Basic Histology Part 1

‭Basic Histology‬ ‭Some epithelial cells have‬‭apical surfaces.‬ ‭Histology‬‭: the study of tissues‬ ‭Apical surface:‬‭The free surface of epithelial tissues‬ ‭Apical specializations‬ ‭Cilla‬ ‭Microvilli‬ ‭Stereocillia‬ ‭Motile‬ ‭Non-motile‬ ‭Non-motile‬ ‭Hairlike‬ ‭Brush border‬ ‭Elongated & branching‬ ‭Types of tissues‬ ‭Epithelial‬ ‭Derived from ectoderm, mesoderm, endoderm‬ ‭ ‬ ‭Fun‬‭ction: _______________________‬ ★ ‭ ‬D ★ ‭ istance:‬‭close to each other‬‭(membranes)‬ ‭★‬ ‭Attached to the‬‭basement membrane‬ ‭★‬ ‭They are‬‭avascular‬ ‭ imple‬ ‭‬ S C ‭L‬ ‭squamous‬ ‭ ‬ A ‭S‬ ‭S‬ ‭I‬ ‭F‬ ‭I‬ ‭C‬ ‭A‬ ‭T‬ ‭I‬ ‭O‬ ‭N‬ ‭ ‬ O ‭F‬ ‭ ‬‭owman’s capsule,‬‭E‬‭ndothelium,‬ B ‭L‬‭oop of Henle,‬‭A‬‭lveoli‬ ‭Simple cuboidal‬ ‭G‬‭land ducts (non-sweat)‬ ‭ ‬‭hyroid follicle walls‬ T ‭T‬‭ubules of kidney‬ ‭Simple columnar‬ ‭Non-ciliated:‬‭Gallbladder‬ ‭Ciliated:‬‭U‬‭terine‬‭T‬‭ube‬ ‭ tratified‬ S ‭squamous‬ ‭Keratinized:‬‭S‬‭kin‬ ‭ tratified‬ S ‭cuboidal‬ ‭Sweat Gland Ducts‬ ‭ tratified‬ S ‭columnar‬ ‭_______________‬ ‭Some epithelial cells have‬‭glands‬‭.‬ ‭Endocrine Glands‬ ‭Exocrine Glands‬ ‭Secrete into organs or body surfaces‬ ‭Secrete directly into the blood‬ ‭_______________‬ ‭_______________‬ ‭Involved with pancreatic hormones‬ ‭Involved with pancreatic enzymes‬ ‭Tubular‬ ‭Compound‬‭(Tubulo-Acinar)‬ ‭Merocrine‬ ‭Apocrine‬ ‭Holocrine‬ ‭None‬ ‭Some‬ ‭_________‬ ‭Goblet cells‬ ‭Sweat glands‬ ‭Mammary‬ ‭glands‬ ‭Sebaceous‬ ‭glands‬ ‭Cytoplasm Loss‬ ‭Examples‬ ‭ ‭Submandibular‬ ‭Methods of Secretion‬ ‭V‬‭agina,‬‭E‬‭sophagus,‬‭C‬‭ervix‬ ‭‬ E ‭P‬ ‭I‬ ‭ seudostratified‬ C P ‭ iliated:‬‭Trachea‬ ‭T‬ c ‭ olumnar‬ ‭H‬ ‭Stereociliated:‬‭__________‬ ‭E‬ ‭L‬ ‭I‬ ‭Transitional‬ ‭Urinary Bladder‬ ‭U‬ ‭M‬ ‭ imple:‬‭Sweat & pyloric‬ S ‭Compound:‬‭Brunner‬ ‭Simple:‬‭Littre‬ ‭Compound:‬‭Lacrimal‬ ‭ ypes and‬ T ‭Examples of‬ ‭Acinar‬ ‭Exocrine‬ ‭Glands‬ ‭Nervous‬ ‭Derived from‬‭ectoderm‬ ‭●‬ ‭Function: rapid communication.‬ ‭Main types of cells:‬ ‭1.‬‭Neurons‬ ‭ ‬ R ★ ‭ eceive‬‭stimuli‬ ‭★‬ ‭Conduct‬‭wave of excitability‬ ‭2.‬‭________‬ ‭ ‬ _ ★ ‭ __________‬ ‭★‬ ‭For support, protection, and insulation‬ ‭Types of Neuroglia (Glial cells)‬ ‭Astrocytes‬ ‭In CNS: Critical in many body functions‬ ‭Schwann cell‬ ‭In PNS: Myelin production‬ ‭Oligodendrocyte‬ ‭In CNS: Myelin production‬ ‭_________‬ ‭In CNS: Macrophages‬ ‭Ependymal cells‬ ‭In CNS: Secretes CSF‬ ‭Satellite cells‬ ‭In PNS: Protective functions‬ ‭Muscular‬ ‭Derived from‬‭mesoderm‬ ‭●‬ ‭Function‬‭:‬‭_____________‬ ‭They are highly specialized types of tissues‬ ‭Skeletal‬ ‭★‬ ‭Elongated/Cylindrical‬ ‭‬ T ‭y‬ ‭p‬ ‭e‬ ‭s‬ ‭★‬ ‭ ‬ ★ ‭Smooth‬ ‭★‬ ‭ ‬ ★ ‭★‬ ‭ ‬ ★ ‭ ardiac‬ ‭★‬ C ‭ ‬ ★ ‭★‬ ‭ ‬ ★ ‭ ‬ ★ ‭Connective‬ ‭ ultinucleated (peripheral)‬ M ‭Voluntary‬ ‭Spindle-shaped. tapered‬ ‭Non-striated‬ ‭Uninucleated (central)‬ ‭Most able to regenerate‬ ‭Cylindrical‬ ‭Branching‬ ‭1-2 nuclei (central)‬ ‭Least able to regenerate‬ ‭With intercalated disk‬ ‭Derived from‬‭mesoderm‬ ‭‬ M ● ‭ OST ABUNDANT type of tissue‬ ‭●‬ ‭Functions: ________________‬ ‭Components‬ ‭ ‭1. Extracellular Matrix (_______________)‬ ‭ ‬ A ★ ‭ morphous & gel-like‬ ‭★‬ ‭Where‬‭cells and fibers‬‭are suspended‬ ‭2. Cells‬ ‭ . Fixed:‬‭adipocytes, fibroblasts, mast cells‬ A ‭B. Wandering:‬‭White blood cells‬ ‭3. Fibers:‬‭produced by‬‭___________‬ ‭ ‬ C ‭ ollagen‬ ➔ ‭◆‬ ‭Most abundant and major component of CT‬ ‭ ‬ ‭Elastic Fibers‬ ➔ ‭◆‬ ‭Can stretch and recoil; with resilient property‬ ‭ ‬ ‭Reticular‬ ➔ ‭◆‬ ‭Argyrophilic; important for lymphoid tissue support, but delicate‬ ‭Examples of Connective Tissue‬ ‭General‬ ‭ oose: BM, lymph node, embryo, hypodermis‬ L ‭Dense: corneal stroma, tendons, dermis‬ ‭Special‬ ‭Cartilage: hyaline, fibrous, elastic‬ ‭Bone: compact (diaphysis), cancellous (epiphysis)‬ ‭Others: blood, lymph. Hematopoietic tissue, adipose tissue‬ ‭Deposits‬ ‭Fibrin: insoluble protein seen after injury and inflammation‬ ‭Fibrinoid: eosinophilic, seen in collagen diseases‬ ‭Hyaline: wide variety of exudates and deposits‬ ‭Amyloid: composed of chondroitin sulfate acid protein complex‬ ‭Other Relevant Basic Histology Information‬ ‭ . If Glycogen is stored form of glucose in liver, then Mucin is a carbohydrate‬ 1 ‭bound to other substances as CT matrix, and are secreted by‬‭goblet cells‬ ‭2. Acid Mucopolysaccharides are mucins that are‬‭PAS-negative‬ ‭3. Mucoproteins are also mucins that‬‭do not stain‬‭with Alcian Blue‬ ‭4. Hyaline is stained by PAS‬ ‭4.‬‭Ground substance‬‭of an extracellular matrix is‬‭a transparent, colourless,‬ ‭amorphous gelatinous material that fills the spaces between fibers and cells.‬ ‭General Pathology‬ ‬ ‭Cell Adaptation‬ ‭Pathology (a.k.a. pathobiology)‬ ‭★‬ ‭Etymology: Greek words‬‭“Pathos” (pain)‬‭and‬‭“logos”‬‭(study).‬ ‭Atrophy‬ ‭_________ in size‬ ‭ he study of the structural and functional changes in cells, tissues,‬ T ‭and organs that underlies the disease.‬ ‭ ‬ ‭Characteristic feature:‬‭Autophagic granules‬ ★ ‭It bridges the discipline of both basic science and clinical practice.‬ ‭★‬ D ‭ ecreased‬‭workload‬ ‭ ‬ ‭Muscle denervation‬ ★ ‭(↓‬‭uterus size due to childbirth)‬ ‭★‬ ‭Decreased blood supply‬ ‭★‬ ‭Decreased lymphoid tissue‬ ‭★‬ N ‭ utritional deficiency‬ ‭★‬ ‭Old age‬ ‭★‬ ‭Misuse‬ ‭★‬ ‭Others are idiopathic‬ ‭Divisions of Pathology‬ ‭1. Gross (Macroscopic) and Microscopic Pathology‬ ‭2. Anatomic Pathology‬ ‭ ‬ ‭Exfoliative cytology:‬‭examination of desquamated cells‬ ➢ ‭ ‬ ‭Autopsy:‬‭to know the cause of death (‬‭for dead persons‬‭)‬ ➢ ‭ ‬ ‭Surgical pathology:‬‭parts removed from‬‭living persons‬ ➢ ‭3. Clinical Pathology‬ ‭★‬ ‭Includes‬‭the usual sections of laboratory medicine‬ ‭4‬‭. Molecular Pathology‬ ‭★‬ ‭Includes genetics, molecular biology and diagnostics‬ ‭Cellular Growth and Differentiation‬ ‭Physiologic‬ ‭Hypertrophy‬ ‭Pathologic‬ ‭Increased _________ leads to larger organ size‬ ‭ ‬ ‭NO NEW CELLS:‬‭synthesis of more structural components‬ ★ ‭ ‬ C ‭ ause:‬‭Increased functional demand‬ ★ ‭ ‬ ‭Seen in‬‭skeletal and heart muscles‬ ★ ‭ hysiologic: __________‬ P ‭Pathologic: Myocardial hypertrophy‬ ‭Classes of Cells - “How they divide to replace lost cells.”