus cutis, Pigmented verrucous nevus of the
skin (31)………………………………………………………………………..52
47. Neurinoma anguli pontocerebellaris dextri, Neurinoma of the right
cerebellopontine angle (83)………………………………………………….....53
48. Papilloma laryngis, Papilloma of the larynx (28)………………………...…54
49. Ren macropolycysticus, Polycystic kidney disease (59)…………………….55
50. Struma glandulae thyreoideae, Nodular goiter of the thyroid (39)………..56

4
51. Tuberculosis caseosa cavernosa pulmonis sinistri, Caseous pulmonary
tuberculosis with formation of tuberculous caverna (25)……………….….57
52. Tuberculosis miliaris pulmonis, Miliary pulmonary tuberculosis (24)..…..58
53. Tumor malignus metastaticus in hepate, Hepatic metastases of a malignant
tumor (100)…………………………………………………………………….59
54. Tumor malignus metastaticus pulmonis sinistri, Pulmonary metastases of a
malignant tumor (36)……………………………………………………….…60
55. Ulcus chronicum ventriculi ad pancreatem penetrans, Chronic gastric ulcer
penetrating to the pancreas (74)……………………………………………....61

56. Ulcus chronicum ventriculi, Chronic gastric ulcer (73)……………………..62

57. Ureter duplex, Duplicated ureter (60)………………………………….……63

5
PREFACE

The Practical Handbook of Macroscopic Examination in Pathology for medical students

has been designed to help students to recognize diagnostic value of macroscopic
examination in pathological diagnosis.

It provides a concise review of preparations which have been shown to students in

recent years during the course in Pathology. This Handbook is followed by CD with
Power Point Presentation and photographs of macroscopic preparations. Important
features have been marked on each preparation and it can make learning easy and more
interesting.

As the authors of this practical Handbook, we are willing to keep modernizing an

improving it with new preapartions, descriptions and photos.

We would be grateful to the readers, particulary the students, who would contribute to
constant improvement of this handbook by their remarks and suggestions.

6
 Abscessus cerebri, Brain abscess (7)

Specimen represents brain of an adult, approximately of regular size, which is cut along
the transversal plane. Leptomeninges are thin, grayish, and translucent. Cortical gyri are
widened and flattened, and sulci between them are narrowed (brain edema). On cut
surface, grey and white matters of cerebral parenchyma are visible, and border between
them is clear. Both lateral cerebral ventricles are visible also, covered with thin,
translucent ependyma. Right lateral ventricle is of regular shape. Left lateral ventricle is
deformed due to presence of cavity situated in left occipital lobe. The diameter of cavity
is about 5 x 3x 2 cm. Inner surface of cavity is granular and gray.

7
Adenocarcinoma renis, Renal adenocarcinoma (35)

The specimen represents regular sized and slightly deformed kidney. The capsule is
removed. On cut surface, renal parenchyma is partially replaced with tumor; which is
clearly demarcated from the surrounding parenchyma, but not incapsulated. Dimensions
of the tumor are approximately 5 x 4 cm. Tumor tissue is partially necrotic, with
hemorrhagic areas. The rest of the kidney parenchyma is unremarkable, as are renal
pelvis and renal calices.

8
Amyloidosis lienis, Amyloidosis of the spleen (6)

Preparation is a very enlarged spleen, approximately of regular shape, with rounded

edges. Capsule is tight, gray-whitish, and semitransparent. The parenchyma is light
purple. Spleen is longitudinally cut. On cut surface one can notice the diffuse presence
of grey-brownish rounded glassy deposits in white pulp, with diameter up to 0.2 cm.
The red pulp looks regular, colored from light brownish to purple.

9
 Aneurysma arteriae basilaris cerebri, Aneurism of
basilar artery of the brain (78)

The sample is a basal half of the horizontal cross section of the brain of a human adult, of
regular size and shape. The soft meninges are smooth, thin, glossy, translucent, grayish,
the gyri are slightly expanded and flattened; the grooves are mildly narrowed. At the
cross section, the chamber system is symmetrical, of appropriate width, coated with thin,
smooth and translucent ependymoma. Gray and white matter is of appropriate spatial
arrangement, each clearly defined. The blood vessels of the Hexagon Wilson, excluding
the basilar artery, are of regular shape and size with no visible atherosclerosis. In the a.
basilaris area, we see a baggy lumen dilatation (aneurysm), measuring 2 x 1.5 cm, cut
longitudinally. At the cross section, the wall of the blood vessel is grayish, its thickness
measures about 0.1 cm, and the lumen of the aneurysm is completely occupied by
thrombi.

10
 Anthracosis lymphonodorum bronchopulmonalium et
pulmonis, Anthracosis of the lung and
bronchopulmonary lymph nodes (11)

Preparation is a left lung of regular size and shape. Inferior lobe is cut longitudinally
and opened. Visceral pleura is mostly thin, smooth, transparent, and focally whitish,
thickened and non transparent. The parenchyma of lung is of regular structure, grayish,
with diffuse net-like dark grey and black deposits of anthracotic pigment. In the hilum
there are few rounded lymph nodes up to 1 cm in size, and of black color due to
anthracotic pigment. Bronchi and blood vessels in the hilum are of regular diameter and
wall thickness, with regular mucosa and yellowish intima respectively.

11
 Atherosclerosis arteriarum baseos cerebri,
Atherosclerosis of the arteries at the base of the brain
(10)

Specimen represents lower halves of cerebral hemispheres, cerebellum and brainstem.

The meninges are smooth, shiny and translucent. The gyri of cerebral cortex are slightly
widened and flattened and the sulci are narrowed and shallow. On cut surface,
demarcation of white and grey matter is distinct. Both lateral cerebral ventricles are
exposed, covered by thin, whitish ependyma, and in the posterior horn of both ventricles
greyish choroid plexus is present. Brainstem and cerebellum are grossly unremarkable.
The arteries at the base of the brain are altered due to atherosclerosis, their wall is
diffusely thickened, yellowish colored, and their lumina are focally significantly
narrowed.

