Swiss Cheese

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A popular term used in various specialties referring to a gross appearance, microscopic pattern, or morphology characterised by multiple, sharply demarcated variably sized and randomly scattered rounded spaces superimposed on a relatively homogeneous or solid background, thus being likened to Swiss cheese. The significance of the pattern reflects the pathological diagnosis, but is often benign
Bone Bone with advanced osteoporosis is characterised by multiple spaces and thus has the gross appearance of Swiss cheese
Brain A descriptive term referring to (lack of fixation) artefact seen in brains inadequately infiltrated with formalin, coupled with invasion of the not-quite-fixed brain by gas-forming Clostridium spp, resulting in multiple gas-filled cysts
(1) Juvenile papillomatosis A term referring to the appearance of a ductal hyperplasia with epithelial proliferation and clustered cyst formation, usually seen in girls and premenopausal women, presenting as localized multinodular masses simulating fibroadenoma
(2) A nonspecific desrictive term for multiple, variably sized spaces lined by ductal epithelium, seen in various benign breast diseases—e.g., blunt duct adenosis, fibrocystic disease, epitheliosis—papillomatosis
Cartilage Kneist syndrome
Endometrium A popular term for the histologic changes of cystic glandular hyperplasia which is seen in the menopausal endometrium, associated with increased estrogen from persistent follicles, granulosa-theca cell tumours of the ovaries, adrenocortical hormones or related to exogenous estrogen therapy. The Swiss cheese effect may occur in postmenopausal bleeding: by light microscopy, there are increased epithelial and stromal elements with large dilated glands lined by a one-cell layer of epithelium. When the cystic glandular hyperplasia is particularly exhuberant, the resulting tissue is termed endometrial polyp, here seen by ultrasonography
Haemangioma Swiss cheese has been used to describe the imaging pattern in musculoskeletal hemangiomas
Heart Swiss cheese changes refer to a specific type of ventricular septal defect that is characterised by multiple serpentine defects—perforations—in the ventricular muscle, which makes surgical closure difficult
Histiocyte Mononuclear-phagocytic cells seen in mucopolysaccharidosis type VIII are characterised by granular cytoplasm filled with variably sized, circumscribed storage vacuoles, likened to Swiss cheese, an appearance which may also be seen in alveolar macrophages following injection of silicon
Liver Swiss cheese refers to the changes in the liver in peliosis hepatis which is punctuated by multiple 0.2 mm in diameter blood-filled lacunae, often devoid of endothelial lining, which may represent distended sinusoids or vessels
(1) A Swiss cheese pattern is seen in a plain chest film in infants with cystic adenomatoid malformation, in which the involved area is overexpanded and mediastinum is shifted towards the normal lung, The infant presents with respiratory distress and may require an emergency lobectomy or pneumonectomy depending on the extent of the lesion
(2) The term Swiss cheese has been used to describe oedematous lungs with marked emphysema; the term honeycomb is more commonly used
Pathology Swiss cheese has been used non-specifically for what is more commonly known as the cribriform patterm, which is characteristic of adenoid cystic carcinomas of any site
Platelet Swiss cheese has been used to describe giant platelets with vacuolated granular spaces, accompanied by thrombocytopenia, increased bleeding time and an abnormal platelet aggregation response to ADP and collagen
Colon Swiss cheese has been used to describe the low-power light microscopic findings in the juvenile retention polyp, a hamartomatous—not precancerous—lesion of the colon. The polyp’s dilated glands are filled with mucus; retention polyps may be first recogn