‬ ‭Labile‬ ‭Frequent division: ____________ (Skin, hematopoietic cells)‬ ‭Stable‬ ‭Definite replication pattern‬‭(Hepatocytes, parenchymal‬‭cells)‬ ‭_________‬ ‭Non-replicating‬‭(Neurons, myocardial cells)‬ ‭Cell Growth Abnormalities‬ ‭Aplasia‬ ‭Incomplete/Defective tissue development‬ ‭________‬ ‭Non-appearance of organ‬ ‭_________‬ ‭Failure of an organ to reach adult/mature size‬ ‭Atresia‬ ‭Failure of an organ to form an opening‬ ‭ ‭Hyperplasia‬ ‭Increased __________ leads to larger organ size‬ ‭ ‬ ‭WITH CELL DIVISION‬ ★ ‭➢‬ ‭Occurs if cells are‬‭capable of producing DNA‬‭, enabling‬‭mitotic division‬ ‭Physiologic‬ ‭ ‬ ‭From normal stimuli‬ ★ ‭Pathologic‬ ‭Growth factor stimulation‬ ‭★‬ ‭Hormonal‬ ‭★‬ ‭➢‬ ‭breast and uterus hyperplasia‬ ‭★‬ ‭during pregnancy‬ ‭★‬ ‭★‬ ‭Compensatory‬ ‭★‬ ‭➢‬ ‭Liver regeneration following‬ ‭hepatectomy‬ ‭➢‬ ‭Kidney enlargement‬ ‭ ‬‭Hormonal stimulation‬ ↑ ‭Papilloma virus‬ ‭Lymphoid hyperplasia‬ ‭Grave’s disease (Diffuse)‬ ‭Metaplasia‬ ‭Change of one cell type to another‬ ‭Still‬‭reversible‬ ‭➢‬ ‭Adaptation to environmental changes or functional demands‬ ‭ OST COMMON TYPE: __________________‬ M ‭Squamous Metaplasia‬ ‭Seen commonly among Smokers‬ ‭Cell Injury‬ I‭ t may be:‬ ‭1. The cell’s adaptive response limits have been exceeded.‬ ‭2. The cell is exposed to a damaging agent or stress.‬ ‭The affected cell may recover (reversible) or die (reversible)‬ ‭ quamous to Columnar:‬‭________________‬ S ‭Intestinal Metaplasia‬ ‭Seen in persons with acid reflux‬ ‭Dysplasia‬ ‭Change of cell appearance to variable forms‬ ‭Also known as‬‭________________‬ ‭ ‬A ★ ‭ bnormal growth and differentiation (pleomorphic)‬ ‭★‬ ‭With variable size, shape, and orientation‬ ‭★‬ ‭Also still‬‭reversible‬‭(like metaplasia)‬ ‭ s a‬‭preneoplastic lesion,‬‭it may lead to cancer‬ A ‭but not necessarily.‬ ‭Anaplasia‬ ‭Cell Injury Classification‬ ‭Reversible‬ ‭Patterns of Cell Injury‬ ‭Microscopic‬ ‭Change of cell to a more primitive form‬ ‭A‬‭lso known as‬‭_________________‬ ‭Ultrastructural‬ ‭➔‬ ‭Plasma membrane changes‬ ‭ ‬ ‭Blebbing‬ ◆ ‭◆‬ ‭Blunting‬ ‭◆‬ ‭Microvilli loss‬ ‭➔‬ ‭Mitochondrial changes‬ ‭➔‬ ‭ER dilation‬ ‭➔‬ ‭Nuclear aggregations‬ ‭★‬ ‭Less differentiated, embryonic looking.‬ I‭ t exhibits the following:‬ ‭1. Pleomorphism (like dysplasia)‬ ‭2. Hyperchromatism‬ ‭3. Increased N:C ratio‬ ‭4. Prominent nucleoli‬ ‭5. Abnormal mitoses‬ ‭6. Cellular dyspolarity‬ ‭ ‭Among all cell adaptations, Anaplasia is the only one that is‬‭____________‬ ‭Neoplasia‬ ‭*see page 7 for full discussion*‬ ‭➔‬ ‭________________________‬ ‭◆‬ ‭Cellular swelling‬ ‭◆‬ ‭Vacuole formation‬ ‭➔‬ ‭Eosinophilia‬ ‭ atty‬ F ‭Degeneration‬ ‭It affects the‬‭______________‬ ‭ yaline‬ H ‭changes‬ ‭ ause: ____________________‬ C ‭_______________________‬ I‭ n H&E, it appears‬‭homogeneous,‬ ‭glassy, and eosinophilia‬ ‭ . Carbon‬ 1 ‭2. Silica‬ ‭3. Iron‬ ‭ __________‬ _ ‭pigment‬ ‭accumulation‬ ‭. 