12
 Atrophia e comressione hepatis, Atrophy of the liver
due to compression (1)

Preparation is brownish to dark red colored liver, regularly sized and shaped. Capsule is
thin, smooth, tight and transparent. On the right lobe of the liver, on the diaphragmal
side one can find parallel impressions long from 5 to 6 cm and wide up to 1cm, deep up
to 0.3 cm. Gallbladder is not present

13
 Bronchectasiae cylindricae lobi inferioris pulmonis
sinistri, Cylindrical bronchiectasis in lower lobe of left
lung (51)

The preparation is a lengthwise slit left lung resectioned at the level of the left main
bronchus. The lung is properly shaped, with moderately reduced dimensions, sharp
edges and less airy. The wall of the main bronchus is 0.1 cm thick, the lumen is empty
and of regular width. Bronchial mucosa is pink and beamly uneven. The wall of the
pulmonary artery is 0.1 cm thick, the lumen is empty and of common width, and the
intimal layer is smooth, thin and airy. Lymph nodes of the hilar region are gray-brown
with a diameter of up to 0.5 cm. Costal pleura is thickened to a larger extent, it is
whitish and uneven due to the presence of numerous ruptured, striped and thready
adhesions. The upper lobe is at the intersection of recognizable drawing, less airy and
interspersed by pinto and striped black (anthracotic) pigment. The lower lobe is entirely
cystically altered due to the presence of transversely intercepted and tubularly dilated
segmental and subsegmental bronchi that go up to the surface of the pleura. The walls of
all bronchi are thickened and whitish, the lumen is empties and the mucous membrane
is grayish and slightly uneven. The remainder of the lung parenchyma of the lower lobe
is compressed and almost airless.

14
 Carcinoma bronchi lobi superioris pulmonis infiltrans
mediastini, Bronchial carcinoma of upper pulmonary
lobe with infiltration of mediastinum (90)

The preparation is a lengthwise slit left lung resectioned at the level of the left main
bronchus with adherent mediastinal structures. The lung is properly shaped, with
moderately reduced dimensions, sharp edges and less airy. The initial part of the main
bronchus is open lengthwise. The wall of the main bronchus is 0.1 cm thick, the lumen
is empty and of regular width. Bronchial mucosa is pink and beamly uneven. The wall
of the pulmonary artery is 0.1 cm thick, the lumen is empty and of common width, and
the intimal layer is smooth, thin and airy. Lymph nodes of the hilar region are gray-
brown with a diameter of up to 0.5 cm. Costal pleura is thickened to a larger extent, it is
whitish and uneven due to the presence of numerous ruptured, striped, thready and
plated adhesions. The lower lobe is at the intersection of recognizable drawing, less airy
and interspersed by pinto and striped black (anthracotic) pigment. The upper lobe is
mostly infiltrated by a whitish, solid tumor with dimensions of 14 x 4 cm. The tumor
tissue infiltrates the mediastinal pleura, part of the pulmonary artery and aortic arch.

15
 Carcinoma exophyticum intestine crassi, Exophyting
carcinoma of the large intestine (91)

The sample is a colon resection 12 cm in length, with its surrounding mesocolon fatty
tissue. The colon is opened longitudinally. Visible serosa is grayish and smooth. In the
central part of the resection, the structure of the colon mucosa is disrupted by the
presence of the exophytic tumor node, irregularly shaped 6 x 5 x 3.5 cm, of grayish
color, of particularly papillary unstable structure. The tumor tissue is fixed to the mucosa
of the colon via a broad base. The remaining part of the mucosa is of preserved
appearance, with preserved transverse folds. The colonic wall is of preserved lamination,
measuring a thickness of less than 0.1 cm. Serosa at the tumor affected area is whitish,
thickened, whereas it is smooth, thin, bright, translucent and grayish elsewhere.

16
 Carcinoma exulceratum mammae, Ulcerating breast
carcinoma (34)

The specimen is left female breast covered with a wrinkled skin. The nipple is slightly
retracted and surrounded with regular areola. In the upper quadrants there are three large
and deep defects of the skin (two in the lateral and one in the medial upper quadrant)
with heaped-up edges and necrotic floor, measuring 8 cm, 5 cm and 4 cm in diameter.
Medially to the largest ulceration there are three subcutaneous dome-shaped nodules
covered with a normal skin, measuring 1 cm each.

17
 Carcinoma exulceratum ventriculi, Ulcerated gastric
carcinoma (75)

The sample is the stomach of a human adult, showing both the end part of the esophagus
and the front part of the duodenum, including the associated connective tissue. The
stomach is opened along the major curvature. Gastric mucosa is grayish, glossy, partly
made up of aligned, and partly of preserved folds, of non-disrupted continuity, except in
the area of the stomach fundus, closer to the cardia, where ulcer-infiltrative tumor is
observed, oval in shape, and measuring around 8 cm in diameter, gray-whitish in color,
and of uneven, elevated edges and of uneven, unstable bottom area. The described ulcer
completely distorts the layers of the stomach wall, and infiltrates the surrounding
connective adipose tissue.

18
 Carcinoma glandulae thyreoideae, Carcinoma of the
thyroid gland (38)

The specimen consists of tongue, pharynx, larynx, trachea, proximal segments of

principal bronchi, and thyroid gland of an adult person. The tongue is of normal size,
symmetrical. Its mucosa on the upper aspect is regularly rough. The thyroid is
misshapen and bilaterally enlarged (mostly on the right side), measuring approximately
9 x 7 x 4 cm. The capsule is rough and thickened. A part of the right lobe is notched to
show thyroid parenchyma replaced by a variegated tumor tissue composed of solid and
cystic areas, the latter being traversed by multiple trabecular structures. The tumor
tissue infiltrates the larynx, narrowing its lumen. Laryngeal mucosa is mostly smooth,
but in the subglottic region there is an oval exophytic mass measuring 0.8 cm in
diameter, probably continuous with the tumor in the thyroid. Immediately above the
bifurcation of the trachea there is a conglomerate of enlarged lymph nodes measuring
approximately 5 x 3.5 x 2 cm. Appearance of the trachea and the principal bronchi is
normal.

