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Classic Labs/Finding
Lab/diagnostic finding vs Diagnosis/disease
Lab/diagnostic finding | Diagnosis/disease |
---|---|
Anticentromere antibodies | Scleroderma (CREST) |
Antidemoglein (epithelial) antibodies | Pemphigus vulgaris (blistering) |
Anti-glomerular basement membrane antibodies | Goodpasture's syndrome (glomerulonephritis and hemoptysis |
Antihistone antibodies | Drug-induced SLE (hydralazine, isoniazid, phenytoin, procainamide) |
Anti-IgG antibodies | Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity) |
Antimitochondrial antibodies (AMAs) | 1° biliary cirrhosis (female, cholestasis, portal hypertension) |
Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA) | SLE (type III hypersensitivity) |
Antiplatelet antibodies | Idiopathic thrombocytopenic purpura (ITP) |
Anti-topoisomerase antibodies | Diffuse systemic scleroderma |
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies | Celiac disease (diarrhea, distention, weight loss) |
"Apple core" lesion on abdominal x-ray | Colorectal cancer (usually left-sided) |
Azurophilic granular needles in leukemic blasts | Auer rods (actue myelogenous leukemia, especially the promyelocytic [M3] type) |
Bacitracin response | Sensitive: Streptococcus pyogenes (group A); resistant: Streptococcus agalactiae (group B) |
"Bamboo spine" on x-ray | Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27 |
Basophilic nuclear remnants in RBCs | Howell-Jolly bodies (due to splenectomy or nonfunctional spleen) |
Basophilic stippling of RBCs | Lead poisoning or sideroblastic anemia |
Bloody tap on LP | Subarachnoid hemorrhage |
"Boot-shaped" heart on x-ray | Tetralogy of Fallot, RVH |
Branching gram-positive rods with sulfur granules | Actinomyces israelii |
Bronchogenic apical lung tumor | Pancoase tumor (can compress sympathetic ganglion and cause Horner's syndrome) |
"Brown" tumor of bone | Hemorrhage (hemosiderin) causes brown color of osteolytic cysts. Due to: 1. Hyperparathyroidism 2. Osteitis fibrosa cystica |
Cardiomegaly with apical atrophy | Chagas' disease (Trypanosoma cruzi) |
Cellular crescents in Bowman's capsule | Rapidly progressive crescentic glomerulonphritis |
"Chocolate cyst" of ovary | Endometriosis (frequently involves both ovaries) |
Cirrular grouping of dark tumor cells surrounding pale neurofibrils | Homer Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma) |
Colonies of mucoid Pseudomonas in lungs | Cystic fibrosis (AR mutation to CFTR resulting in fat-soluble vitamin deficiency and mucous plugs) |
Decreased α-fetoprotein in amniotic fluid/maternal serum | Down syndrome or other chromosomal abnormality |
Degeneration of dorsal column nerves | Tabes dorsalis (3° syphilis) |
Depigmentation of neurons in substantia nigra | Parkinson's disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia) |
Desquamated epithelium casts in sputum | Curschmann's spirals (bronchial asthma; can result in whorled mucous plugs) |
Disarrayed granulosa cells in eosinophilic fluid | Call-Exner bodies (granulosa-theca cell tumor of the ovary) |
Dysplastic squamous cervical cells with nuclear enlargemnt and hyperchromasia | Koilocytes (HPV: predisposes to cervical cancer) |
Enlarged cells with intranuclear inclusion bodies | "Owl's-eye" appearance of CMV |
Enlarged thyroid cells with ground-glass nuclei | "Orphan Annie" eye nuclei (papillary carcinoma of the thyroid) |
Eosinophilic cytoplasmic inclusion in liver cell | Mallory bodies (alcoholic liver disease) |
Eosinophilic cytoplasmic inclusion in nerve cell | Lewy body (Parkinson's disease) |
Eosinophilic globule in liver | Councilman body (toxic or viral hepatitis, often yellow fever) |
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells | Rabies virus (Lyssavirus) |
Extracellular amyloid deposition in gray matter of brain | Senile plaques (Alzheimer's disease) |
Giant B cells with bilobed nuclei with prominent inclusions ("owls eye") | Reed-Sternberg cells (Hodgkin's lymphoma) |
Glomerulus-like struction surrounding vessel in germ cells | Schiller-Duval bodies (yolk sac tumor) |
"Hair-on-end" (crew cut) appearance on x-ray | β-thalassemia, sickle cell anemia (marrow expansion) |
hCG elevated | Choriocarcinoma, hydatidiform mole (occurs with and without embryo) |
Heart nodules (granulomatous) | Aschoff bodies (rheumatic fever) |
Heteropphile antibodies | Infectious mononucleosis (EBV) |
Hexagonal, double-pointed, needle-like crystals in bronchial secretions | Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules) |
High level of D-dimers | DVT, pulmonary embolism, DIC |
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify) | Ghon complex (1° TB: Mycobacterium bacilli) |
"Honeycomb lung" on x-ray | Interstitial fibrosis |