1 ‭2. ‭3 ‭4. ‭Calcification‬ ‭ etastatic (hormonal): due to‬ M ‭hypercalcemia‬ Melanin‬ Bilirubin‬ Hemosiderin: contains‬‭ferritin‬ Lipofuscin: “wear and tear” pigment‬ ‭ ystrophic: previously damaged‬ D ‭tissues (old trauma, lesions)‬ ‭Cell Death‬ ‭It is the ultimate result of cell injury‬ ‭Patterns of Cell Death‬ ‭Necrosis‬ ‭Apoptosis‬ ‭Basic definition‬ ‭_________________‬ ‭_________________‬ ‭Nucleus‬ ‭Pyknosis to Karyolysis‬ ‭Fragmentation‬ ‭Cytoplasm‬ ‭___________‬ ‭___________‬ ‭Plasma Membrane‬ ‭Disrupted‬ ‭Intact‬ ‭Action/Mechanism‬ ‭★‬ E ‭ nzyme digestion of dead‬ ‭cellular elements‬ ‭★‬ ‭Protein denaturation‬ ‭ ‬ C ★ ‭ ytoplasmic bleb formation‬ ‭★‬ ‭Phagocytosis of apoptotic‬ ‭cells‬ , ‭ . Plumbism (Lead)‬ 4 ‭5. Argyria (Silver)‬ ‭ __________‬ _ ‭pigment‬ ‭accumulation‬ ‭There is an‬‭inflammatory reaction in necrosis‬‭, while‬‭none in apoptosis.‬ ‭Necrobiosis‬‭is‬‭physiological cell death‬‭, such as‬‭cell‬‭sloughing of skin.‬ ‭Irreversible‬ ‭It leads to‬‭_________‬‭.‬ ‭Patterns of Necrosis‬ ‭It involves the following:‬ ‭ ‬ ‭Enzymatic digestion of dead cellular elements‬ ➔ ‭➔‬ ‭Protein denaturation‬ ‭➔‬ ‭Autolysis by‬‭lysosomal enzymes‬ ‭➔‬ ‭Increased eosinophilia in the cytoplasm‬ ‭➔‬ ‭Nonspecific breakdown of DNA*‬ ‭*Mechanisms of nonspecific DNA breakdown‬ ‭1. _________‬ ‭Appearance:‬‭___________;‬‭outline of cells is maintained‬ ‭Cause:‬‭Ischemia‬ ‭Examples: My‬‭ocardial infarction,‬‭L‬‭ungs,‬‭K‬‭idney,‬‭S‬‭pleen‬ ‭___________‬ ‭Appearance:‬‭Liquefied;‬‭pus formation‬ ‭Mechanism:‬‭Complete destruction of cells‬ ‭Examples:‬‭Cerebral infarction‬ ‭Caseous‬ ‭Shrinkage/Reduction/Condensation‬ ‭2. Karyorrhexis‬ ‭F‬‭r‬‭agmentation‬ ‭3. _________‬ ‭Coagulative‬ ‭Macroscopic appearance:‬‭________________‬ ‭Microscopic appearance:‬‭amorphous eosinophilic‬ ‭Examples:‬‭TB, Tularemia, Lymphogranuloma venereum‬ ‭______‬ ‭Disso‬‭l‬‭ution/Fading‬ ‭Appearance:‬‭“Chalky white” due to fatty acids and‬‭calcium‬ ‭Cause:‬‭Fat destruction - release of pancreatic lipase‬ ‭Examples:‬‭Pancreatitis‬ ‭ ‭___________‬ ‭ ause:‬‭Necrosis (2° to ischemia), with superimposed‬‭infection‬ C ‭Mechanism:‬‭sulfide gas production‬ ‭Wet Gangrene‬ ‭Dry Gangrene‬ ‭Cause‬ ‭V‬‭enous occlusion‬ ‭A‬‭rterial occlusion‬ ‭Example‬ ‭Embolism of foot‬ ‭Bacterial infection‬ ‭Inflammation‬ ‬ ‭Ulcer‬‭is a local defect (‬‭excavation)‬‭of a tissue surface‬‭by sloughing of inflamed tissue‬ ‭It is a complex reaction to various damaging agents‬ ‭➔‬ ‭Vascular response‬ ‭Edema‬‭is an excess fluid in the interstitial tissue‬‭or serous cavities‬ ‭Exudation‬‭is the‬‭escape‬‭of fluid, proteins, and cells‬‭from blood into body cavities‬ ‭ ‬ ‭Migration and activation of leukocytes‬ ➔ ‭➔‬ ‭Systemic reactions‬ ‭It is essential in tissue repair‬ ‭ ‬ ‭Destroy, dilute, or wall-off (separate) infectious agent‬ ➔ ‭➔‬ ‭Sets in motion the tissue repair:‬‭regeneration & scarring‬ ‭Ultimate goal‬‭:‬‭___________________________________________‬ ‭Types of exudation‬ ‭Transudate‬ ‭Less number of‬‭cells and proteins‬ ‭With‬‭pus‬‭;‬‭↑‬ ‭inflammatory cells, and debris‬ ‭Exudate‬ ‭Cardinal Signs of Inflammation‬ ‭Rubor‬ ‭Redness (‬‭↑‬ ‭blood flow)‬ ‭Calor‬ ‭Heat (‬‭↑‬ ‭blood flow)‬ ‭Tumor‬ ‭Swelling (‬‭↓‬‭capillary permeability)‬ ‭Dolor‬ ‭Pain (‬‭↑‬ ‭sensory nerve pressure)‬ ‭Functio Laesa‬ ‭Loss of function‬ ‭Acute Inflammation‬ ‭ apid response‬ R ‭Hallmark:‬‭________________‬ ‭Cells involved:‬‭PMNs (neutrophils)‬ ‭With alterations in blood flow‬ ‭ equence of response:‬ S ‭1. Emigration‬ ‭2. Chemotaxis‬ ‭3. Phagocytosis‬ ‭4. Opsonization‬ ‭5. Intracellular microbial killing‬ ‭Results/Outcomes‬ ‭Resolution of structure and function‬ ‭Conversion to chronic inflammation‬ ‭Serous‬ ‭ rom‬‭serosal mesothelial cells‬‭(Pleural, pericardial,‬ F ‭peritoneal)‬ ‭________‬ ‭Large molecules (‬‭fibrinogen)‬‭pass out from the blood‬ ‭________‬ ‭Mucosal hypersecretion‬ ‭Hemorrhagic‬ ‭Exudates‬‭with‬‭______‬ ‭Suppurative (Purulent)‬ ‭Exudates‬‭with‬‭___‬ ‭Chronic Inflammation‬ ‭ rolonged duration‬ P ‭Cells involved:‬‭Mononuclears‬ ‭With tissue destruction‬ ‭ ealing attempt by connective‬ H ‭tissue replacement‬‭via‬ ‭1. Angiogenesis‬ ‭2.‬‭Fibrosis (scarring)‬ ‭ ranulomatous Inflammation‬ G ‭★‬ ‭A distinctive pattern of chronic‬ ‭inflammation‬ ‭ ‬ ‭Hallmark:‬‭Granulomas‬‭**‬ ★ ‭★‬ ‭Multinucleated giant cells seen‬‭***‬ ‭ een in: TB, syphilis, Leprosy‬ S ‭Schistosomiasis, Cat Scratch disease‬ ‭. ‭Destruction and persistence*‬ ‭Inflammation according to exudate characteristic‬ ‭________‬‭is the resolution of inflammation.‬ ‭ imple resolution‬‭involves the following:‬ S ‭1.‬‭No destruction‬‭of normal tissue‬ ‭2. The offending agent is neutralized‬ ‭3. Vessels return to their normal permeability state‬ ‭4. Excess fluid is absorbed‬ ‭5. Clearance of mediators and inflammatory cells‬ ‭ egeneration‬‭involves:‬ R ‭1. Replacement of loss/necrotic tissue to a new one.‬ ‭2. Intact, neighbouring cells surrounding the dead cells will proliferate.‬ ‭If too much damage has been done, the solution would be‬‭_______‬‭________‬‭.‬ ‭ ibrosis‬‭is composed of fibroblasts and connective‬‭tissue fibers‬ F ‭via‬‭_________________________‬ ‭Neoplasia‬ ‭It is the process of‬‭____________‬ ‭ The new growth (neoplasm) is known as‬‭tumor (swelling).‬ ‭Neoplasm‬ ‭ ‬ ★ ‭★‬ ‭★‬ ‭★‬ ‭★‬ ‭ bnormal tissue mass‬ A ‭Growth‬‭exceeds and uncoordinated‬‭with that of a normal‬‭tissue‬ ‭Behaves like parasites; undergoes competition with normal cells‬ ‭Persists after cessation of stimuli which evoked the change‬ ‭Persistence results from‬‭heritable genetic alterations‬ ‭Mixed tumors‬ ‭_______________________: dissimilar from others‬ ‭Most common: Pleomorphic adenoma‬‭(salivary glands)‬ ‭Teratomas‬ ‭Compound tumors‬‭: with cells from at least one germ‬‭layer‬ ‭Classification of neoplasms‬ ‭Differentiation‬ ‭If cells are comparable to normal cells‬ ‭Well-differentiated tumors (‬‭resemble normal cells)‬‭are ruled as‬‭less malignant.‬ ‭Components of a tumor‬ ‭ . Parenchyma: made of‬‭_____________________‬ 1 ‭2. Stroma: made of‬‭___________________________‬ ‭Undifferentiated cell =‬‭younger forms (anaplastic)‬ ‭Nomenclature of neoplasms‬ ‭ enign:‬‭well-differentiated‬ B ‭Malignant:‬‭lack of differentiation with anaplasia‬ ‭Benign‬ ‭Metastasis‬ ‭Tumors are localized; does not metastasize‬ ‭Tumor implants discontinue from primary tumor‬ ‭Benign mesenchymal tumors‬ ‭ ‬ ‭Most reliable feature of malignancy‬ ★ ‭. 