19
 Carcinoma metastaticum corporis vertebrae
thoracalis, Metastatic carcinoma of thoracic vertebral
bodies (42)

The preparation is a frontal intersection of nine thoracic vertebrae with associated

intervertebral discs. Part of the vertebral column has a length of about 30 cm. Grayish-
brownish vertebrae are mostly up to 2.5 cm thick. In the central part of the preparation
the vertebrae are substantially thinned, from 0.3 to 0.8 cm with a clear loss of bone
trabeculae. Between the vertebral bodies there are silvery-whitish discs of elastic
consistency and thickness of up to 1.2 cm. In the upper half of the preparation the
vertebral bodies and intervertebral discs are unrecognizably structured due to diffuse
infiltration of grayish-whitish and focally cystic tumor tissue.

20
 Carcinoma papillare renis, Papillary carcinoma of the
kidney (64)

The specimen represents a discretely deformed and slightly decreased kidney. The
capsule is removed. Surface of the kidney is granular. On cut surface, renal pelvis and
renal calices are partially filled with tumor. Dimensions of the tumor are 6.5 x 5 x 3.5
cm. Tumor tissue is whitish; it consists of many arborized papillary fronds, with overall
cauliflower appearance. The rest of the renal pelvis and renal calices are covered by
slightly thickened mucosa. The renal parenchyma is atrophic with focally blurred
corticomedullary border.

21
 Carcinoma stenosans intestine crassi, Stenosing
carcinoma of the large intestine (76)

The sample is a colon resection of 15 cm in length, with its surrounding mesocolon fatty
tissue, which is opened longitudinally. The stratification of the colon wall is mostly
preserved, whereas it is completely distorted about 2.5 cm from the distal edge of the
resection due to the presence of the stenosing infiltrative tumor node, which almost
completely obliterates the lumen of the colon, in an area covering 4 cm in length. On the
resection, the tumor tissue shows vague borderlines, it is of whitish-gray color and has an
uneven and unstable surface. The tumor penetrates all layers of the wall, and infiltrates
the surrounding fatty tissue. The proximal part of the colon (above the tumor) is
moderately dilated, the wall thickness measures 0.5 cm, the mucus is grayish, opaque
and with mildly aligned folds. Distal to the tumor node, the intestinal lumen is slightly
narrowed, the mucosa is of preserved appearance with some transverse folds present; its
form is vivid, with a wall thickness of 0.5 cm. The outer wall, at the tumor-affected area,
shows whitish, thickened serosa, and the surface is mildly indrawn. The remaining serosa
is smooth, thin, glossy, translucent and grayish.

22
 Cicatrix cutis, Skin scar (17)

Specimen represents a spindle-shaped fragment of the skin with subcutaneous adipose

tissue, with approximate size of 15 x 6 x 3 centimeters. On the surface of the skin, linear
scar can be seen, 15 centimeters long and 2 centimeters wide, of pearly-white color, and
uneven surface. In the middle part of the specimen, scar tissue irregularly widens in
form of anastomosing bands, reaching the lateral edges of the skin. The remainder of the
skin is yellow-brownish and slightly wrinkled. Subcutaneous fat tissue is yellowish,
traversed by white, delicate fibrous septa.

23
Cirrhosis micro- et macronodularis hepatis, Micro- and
macronodular liver cirrhosis (72)

The sample includes a liver and a gallbladder of a human adult. The gallbladder is
unopened; it measures 6 cm in length and 2 cm in width, covered by whitish-gray
smooth serosa. The liver has a markedly disrupted macroscopic appearance; it shows a
decrease in dimensions, and is of sharp edges. The liver capsule is thickened, grayish,
focally mildly blurred. Liver parenchyma is diffusely occupied by numerous high-
density nodules, which are round , have a smooth surface, and measure from 2 mm to 2.5
cm in diameter. The described nodules make the liver appear extremely nodular.

24
Complexus primaries tuberculosis pulomonis, Primary
complex of pulmonary tuberculosis (23)

Specimen represents tongue, larynx, trachea, main bronchi and both lungs. Judging by
its size, specimen originates from a child. Tongue is of regular size and shape, covered
by unremarkable mucosa. Larynx, trachea and main bronchi are opened along their
posterior side. Their wall is of normal thickness, preserved layers, covered by grayish,
thin mucosa, and lumina are regularly wide. Pleura is smooth, shiny and translucent. In
the upper part of the inferior lobe of the left lung, a node can be seen, which is
approximately 0.8 centimeters in diameter, gray colored, homogenous on cut surface,
situated just beneath the pleura. In the vicinity of trachea and principal bronchi, a few
enlarged lymph nodes are present, up to one centimeter in diameter, gray colored and
homogenous on cut surface, as well. The node in lung parenchyma represents so-called
primary affect of tuberculosis, while the lymph nodes are affected by tuberculous
lymphadenitis. These two entities, together with tuberculous lymphangitis (which
cannot be easily recognized by gross examination only), represent primary complex of
pulmonary tuberculosis.

25
 Contentum sanguineum vesicae urinariae,
Hemorrhagic content of the urinary bladder (62)

The specimen consists of the urinary bladder and prostate, which are open
longitudinally along the front. The urinary bladder is at the back mostly covered with
greyish, smooth peritoneum and around the present and yellowish-orange adipose
tissue. The bladder is dilated, with thinned wall, and lumen is almost completely filled
with brown-gray content corresponding to coagulated blood. Prostatic urethra is 2.5 cm
long, covered with a grayish mucosa and lumen is partly narrowed. On cut surface,
prostatic tissue is grayish color and it has slightly nodular structure.