Hypersegmented neutrophils | Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms) |
Hypochromic, microcytic anemia | Iron deficiency anemia, lead poisoning, thalassemia (HbF sometimes present) |
Increased α-fetoprotein in amniotic fluid/maternal serum | Dating error, anencephaly, spina bifida (neural tube defects) |
Increase uric acid levels | Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics |
Intranuclear eosinophilic droplet-like bodies | Cowdry type A bodies (HSV or CMV) |
Iron-containing nodules in alveolar spetum | Ferruginous bodies (asbestosis: increase chance of mesothelioma) |
Large lysosomal vesicles in phagocytes, immunodeficiency | Chediak-Higashi disease (congenital failure of phagolysosome formation) |
"Lead pipe" appearance of colon on x-ray | Ulcerative colitis (loss of haustra) |
Linear appearance of glomeruli on immunofluorescence | Goodpasture's syndrome |
Low serum ceruloplasmin | Wilson's disease (hepatolenticular degeneration) |
"Lumpy-bumpy" appearance of glomeruli on immunofluorescence | Poststreptococcal glomerulonphritis (immune complex deposition of IgG and C3b) |
Lytic ("hole-punched") bone lesions on x-ray | Multiple myeloma |
Mammary gland ("blue-domed") cyst | Fibrocystic change of the breast |
Monoclonal antibody spike | 1. Multiple myeloma (called the M protein; usually IgG or IgA) 2. Monoclonal gammopathy of undetermined significance (MGUS; normal consequence of aging) 3. Waldenstrom's (M protein = IgM) macroglobulinemia 4. Primary amyloidosis |
Monoclonal globulin protein in blood/urine | Bence Jones proteins (multiple myeloma [kappa or lambda Ig light chains in urine]), Waldenstrom's macroglobulinemia (IgM) |
Mucin-filled cell with peripheral nucleus | Signet ring (gastric carcinoma) |
Narrowingof bowel lumen on barium radiograph | "String sign" (Crohn's disease) |
Needle-shaped, negatively birefringent crystals | Gout (monosodium urate crystals) |
Nodular hyaline deposits in glomeruli | Kimmelstiel-Wilson nodules (diabetic nephropathy) |
Novobiocin response | Sensitive: Staphylococcus epidermidis; resistant: Staphylococcus saprophyticus |
"Nutmeg" appearance of liver | Chronic passive congestion of liver due to right heart failure |
"Onion-skin" periosteal reaction | Ewing's sarcoma (malignant round-cell tumor) |
Optochin response | Sensitive: Streptococcus pneumoniae; resistant: Viridans streptococcus |
Periosteum raised from bone, creating triangular area | Codman's triangle on x-ray (osteosarcoma, Ewing's sarcoma, pyogenic osteomyelitis) |
Podocyte fusion on EM | Minimal change disease (child with nephrotic syndrome) |
Polished, "ivory-like appearance of bone at cartilage erosion | Eburnation (osteoarthritis resulting in bony sclerosis |
Protein aggregates in neurons from hyperphosphorylation of protein tau | Neurofibrillary tangles (Alzheimer's disease and CJD) |
Pseudopalisading tumor cells on brain biopsy | Glioblastoma multiforme |
RBC casts in urine | Acute glomerulonephritis |
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells | Reinke crystals (Leydig cell tumor) |
Renal epithelial casts in urine | Actue toxic/viral nephrosis |
Rhomboid crystals, positively birefringent | Pseudogout (calcium pyrophosphate dihydrate) |
Rib notching | Coarctation of the aorta |
Ring-enhancing brain lesion in AIDS | Toxoplasma gondii |
Sheets of medium-sized lymphoid cells ("starry sky" appearance on histology) | Burkitt's lymphoma (t[8:14] c-myc activation, associated with EBV; "black sky" made up of malignant cells) |
Silver-staining spherical aggregation of tau proteins in neurons | Pick bodies (Pick's disease: progressive dementia, changes in personality) |
"Soap bubble" in femur or tibia on x-ray | Giant cell tumor bone (generally benign) |
"Spikes" on basement membrane, "dome-like" subepithelial deposits | Membranous glomerulonephritis (may progress to nephrotic syndrome) |
Stacks of red blood cells | Rouleaux formation (high ESR, multiple myeloma) |
Stripped vaginal epithelial cells | "Clue cells" Gardneralla vainalis) |
"Tennis-racket" -shaped cytoplasmic organelles (EM) in Langerhans cells | Birbeck granules (histiocytosis X: eosinophilic granuloma) |
Thrombi made of white/red layers | Lines of Zahn (arterial thrombus, layers of platelets/RBCs) |
"Thumb sign" on lateral x-ray | Epiglottitis (Haemophilus influenzae) |
Thyroid-like appearance of kidney | Chronic bacterial pyelonephritis |
"Tram-track" appearance on LM | Membranoproliferative glomerulonephritis |
Triglyceride accumulation in liver cell vacuoles | Fatty liver disease (alcoholic or metabolic syndrome) |
WBCs that look "smudged" | CLL (almost always B cell; affects the elderly) |
"Wire loop" glomerular appearance on LM | Lupus nephropathy |
Yellow CSF | Xanthochromia (previous subarachnoid hemorrhage) |