1 ‭2. ‭3. ‭4. ‭ enign:‬‭absent‬ B ‭Malignant: frequently present‬ ‭★‬ ‭They penetrate blood vessels, lymphatics, and body cavities to spread‬ Fibroblasts: fibroma‬ Chondroblasts: chondroma‬ Osteoblasts: Osteoma‬ Lipoblasts: lipoma‬ ‭Benign epithelial tumors‬ ‭. 1 ‭2. ‭3. ‭4. Glandular pattern: adenoma‬ Finger-like/warty projections: papilloma‬ Large cystic mass: cystadenoma‬ Placental: __________________‬ ‭Malignant‬ ‭Invasive; destroys adjacent areas‬ ‭Malignant mesenchymal tumors‬‭(‬‭sa‬‭rcomas)‬ ‭. 1 ‭2. ‭3. ‭4. Fibrosarcoma‬ Chondrosarcoma‬ Osteosarcoma‬ Leukemia/lymphoma‬ ‭ ‭ alignant epithelial tumors‬‭(‬‭car‬‭cinomas)‬ M ‭1.‬‭Adenocarcinoma‬ ‭2. Squamous cell carcinoma‬ ‭3. Testicular:‬‭_________‬ ‭All neoplasms metastasize EXCEPT‬‭______________________________‬ ‭Local invasion‬ ‭Infiltration of surrounding normal tissues‬ ‭ ost common pathway for carcinomas:‬‭__________________‬ M ‭Most common pathway for sarcomas:‬‭__________________‬ ‭ enign:‬‭With well-demarcated masses that do not invade‬‭surrounding cells‬ B ‭Malignant:‬‭Locally invasive‬ ‭When penetrating a natural field (‬‭seeding‬‭), they usually‬‭use the‬‭____________‬ ‭Rate of Growth‬ ‭Enlargement of the tumor‬ ‭ enign:‬‭Progressive and slow‬ B ‭Malignant:‬‭Erratic and slow to rapid‬ ‭Based on (‬‭1) degree of differentiation,‬‭and‬‭(2)‬‭number of mitoses‬ ‭Differentiated cells‬ ‭Undifferentiated cells‬ ‭I‬ ‭100 - 75 %‬ ‭0 - 25 %‬ ‭II‬ ‭75 - 50 %‬ ‭25 - 50 %‬ ‭III‬ ‭50 - 25 %‬ ‭50 - 75 %‬ ‭IV‬ ‭25 - 0 %‬ ‭75 - 100 %‬ ‭Excision and examination of tissue in‬‭living persons.‬ ‭Primary usage‬‭:‬‭Diagnosis of malignant disease‬ ‭Broder’s Classification‬ ‭Grades‬ ‭Types of Biopsy‬ ‭Staging of Tumors‬ ‭Excisional biopsy‬ ‭➢‬ ‭Tissue removal:‬‭________‬ ‭ ‬ ‭MOST RELIABLE BIOPSY‬ ➢ ‭Incisional biopsy‬ ‭ ‬ ‭Tissue removal:‬‭________‬ ➢ ‭➢‬ ‭Preferred for‬‭large tumors‬‭that cannot be excised‬ ‭____________‬ ‭➢‬ ‭Tissue removal:‬‭fluid aspiration‬ ‭ ‬ ‭LEAST INVASIVE‬ ➢ ‭➢‬ ‭Simple, inexpensive, no need for hospitalization‬ ‭Most common system for staging:‬‭TNM Classification‬ ‭Basis of staging and corresponding scores‬ ‭Size and extent of invasion‬ ‭Lymph node involvement‬ ‭“T” score‬ ‭“N” score‬ ‭“M” score‬ ‭Carcinoma in situ‬ ‭N‬‭x‬ ‭Cannot be evaluated‬ ‭M‬‭0‬ ‭No metastasis‬ ‭T‬‭a‬ ‭Non-invasive‬ ‭N‬‭0‬ ‭No regional nodes‬ ‭M‬‭1‬ ‭With metastasis‬ ‭T‬‭x‬ ‭Cannot be evaluated‬ ‭N‬‭1‬ ‭1 regional node‬ ‭M‬‭x‬ ‭Not evaluable‬ ‭T‬‭0‬ ‭Free of tumor‬ ‭N‬‭2‬ ‭Multiple mobile nodes‬ ‭T‬‭1‬ ‭Lesion <2 cm‬ ‭N‬‭3‬ ‭Fixed regional nodes‬ ‭T‬‭2‬ ‭Lesion 2-5cm‬ ‭N‬‭4‬ ‭Beyond regional nodes‬ ‭T‬‭3‬ ‭Skin/chest wall involved‬ ‭T‬‭4‬ ‭Tumor invasion‬ ‭Adjacent organs‬ ‭T‬‭4b‬ ‭Distant organs‬ ‭____________‬ ‭➢‬ ‭Tissue removal:‬‭partial by‬‭special forceps‬ ‭Example:‬‭Endoscopic biopsy‬ ‭Cutaneous biopsy‬ ‭Punch biopsy‬ ‭➢‬ ‭Tissue removal:‬‭skin fragments‬ ‭ ‬ ‭For diagnosis of‬‭__________‬ ➢ ‭➢‬ ‭Tissue removal:‬‭short cylinder or “apple core”‬ ‭ ‬ ‭For skin specimens >2 mm in a paraffin block‬ ➢ ‭Shave biopsy‬ ‭➢‬ ‭Tissue removal:‬‭shaving off top skin layer‬ ‭ ‬ ‭For curettage specimens‬ ➢ ‭____________‬ ‭➢‬ ‭Tissue removal:‬‭wedge shaped‬ ‭ ‬ ‭Usually for lung specimens (whole organs)‬ ➢ ‭Exfoliative Cytology‬ ‭*see page 31 for full discussion*‬ ‭Death‬ ‭Laboratory Diagnosis‬ ‭ ‭•‬‭Histologic & Cytologic Methods‬ ‭•‬‭Immunohistochemistry‬ ‭•‬‭Molecular methods‬ ‭•‬‭Flow cytometry‬ ‭Examples:‬‭FNAB, BM aspiration‬ ‭Presence of metastases‬ ‭T‬‭is‬ ‭T‬‭4a‬ ‬ ‭Biopsy‬ ‭Grading of Tumors‬ ‭•‬‭Tumor markers‬ ‭It is the cessation of life.