26
 Cystes congenitalis ovarii bilateralis, Congenital
bilateral ovarian cysts (96)

Specimen represents both ovaries, both fallopian tubes, uterus and proximal portion of
vagina. Judging by its size, the specimen originates from a child. Both ovaries are
deformed and enlarged, about 6 centimeters in diameter each, due to numerous cystic
formations, which results in overall nodular appearance of the ovaries. Outer surface of
the cysts (and ovaries) is mostly smooth, grayish and partially see-through so brownish
content of the cyst can be seen. Both fallopian tubes are of regular size and shape,
covered with whitish serosa. Uterine corpus and cervix are of regular size and shape
also, covered with whitish serosa. Proximal portion of the vagina, which is
longitudinally opened, is approximately 2 cm long, and is covered with grayish, slightly
wrinkled mucosa.

27
 Cystes retentions renis, Retention cysts of the kidney
(57)

The specimen represents a kidney of an adult man with present ureter length of 6 to 7
cm. The kidney is cut longitudinally so that there is only one half. The capsule is
removed. The kidney is of disturbed structure due to the presence of several cystic
formations diameter from 0.2 to 8 cm. Cystic formations are round in shape, thin,
transparent walls, smooth outer surface, easily uneven and inner surface is reticulated
with connective tissue bands. Cystic formations are partly open and emptied lumens, a
mostly closed and filled with clear to opaque liquid. Cystic formations are localized
inside or subcapsular in the kidney parenchyma. The rest of the surrounding renal
parenchyma is grayish in color with clear borders between the cortex and the pyramids.

28
 Cystis hydatidosa lienis; Atrophia e compressione
lienis, Hydatid cyst of the spleen; Atrophy of the spleen
due to compression (2)

Preparation is spleen, cut longitudinally opposite to the hilum. Spleen shape is rounded;
capsule is thin, transparent and wrinkled. The major part of the spleen is occupied by a
cystic formation with diameter up to 10 cm, with grey-whitish capsule wide from 0.1 to
0.2 cm. Cystic formation is fulfilled by semitransparent grey-yellowish membranes and
secondary cysts, with wall width less then 0.1cm. The spleen parenchyma is very
narrowed and located on the periphery, of dark gray color, recognizable structure, and
the width of up to 1cm.

29
Diverticulosis intestini tenuis, Diverticulosis of the small
intestine (70)

The sample is a small intestine resection of about 20 cm in length, with its surrounding
fatty tissue, opened longitudinally. Serosa is grayish and smooth, and the wall is thick
from 6 to 7 mm, of preserved stratification. The mucous membrane of the intestines is
grayish, with partly aligned folds, whereas along the middle line of the resection, a larger
number of mucosal bypass are observed as a diverticulum, of approximately 5 mm in
diameter. The described diverticula have an unoccupied lumen, a thin transparent wall
comprising only the mucosa or, possibly, the submucosa as well.

30
 Diverticulum Meckeli intestine tenuis, Meckel's
diverticulum of the small intestine (69)

The specimen represents small intestine length up to 12 cm with very poorly

surrounding adipose tissue of the mesentery. Serosa is smooth and thin; the wall is
thinned and translucent while the visible part of the mucosa is partly smooth and with
partially preserved structures. In the central part of the small intestine, a diverticulum of
3.5 cm in length is observed. The proximal end of the diverticulum is communicating
with the lumen of the small intestine. The distal end of the diverticulum is blindly
closed. Diverticulum is about 1.5 cm in diameter, and its walls have the same
characteristics as described in the wall of the small intestine.

31
 Embolia thrombotica recens trunci pulmonalis et
arteriarum pulmonalium, Recent thromboembolism of
pulmonary trunk and pulmonary arteries (14)

Specimen represents heart of an adult person, with pulmonary trunk, both main
pulmonary arteries and parts of both lungs. Heart is of regular shape and moderately
enlarged. Epicardium is thin, see-through, and small amount of subepicardial adipose
tissue is present beneath it. Myocardium of right ventricle is up to 5 millimeters thick,
grossly appearing normal. Endocardium is thin and see-through. Right ventricle is
dilated. Pulmonary valves are thin, and with free borders. Pulmonary trunk and both
main pulmonary arteries are dilated, almost completely filled with convoluted, brown
colored worm-like masses, which represent thromboemboli. Visceral pleura is slightly
wrinkled, partially see-through. Parenchyma of both lungs is of atelectatic appearance,
containing anthracotic pigment.

32
 Endocarditis bacterialis, Bacterial endocarditis (54)

The preparation is a heart with initial parts of large blood vessels (pulmonary trunk and
aorta). The heart is of regular shape and moderately increased at the expense of
expanded left ventricle and atrium. The atria and ventricles are lengthwise slit, but only
the left half of the heart is open. The top of the heart belongs to the left ventricle.
Visceral layer of the pericardium (epicardium) is smooth, thin and airy. Beneath the
epicardium gleam the blood vessels of the heart with thin walls, and on the border
between the atria and the ventricles there is a small amount of yellowish-whitish
adipose tissue. The wall of the pulmonary trunk and the initial part of the aorta is about
0.2 cm thick, and the lumen of both blood vessels is of common width. The intimal
layer of the pulmonary trunk is smooth, thin and airy, while the intimal layer of the aorta
is uneven due to the presence of numerous, sporadically seamless, soft, yellowish
plaques with a diameter of up to 0.3 cm. The visible part of the cardiac muscle is
normally thick, fibrous, brownish and covered in smooth, thin and airy endocardium.
The trabeculae carneae of the left ventricle are highlighted, thick and rounded. Papillary
muscles are short, roundly thickened as well as the hordes that show minimal
contraction and fusion. The valves, with moderately dilated mitral orifice are smooth,
thin and airy at the attachments. At free edges they are slightly curved and thickened,
partly perforated and partly uneven due to the presence of gray-brown and fragile
vegetations with a diameter of up to 2 cm that are mainly present at the atrial side of the
valves.

33
 Epicarditis, fibrinosa acuta, Acute fibrous epicarditis-
Cor villosum (56)

The preparation is a heart with initial parts of large blood vessels (pulmonary trunk and
aorta). The heart is of regular shape and normal size. The coronary chambers are
lengthwise slit but the heart is not open. The top of the heart mostly belongs to the left
ventricle. Visceral layer of the pericardium (epicardium) is mostly thickened, whitish
and uneven due to the presence of numerous, thin and thick whitish strips of fibrin
which give it a villous appearance. The wall of the pulmonary trunk and the initial part
of the aorta is about 0.2 cm thick, and the lumen of both blood vessels is of common
width. The intimal layer of the pulmonary trunk is smooth, thin and airy, while the
intimal layer of the aorta is uneven due to the presence of numerous, sporadically
seamless, soft, yellowish plaques with a diameter of up to 0.3 cm. Near the blood
vessels there is a gray-brown node with a diameter of 0.8 cm.

34
 Fibroma pendulans, Pendular fibroma (27)

Specimen represents an oval-shaped fragment of the skin 2.5 x 2 x 0.5 centimeters in

diameter. In the central part of the skin exophytic tumor is present, consisting of stalk
and oval tumor node. The stalk is approximately 4 centimeters long and half a
centimeter wide. Tumor node is approximately 5 x 3 x 3 centimeters in diameter,
covered with wrinkled skin.

35
 Foramen ovale apertum (53)

The preparation is a heart with initial parts of large blood vessels (pulmonary trunk and
aorta). The heart is unopened, of regular shape and normal size. Atria and ventricles are
lengthwise slit and open. The top of the heart belongs to the left ventricle. Visceral layer
of the pericardium (epicardium) is smooth, thin and airy. Beneath the epicardium gleam
the blood vessels of the heart with thin walls, and on the border between the atria and
the ventricles there is a small amount of yellowish-whitish adipose tissue. The wall of
the pulmonary trunk and the initial part of the aorta is about 0.2 cm thick, and the lumen
of both blood vessels is of common width. The intimal layer of the blood vessels is
smooth, thin and airy. The left atrium is slightly dilated. The visible part of the cardiac
muscle is normally thick, fibrous, brownish and covered in smooth, thin and airy
endocardium. The trabeculae carneae and papillary muscles are with common
characteristics. The valves with slightly dilated mitral orifice are smooth, thin, airy and
foldable. In the area of interatrial septum there is an oval aperture with a diameter of 1.5
cm, which is mostly covered with whitish, thin, transparent membrane, perforated at
several spots, which covers it in the form of a curtain.

36
 Haematocephalus internus, Internal hematocephalus
(79)

Specimen represents left cerebral hemisphere, left hemisphere of cerebellum and left
half of brainstem. The meninges are smooth, thin, translucent, and network of blood
vessels can be seen beneath them. The cerebral gyri are moderately widened and
flattened, while the sulci are shallow and narrowed. Left lateral cerebral ventricle and
fourth cerebral ventricle are exposed in the specimen, dilated and filled with greyish
masses, which represent coagulated blood. The cerebral parenchyma in the region of
mesencephalon, in the vicinity of lateral cerebral ventricle, is imbibed with fresh blood,
so is the parenchyma of cerebellum in the vicinity of the fourth cerebral ventricle. The
rest of the parenchyma of the cerebrum and cerebellum is grossly unchanged.

37
 Haemorrhagia recens cerebri, Recent cerebral
hemorrhage (15)

Specimen represents upper halves of cerebral hemispheres. The meninges are smooth,
shiny and translucent. The gyri are widened and flattened, while the sulci are shallow
and narrowed (gross appearance of cerebral edema). On cut surface, boundary between
grey and white matter is distinct, and parts of both lateral cerebral ventricles can be
seen, containing grey colored choroidal plexus. In the cerebral parenchyma three foci of
recent hemorrhage are present. The first one is localized in the vicinity of the anterior
horn of the left lateral cerebral ventricle, and is approximately 2 centimeters wide, gray
to brownish colored. The second one is subcortically situated in the left parietal lobe,
about the same size and color as the first one described. The third area of recent
hemorrhage is in the right occipital lobe, about 4 x 2.5 centimeters in diameter, gray to
brownish colored.

38
Hyalinosis pleurae parietalis, Hyalinosis of the parietal
pleura (7)

Preparation is resected part of parietal pleura of whitish color, mostly non-transparent,

dimensioned about 25 x 10 cm and wide about 0.1 to 0.2 cm. On the inferior third there
are numerous small whitish rounded plaques with convex surface, with diameter from
0.1 to 0.5 cm and elevated up to 0.1 cm. On the top of the preparation there is a small
remnant of lung parenchyma, sized up to 2 cm.

39
 Hypertrophia myocardii et dilatation ventriculorum
cordis- Cor bovinum, Myocardial hypertrophy and
ventricular dilatation of the heart (3)

Preparation is a heart with initial parts of great blood vessels. Heart is extremely
enlarged. Shape is deformed, mostly on the right side. Both atria and ventriculi are cut
longitudinally. Epicardium is thin, smooth, grayish and transparent. Subepicardial
adipose tissue is mostly present around coronary blood vessels. Myocardium of both
vetriculi is thickened up to 2 cm. Endocardium of both ventriculi is thin, smooth,
grayish and transparent. Underlying trabeculae carneae and papillary muscles are
significantly thickened. Both ventriculi are extremely dilated, mostly the right one.
Endocardium of both atria is thin, smooth, grayish and transparent. Both atria are
extremely dilated. Due to preparation position in jar, valves can be seen only partially
and they are whitish and slightly thickened. Aortal intima is mostly yellowish and
smooth but there are few intimal yellow plaques, sized up to 0.5 cm.

