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Here are the answers for both histopathology OSPE charts:

Chart 26 (Top Image)

1. Lesion: Hashimoto's Thyroiditis (Chronic Lymphocytic Thyroiditis)
2. Two Microscopic Features:
  • Dense lymphocytic infiltration with formation of lymphoid follicles bearing germinal centers within the thyroid parenchyma
  • Hurthle cell (Askanazy cell) metaplasia - residual thyroid follicles are lined by large epithelial cells with abundant, granular, eosinophilic cytoplasm
(Additional feature if needed: atrophy/destruction of thyroid follicles with depleted colloid)

Chart 27 (Bottom Image)

1. Lesion: Actinomycosis (showing characteristic sulfur granules in tissue)
2. Two Microscopic Features:
  • Sulfur granules (Splendore-Hoeppli phenomenon) - basophilic, lobulated colonies of filamentous Actinomyces bacteria with peripheral eosinophilic, amorphous proteinaceous material (clubs)
  • Suppurative inflammation - bacterial colonies surrounded by dense neutrophilic infiltrate forming microabscesses
(Additional feature if needed: surrounding fibrosis and granulation tissue with chronic inflammatory cells)
Quick memory aids:
  • Hashimoto's = "lymphocytes eating the thyroid" + Hurthle cell change
  • Actinomycosis = "sulfur granules in pus" + filamentous gram-positive bacteria (not a true fungus!)
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