‬ ‭ omatic death‬‭is the death of the organism‬‭as a‬‭whole.‬ S ‭Two‬‭physicians are needed to declare that a person‬‭is dead.‬ ‭(At least one of the two physicians should have a minimum of‬‭5 years‬‭of experience)‬ ‭Self-digestion of cells‬ ‭Primary Changes‬‭DURING‬‭Somatic Death‬ ‭Autolysis‬ ‭C‬‭irculatory,‬‭R‬‭espiratory, and‬‭C‬‭entral Nervous System‬‭failure‬ ‭ echanism:‬‭_______________________‬ M ‭★‬ ‭Putrefactive bacteria enhances cellular destruction‬ ‭ ‬ ‭No inflammatory response‬ ★ ‭Secondary Changes‬‭AFTER‬‭Somatic Death‬ ‭Algor Mortis‬ ‭Cooling of the body‬ ‭Autopsy‬ ‭Also known as _______________________________‬ ‭ ate of cooling:‬‭____‬ R ‭Not a reliable indicator of the time of death‬ ‭Slower in infectious disease followed by warming of temperature‬ ‭Rigor Mortis‬ ‭People involved in autopsy procedures:‬ ‭ 1. Prosector: the‬‭_________‬ ‭Stiffening of the body‬ ‭Starts‬‭at‬‭___________‬‭2-3 hours after death‬‭and‬‭completes‬‭6-8 hours.‬ ‭Faster in warm temperatures‬ ‭Livor Mortis‬ I‭ t is the systematic examination of a corpse to‬‭determine the cause of death‬ ‭It is also done to preserve the tissues of the dead‬‭for further study.‬ ‭ . Diener: the assistant of the prosector‬ 2 ‭3.‬‭________‬‭: medico-legal examiner‬ ‭Types of Autopsy‬ ‭Purplish discoloration of the body‬ ‭ ause:‬‭sinking of blood into capillaries of the dependent‬‭body parts.‬ C ‭Starts‬‭as early as 20 mins after death‬‭, and‬‭fully‬‭evident within 4-8 hours‬ ‭★‬ ‭Disc‬‭oloration‬‭disappears‬‭upon application of pressure‬ ‭ ‬ ‭Blood oozes‬‭if incised,‬‭unlike ecchymoses (does not‬‭ooze)‬ ★ ‭Value:‬‭__________________________________‬ ‭________‬ ‭ omplete examination of all organs, including the brain‬ C ‭EXCEPT‬‭spinal cord and blood vessels of arms and legs‬ ‭______‬ ‭Partial (‬‭more than one organ‬‭) examination‬ ‭Selective‬ ‭Examination restricted to‬‭at least a single organ‬ ‭ ostmortem Clotting‬ ‭Settling and separation of RBCs from the fluid‬ P ‭Techniques of Autopsy‬ ‭Postmortem clotting‬ ‭Antemortem clotting‬ ‭ ‬ C ❖ ‭ urrant jelly‬‭: Sediments of RBC‬ ❖ ‭ ‬ ‭Not easily detachable from blood vessels‬ ‭❖‬ ‭Chicken fat‬‭: Cleared are of RBC‬ ❖ ‭ ‬ ‭No chicken fat or currant jelly‬ ‭ ‬ ‭Consistency: rubbery‬ ‭ ‬ C ‭ onsistency: granular & friable‬ ❖ ❖ ‭Virchow‬ ‭ rgans are removed‬‭one by one‬ O ‭_________________‬ ‭ dvantage: visualization of pathologic changes of organs‬ A ‭Disadvantage: loss of interorgan relationships‬ ‭Desiccation‬ ‭Drying and wrinkling of anterior chamber of eye‬ ‭Rokitansky‬ ‭In situ‬‭dissection, in part combined with‬‭en bloc‬ ‭Putrefaction‬ ‭Rotting and decomposition of the body‬ ‭______‬ ‭ n bloc‬‭removal of cervical, abdominal, and urogenital‬ E ‭organ systems as‬‭organ blocks‬ ‭______‬ ‭ n masse‬‭removal (all organs removed at the same time)‬ E ‭Best for routine inspection and preservation of connections‬ ‭between organs and organ systems‬ ‭ ‭Changes seen:‬ ‭•‬‭Greenish blue discoloration‬ ‭•‬‭Corneal retraction‬ ‭•‬‭Skin peeling‬ ‭•‬‭Muscle softening (autodigestion)‬ ‭•‬‭Loss of rigor mortis‬ ‭•‬‭Swelling of face‬ ‭Autopsy procedures‬ ‭ reparatory‬ P ‭Measures‬ ‭ ‬ ‭Consent given by‬‭___________‬‭in this order:‬ ★ ‭Spouse → Child of legal age → Grandchild of legal age →‬ ‭Parent → Adult sibling → Grandparents → Adult uncles and‬ ‭aunts → Other relatives → Friend → Public official in legal‬ ‭authority‬ ‭★‬ ‭Documents: Clinical abstract, medical records‬ ‭ _______‬ _ ‭Inspection‬ ‭ bserving signs of violence, lacerations, identifying marks,‬ O ‭edema, distention, hemorrhages, jaundice‬ ‭ _______‬ _ ‭Inspection‬ ‭Primary incision using‬‭________‬‭to expose the abdomen‬ ‭Dissection‬ ‭Examination of organs‬ ‭Heart‬ ‭ rain‬ B ‭Kidney‬ ‭Lungs‬ ‭ issue,‬ T ‭fluid, and‬ ‭other‬ ‭specimens‬ ‭ Blood flow”‬‭method”:‬‭transverse‬‭cutting‬ “ ‭from inferior vena cava to superior vena cava‬ ‭Coronal‬‭method‬ ‭Along the‬‭longitudinal axis of convexity‬ ‭Sagittal‬‭method‬ ‭ acterial‬ B ‭culture‬ ‭★‬ H ‭ eart’s blood:‬‭20 mL‬‭using a syringe with‬ ‭a needle (‬‭18-20g‬‭) on ventricle or atrium‬ ‭★‬ S ‭ olid organs: sear the surface to‬ ‭sterilize, and use an applicator stick‬ ‭★‬ L ‭ ung: acetone or alcohol cleansing, and‬ ‭slice the specimen for touch preparation‬ ‭Blood‬ ‭ 0-50 mL‬‭for toxicology at femoral artery or‬ 4 ‭veins (‬‭best sites for collection‬‭)‬ ‭_____‬ ‭It should be‬‭pulled,‬‭not cut‬ ‭Nails‬ ‭Either‬‭clippings‬‭or‬‭whole nail‬ ‭ ‭ leural /‬ P ‭ 0 mL‬‭for chemical analysis (pleural) or‬ 5 ‭Peritoneal‬ ‭culture and smear (peritoneal)‬ ‭fluid‬ ‭Organ Weights‬ ‭Liver‬ ‭________________‬ ‭_______‬ ‭1400g (males); 1275g (females)‬ ‭Heart‬ ‭300g (males); 250g (females)‬ ‭Lungs‬ ‭375g (left); 450g (right)‬ ‭Kidneys‬ ‭313g (males); 288g (females)‬ ‭Pancreas‬ ‭110g‬ ‭Thyroid‬ ‭40g‬ ‭Adrenal‬ ‭6g‬ ‭Other Relevant General Pathology Information‬ ‭ . Signs vs. Symptoms: Signs are objective, while symptoms are subjective‬ 1 ‭2. A polyp is a growth on or in an organ that protrudes from a mucous‬ ‭membrane. Most are benign, but others are cancerous.‬ ‭2. Pigmentation occurs when substances that produce color and absorb‬ ‭visible light are deposited in the body‬ ‭Types of Pigments‬ ‭ emosiderin: Hemoglobin pigment with iron‬ H ‭Hematogenous‬ ‭Hematoidin Hemoglobin pigment without iron‬ ‭Pigments‬ ‭Hematin: Hemoglobin without globin‬ ‭Hemozoin: Black malarial pigments‬ ‭Hemofuschin: “Wear and Tear” pigment‬ ‭Non-Hematogenous: Melanin, Lipofuscin, Chromaffin‬ ‭Endogenous Minerals: Iron, Calcium, Copper‬ ‭Exogenous‬ ‭Carbon:‬‭most common exogenous pigment‬ ‭ ‬ ‭Anthracosis‬‭: deposition of black carbon pigments on‬‭lungs‬ ★ ‭★‬ ‭Can be confused with Melanin (Melanin dissolves in bleach)‬ ‭Silica: inhalation causes‬‭Coal’s Worker’s Pneumoconiosis‬ ‭Artefact‬ ‭Due to interaction of tissue components and chemical substances‬ ‭Endogenous‬