40
 Hypertrophia prostatae; Hypertrophia trabecularis
vesicae urinariae; Hypertrophy of the prostate;
Trabecular hypertrophy of the urinary bladder (4)

Preparation represents a prostate and urinary bladder. Prostate is enlarged, regularly

shaped and cut longitudinally on the front side. Capsule is partially smooth and partially
thickened. On the cut surface parenchyma is white to grayish, partially nodulated.
Prostatic part of urethra is narrowed and lined by slightly wrinkled mucosa. Urinary
bladder is regularly shaped, enlarged, dilated, cut and opened on the front side. Its
mucosa is gray-whitish and wrinkled due to trabecular hypertrophy of detrusor muscle.
The wall of urinary bladder is thickened due to broader muscle layer. Serosa is gray-
whitish, partially smooth, partially uneven and thickened.

41
 Hypoplasia renis, Hypoplasia of the kidney (18)

Specimen represents both kidneys, both ureters and urinary bladder. Right kidney is
regular shaped (bean-shaped), slightly enlarged, measuring approximately 12 x 6 x 3
cm, and is partially cut along longitudinal plane. The capsule of left kidney is smooth,
grayish and shiny, while the outer surface has discretely lobulated appearance. Visible
portions of parenchyma have no gross changes. Left kidney is extremely diminished,
hypoplastic, 5 x 3 x 2 cm in diameter, with some mature adipose tissue in hilar region.
The capsule of left kidney is partially removed. Left kidney has also been cut along
longitudinal plane, and its parenchyma is markedly reduced, while peripyelic fat tissue
is abundant. Both ureters are of regular length and diameter, covered with whitish
adventitia. Urinary bladder is opened along one side, covered with grayish, slightly
wrinkled mucosa. Bladder wall has normal thickness. On the outer surface of the
urinary bladder, which is covered with adventitia, small amount of fat can be seen.

42
Infarctus anaemicus lienis, Anemic infarct of the spleen
(13)

Specimen represents a spleen of regular size, sectioned in longitudinal plane, with

slightly wrinkled capsule and small amount of adipose tissue in spleen hilus. On cut
surface, most of the parenchyma of the spleen appears normal, from red to brownish
color, with recognizable reticular base of the parenchyma, but one necrotic area is also
present. Necrotic area is subcapsulary located, approximately 4 x 2.5 cm in diameter,
triangular shaped, with peak pointing to the hilus of the spleen and base orientated
towards the surface. Necrotic tissue is pale, grayish, and its borders towards the
preserved parenchyma are up to 2 mm wide and somewhat darker.

43
 Laryndotracheobronchitis pseudomembranacea,
Pseudomembranous laryngotracheobronchitis (22)

Specimen consists of tongue, larynx, trachea, principal bronchi and both lungs. Judging
by its size, specimen originates from a child. Tongue is regular sized and shaped,
covered by unremarkable mucosa. Larynx, trachea, principal and lobar bronchi are
opened. Mucosa of larynx, trachea, principal and bronchi are partially covered with
grayish membranes, tightly adhered to the surface of mucosa. Lung parenchyma has
recognizable structure, but it is slightly more solid than normal. Pleural membrane is
thin and translucent. Lumen of the larynx is narrowed, while lumina of trachea and
bronchi are normal or slightly dilated. On the anterior side of the trachea there is a
defect, approximately one centimeter in diameter, which most probably represents
tracheostoma.

44
 Leiomyomata subserosa et intramuralis uteri,
Subserosal and intramural leiomyomas of the uterus
(66)

The specimen consists of uterus and ovary, and fallopian tube. Uterus is longitudinally
cut so that there are open cavities of uterus and cervix, which are covered with smooth,
greyish endometrium and endocervix. The cervix is long about 3.5 cm. The body of the
uterus is extremely deformed due to the presence of numerous subserosal and
intramural tumor nodules. Tumor nodules diameters are from 2.5 to 10 cm, smooth,
partly nodular surface, whitish color. On cut surface, tumor nodules are striped and have
circular structure, and elastic consistency. Fallopian tube is about 7 cm long and with
preserved structure. Size of the ovary is 3.5 x 2.5 x 2 cm and ovary is partly cystic.

45
 Lymphoma lienis, Splenic lymphoma (41)

Preparation is longitudinally cut spleen of an adult which is easily increased around

15x6x6 cm, smooth, tight capsule whitish color, focal blurred appearance. The spleen of
the hilus is macroscopically normal appearance with a small amount adipose tissue. On
the cut surface is parenchyma which is largely disturbed structure due to the presence of
numerous, diffuse distributed nodes, partly connected. Tumor nodes are clearly
demarcated from the surrounding parenchyma of the spleen, round shape, white in
color, homogeneous appearance, solid structure, a diameter of 0.2 to 1.3 cm. The
remaining parenchyma of the spleen is preserved structure, brownish-orange color.

46
Melanoma metastaticum cordis, Metastatic melanoma
of the heart( 46)

The preparation is a heart with initial parts of large blood vessels (pulmonary trunk and
aorta). The heart is unopened, of regular shape and normal size. The top part of the heart
mostly belongs to the left ventricle. Visceral layer of the pericardium (epicardium) is
smooth, thin and airy. Beneath the epicardium gleam the blood vessels of the heart with
thin walls, and on the border between the atria and the ventricles there is a small amount
of yellowish-whitish adipose tissue. The wall of the pulmonary trunk and the initial part
of the aorta is about 0.2 cm thick, and the lumen of both blood vessels is of common
width. The intimal layer of the pulmonary trunk is smooth, thin and airy, while the
intimal layer of the aorta is uneven due to the presence of numerous, sporadically
seamless, soft, yellowish plaques with a diameter of up to 0.3 cm. Two, clearly
circumscribed, oval, gray-brown nodes with a smooth surface, diameter of 0.2 and 0.6
cm are located on the back wall of the right ventricle near the coronary sulcus. The
described nodes correspond to metastasis of melanoma into the heart.

