Histological interpretation

Question 1

first questions to ask when given a tissue slide

Answer 1

• Have we got the correct specimen with the correct clinical form and detail?
• What type of tissue sample (biopsy, resection)
• Orientation

Question 2

we are looking at a …….. of a ….. structure in ….

Answer 2

We are looking at a cross section of 3D structure in 2D

Question 3

the small bowel mucosa- cross section

Answer 3

• Villi- finger like projections
  
  • absorption
• Different views of the same structure

Question 4

Higher magnification versus lower magnification

Answer 4

• Start at lower power
• Get a better idea of the architecture of the tissue
• E.g. at a close glance this tree looks diseased, however further away it is clear it is a healthy weeping willow

Question 5

what is this?

Answer 5

e.g. the more magnified version looks malignant, however when we take a step back it is clear that these are just the germinal centres of lymphoid tissue

Question 6

what tissue is this

Answer 6

lung tissue

• can see alveoli air spaces
• will also see airways and vascular supply

Question 7

abnormal lung tissue can be due to

Answer 7

inflammation e.g. due to smoking

Neoplastic tissue

Question 9

inflammation in the lungs e.g. due to smoking

Answer 9

normal architecture of the lung tissue not maintained–> alveoli form large air spaces and form bullae

Question 10

if bullae burst

Answer 10

pneuothorax/ hard to breathe

Question 11

neoplastic tissue benign vs malignant

Answer 11

• Benign – mature cells which have happened in the wrong place
• Malignant- lung tumour

Question 12

benign tumours

Answer 12

• Localised
• No invasion
• No metastases
• Slow growth
• Good differentiation
• Few mitoses
• Normal nuclear chromatin
• Uniform cell size
• Compress tissue

Question 13

malignant tumour

Answer 13

• Spread
• Invasion
• Metastases
• Rapid growth
• Poor differentiation
• Loads mitoses
• Inc nuclear chromatin
• Pleomorphism
• Invade and destroy tissue

Question 14

summary of interpreting histology speciment

Answer 14

• is this lung tissue?
• Yes: is it normal?
• No: is it inflammatory or neoplastic
• neoplastic: is it benign or malignant?
• malignant: is it primary or secondary?

Question 15

eosin

Answer 15

acid- negatively charged attracted to positive molecules such as proteins in the cytoplasm

PINK

Question 16

Haematoxylin

Answer 16

• basic- positively charged attracted to nucleic acid- negatively charged

PURPLE

Question 17

difference bertween hisotlogy versus cytology: what is cytology

Answer 17

• individual cells removed via aspirate or exfoliated

Question 18

histology

Answer 18

looking at cells in natural architecture

e.g. smear test

Question 19

normal tissue from liver

Answer 19

Question 20

normal tissue from skeletal muscle

Question 21

commpon pathology: apoptotic body’s e.g. in the liver

Answer 21

Question 22

Common pathology: Liquefactive necrosis of glomerulus

Answer 22

Question 23

common pathology: acute inflammation

Answer 23

neutrophil polymorphs

Question 24

common pathology: chronic inflammation

Answer 24

lymphocytes

Question 25

what does an atherosclerosis look like

Answer 25

* Coronary artery with plaque * Reduced lumen * Atheroma and fibrosis and area of calcification

Question 27

well differentiated breast cancer

Answer 27

cells fairly similar from what they are derived from * Better prognosis * **Can still see gland structure**

Question 28

poorly differentiated brast cancer

Answer 28

**they don’t look like the cells they originate from** * Tend to be more aggressive- metastases more * Worst prognosis * High grade tumours * Cannot see glands anymore

Question 29

what is a malignant smooth muscle called

Answer 29

leiomyosarcoma

Question 30

leiomyosarcoma

Answer 30

* Nuclei vary in cell size and shape * Mitoses

Question 31

fibroid- benign is called a

Answer 31

leiomyoma

Question 32

what is this

Answer 32

**Reed Sternberg cell of Hodgkin’s lymphoma** * Owl shaped, divided nucleus

Question 33

name the 3 main malignnat tumour types

Answer 33

1. adenoma carcinoma 2. squamous cell carcinoma 3. malignant melanoma

Question 34

adenoma carcinoma

Answer 34

neoplasia of epithelial tissue that has glandular origin, glandular characteristics, or both. - well differentiated- can still see gland

Question 35

lymph node containing metastatic adenocarcinoma

Answer 35

Question 36

squamous cell carcinoma

Answer 36

skin cancer that develops in the squamous cells that make up the middle and outer layers of the skin. Squamous cell carcinoma of the skin is usually not life-threatening, though it can be aggressive * Nuclei show features of malignancies * Pink areas of keratinisation * Can see gaps between cells- intracellular prickles

Question 37

## Footnote **Skin with malignant melanoma**

Answer 37

a type of cancer that develops from the pigment-producing cells known as melanocytes. Melanomas typically occur in the skin but may rarely occur in the mouth, intestines or eye (uveal melanoma). * Brown pigment production of melanin * Malignant melanocytes