47
Meningeoma lobi frontalis haemisphaeri dextri cerebri,
Meningioma in the frontal region of the right cerebral
hemisphere (82)

The sample is the brain of a human adult, of regular size and shape. The soft meninges
are smooth, thin, glossy, translucent, and grayish; the gyri are slightly expanded and
flattened, and the grooves are mildly narrowed. In the area of the right hemisphere
frontal lobe, a node can be observed, clearly distinct from the surrounding environment,
measuring 5 x 3 x 1.5 cm, and it has an uneven, lobular surface owing to the presence of
radially arranged thin cracks, 0.1 cm wide. The tumor node sits on the cobweb cortex,
and does not touch the brain parenchyma.

48
 Mesothelioma pleurae, Pleural mesothelioma (52)

The preparation is the right lung resectioned at the level of the right main bronchus. The
lung is deformed, with quite reduced dimensions, sharp edges and less airy. The wall of
the main bronchus is 0.1 cm thick, the lumen is empty and of regular width. Bronchial
mucosa is pink and beamly uneven. The wall of the pulmonary artery is 0.1 cm thick,
the lumen is empty and of common width, and the intimal layer is smooth, thin and airy.
Lymph nodes of the hilar region are gray-brown with a diameter of up to 0.5 cm. Costal
pleura is thickened to a lesser extent, it is whitish and uneven due to the presence of
numerous ruptured, striped and thready adhesions, and largely modified by tumor. A
solid, grayish-whitish tumor with a thickness of up to 1 cm in the form of thick tissue
shell wraps, compresses and infiltrates the upper lobe of the right lung.

49
 Myeloma multiplex (plasmacytoma) calvariae,
Multiple myeloma (plasmacytoma) of the skull (40)

The specimen is the skull roof of an adult person. The periosteum is thin and focally
disrupted. The bone tissue is massively and irregularly replaced by a homogenous brittle
brownish tumor tissue, which infiltrates the entire thickness of the bone and protrudes
beyond the normal contour of the bone plate. The largest area of the bone replaced by
the tumor measures up to 10 cm in its largest dimension.

50
 Myxoma (pseudomyxoma) atria sinistri cordis,
Myxoma (pseudomyxoma) of the left cardiac atrium
(33)

The specimen is the heart of an adult person with major blood vessels. Parts of the
anterior and the lateral walls of left atrium and left ventricle are removed to expose
chambers of the left heart. The epicardium is thin and smooth and the amount of the
subepicardial adipose tissue is normal. The heart muscle is of normal thickness and its
texture on cut surface is preserved. The endocardium is smooth and translucent, as are
the anterior cuspis and the visible part of the posterior cuspis of the mitral valve. The
left atrium is dilated, partially filled with an irregularly shaped bosselated greyish tumor
mass measuring approximately 5 x 4 x 3 cm whose base is broadly attached to the
posterior atrial wall. A part of the mass protrudes into the left ventricle through the
mitral ostium.

51
 Naevus pigmentosus verrucosus cutis, Pigmented
verrucous nevus of the skin (31)

Specimen represents spindle shaped fragment of the skin, approximately 5.5 x 2.5 x 0.8
centimeters in diameter, with small amount of subcutaneous adipose tissue. Most of the
surface of the epidermis is white to grayish and slightly wrinkled. In the central part of
the skin exophytic tumor node can be seen, of brown to black color, approximately 2 x
1.5 x 0.8 centimeters in diameter. Surface of the tumor is wrinkled, verrucous and
mostly covered with hairs. On the cut surface, tumor node is brown to black, situated in
epidermis and dermis, and the border towards fat tissue beneath it is sharp.

52
Neurinoma anguli pontocerebellaris dextri, Neurinoma
of the right cerebellopontine angle (83)

The sample is the basal half of the horizontal cross section of the brain of a human adult,
of regular size and shape. The soft meninges are smooth, thin, glossy, translucent, and
grayish; the gyri are slightly expanded and flattened, and the grooves are mildly
narrowed. At the cross-section, the chamber system is symmetrical, of appropriate width,
coated with thin, smooth and translucent ependymoma. Gray and white matters are of
appropriate spatial arrangement, each clearly defined. In the right cerebellopontine angle,
an elliptical node can be observed, clearly distinct from the surrounding environment,
measuring 3.5 x 2x 1.5 cm, smooth in surface, grayish in color. The described node
displaces the brainstem to the left.

53
 Papilloma laryngis, Papilloma of the larynx (28)

Specimen represents tongue, hyoid bone, larynx, proximal part of trachea and thyroid
gland. The tongue is of regular size and shape, covered by grayish mucosa with visible
papillae. Larynx and trachea are opened in longitudinal plane through the posterior wall.
The most of laryngeal mucosa is smooth and grayish, except in the area of right vocal
cord, where broad-based, exophytic, grayish colored tumor node is present. Tumor node
is approximately 2.5 x 1.5 x 1 cm in diameter, and most of its surface has papillary
appearance. Lumen of the larynx is narrowed due to presence of the tumor. The
proximal part of trachea is about 2 centimeters long, with regular thickness of the wall,
preserved layers, covered by thin, grayish mucosa. Thyroid gland is of regular size and
shape with both lobes partially cut at their periphery. Visible parts of thyroid
parenchyma are brownish, traversed by delicate fibrous septa.

54
Ren macropolycysticus, Polycystic kidney disease (59)

The specimen represents kidney of an adult man that is enlarged, dimensions 16 x 8 x 7

cm. There is a ureter length of about 5 to 6 cm. The kidney is cut longitudinally in a
half. The capsule is removed. On cut surface, renal parenchyma is reduced due to the
presence of numerous and diffusely distributed cystic formations from 0.2 to 2 cm in a
diameter. Cystic formations are whitish, thin walls, partly open and emptied lumens and
mostly closed and filled with clear to dark hemorrhagic content.

55
 Struma glandulae thyreoideae, Nodular goiter of the
thyroid (39)

The specimen consists of tongue, pharynx, larynx, trachea, and proximal segments of
principal bronchi and thyroid gland of an adult person. The tongue is of normal size,
symmetrical. Its mucosa on the upper aspect is regularly rough. The pharynx is covered
with a smooth mucosa. Diameters of larynx, trachea and bronchi are approximately
normal. The thyroid is misshapen due to uneven enlargement of its lobes (enlargement
the right lobe is more pronounced) and is enveloped in a smooth and semitranslucent
capsule. Medial part of the right lobe is notched to expose thyroid parenchyma, which
on the cut surface appears normal. In the apex of the left lobe there is a round dark-red
hemorrhagic node measuring 2 cm in diameter.

56
 Tuberculosis caseosa cavernosa pulmonis sinistri,
Caseous pulmonary tuberculosis with formation of
tuberculous caverna (25)

Specimen represents left lung of an adult, which is cut along the longitudinal plane.
Almost entire pleura is remarkably thickened, grayish to white colored, especially in the
area of the upper lobe of the lung. Bronchi and blood vessels in the pulmonary hilus are
grossly unremarkable, surrounded by small amount of adipose tissue. On the cut
surface, most of the lung parenchyma has lost its normal structure, due to presence of
multiple and confluent foci of tuberculosis. In both lobes, round cavities inside
parenchyma can be seen, ranging from 2 to 7 cm in diameter, devoid of any content.
Their wall is up to half a centimeter thick, white colored, partially covered by gray,
friable material which represents necrotic caseous detritus. These cavities represent
tuberculous cavities, also known as cavernae.

57
 Tuberculosis miliaris pulmonis, Miliary pulmonary
tuberculosis (24)

Specimen represents the left lung of an adult, which is cut along the longitudinal plane.
Pleura is partially smooth and translucent, but some parts are thickened and grayish.
Blood vessels and bronchi in the pulmonary hilus are grossly unremarkable, surrounded
by small amount of adipose tissue. In the upper lobe, there are a few emphysematous
cavities, up to 2 centimeters in diameter, situated beneath the pleura. On the cut surface
most of the lung parenchyma has lost its normal gross appearance, due to presence of
numerous, diffusely arranged, white miliary nodules, up to half a centimeter wide.
These nodules represent specific tuberculous granulation tissue.

58
 Tumor malignus metastaticus in hepate, Hepatic
metastases of a malignant tumor (100)

The specimen is a slice of the hepatic right lobe covered with a smooth, in some places
umbilicated capsule. Hepatic parenchyma is multifocally replaced by several round and
oval, well-demarcated solid tumor nodules and nodes measuring from 0.8 to 4.5 cm.
Some of them are partially necrotic.

59
 Tumor malignus metastaticus pulmonis sinistri,
Pulmonary metastases of a malignant tumor (36)

The specimen consists of a parasagittally transected left lung with its principal
bronchus. The visceral pleura is smooth, translucent and somewhat thickened, with
readily discernible vascular meshwork, sprinkled with numerous round whitish nodules
measuring up to several millimeters in diameter. Pulmonary parenchyma on the cut
section contains numerous scattered round and oval, well demarcated whitish nodules
composed of solid or necrotic tumor tissue, measuring from 0.2 to 3 cm in largest
diameter. Pulmonary parenchyma outside the tumor nodules appears normal.

60
 Ulcus chronicum ventriculi, Chronic gastric ulcer (73)

The sample is the stomach of a human adult, showing both the end part of the esophagus
and the front part of the duodenum. The stomach is opened along the major curvature,
while parts of the duodenum and the esophagus are opened longitudinally. In the smaller
curvature of the stomach, what can be observed is an ulcer of 2.5 cm in diameter, which
disrupts the continuity of the stomach wall to a great extent. The ulcer is oval in shape
and is of sharp edges, which are aligned with the adjacent mucosa. The ulcer penetrates
the muscle layer to a depth of 0.5 to 0.6 cm, and its bottom is uneven and grayish. The
remaining mucosa of the stomach is of partially aligned, and partially preserved folds.
Serosa above the ulcer is thickened with adherent fatty tissues, while elsewhere it is
smooth, thin, gray and translucent.

61
 Ulcus chronicum ventriculi ad pancreatem penetrans,
Chronic gastric ulcer penetrating to the pancreas (74)

The sample is the stomach of a human adult, showing both the end part of the esophagus
and the front part of the duodenum. The stomach is opened along the major curvature,
while parts of the duodenum and the esophagus are opened longitudinally. The mucosa is
made up of aligned and preserved folds. In the minor curvature of the stomach, an ulcer
can be observed, measuring 5 cm in diameter. It is round in shape and with sharp edges,
which are aligned with the surrounding mucosa. The ulcer penetrates all layers of the
stomach wall, up to the pancreas, which is the bottom part of the ulcer. The pancreatic
tissue is partly whitish, and partly brownish-red, with an observed hematoma. The
remaining part of the stomach wall is of preserved lamination, measuring a thickness of
about 0.7 cm. Serosa is smooth, thin, gray and translucent, and at the outer wall of the
stomach, the adherent tissue of the pancreas has a longitudinal slit of lobular structure.
Also, the major pancreatic duct is observed, lined with smooth greyish mucosa.

62
 Ureter duplex, Duplicated ureter (60)

The specimen represents kidney of an adult with reduced dimensions, atrophic. Size of
the kidney is 8 x 4 x 4 cm. The kidney is cut longitudinally in a half. The capsule is
removed, while the surface is fine-grained with lower retention cysts 2 mm in a
diameter. On cut surface, parenchyma is mildly reduced, grayish in color, unclear
borders between the cortex and the pyramids. In the hilus, a small amount of a whitish
adipose tissue is present. Renal calyces and pelvic are opened longitudinally, covered
with a grayish and smooth mucosa and continue in the two ureters which are also
opened longitudinally and covered with grayish mucosa that after 5 cm are connected
into one ureter.

63