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See: ''[[Lymph node]]'' article for a detailed description of cell types in a lymph node. | See: ''[[Lymph node]]'' article for a detailed description of cell types in a lymph node. | ||
===Signet ring cells=== | ===Signet ring cells=== | ||
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*Rheumatoid nodules. | *Rheumatoid nodules. | ||
== | ==Common morphologic problems== | ||
===DDx of pink stuff (on H&E)=== | |||
The ''ABCs'' of pink: | |||
*'''A'''myloid. | |||
*'''B'''lood clot (organized); fibrin. | |||
*'''C'''ollagen (fibrous tissue). | |||
*'''S'''mooth muscle cells (SMCs). | |||
====Smooth muscle cells (SMCs) vs. fibrous tissue==== | |||
Fibroblasts (fibrous tissue): | |||
*Wavy nuclei with pointy ends. | |||
*Less nuclei. | |||
SMCs: | |||
*Elliptical nuclei. | |||
*More nuclei. | |||
Remembering the above: | |||
*SMCs are stretched; ergo, not wavy. | |||
*Fibrous tissue is fibrous... more protein... less cells; ergo, less nuclei. | |||
*'''F'''ibroblast = '''f'''ootball-like. | |||
*Cigar-shaped nuclei (SMCs) are affected by cigars (smoking causes vascular disease). | |||
Notes: | |||
*Schwann cells (found in nerve): nuclei = wavy appearance, thin. (???) | |||
===DDx of granular crap=== | |||
DDx of granular stuff: | DDx of granular stuff: | ||
#Lipofuscin - especially in old people. | #Lipofuscin - especially in old people. | ||
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*Memory device: '''''M'''änner '''l'''ieben '''f'''eine '''BH'''s'' = Melanin, Lipofuscin, Foreign, Bile, Hemosiderin. | *Memory device: '''''M'''änner '''l'''ieben '''f'''eine '''BH'''s'' = Melanin, Lipofuscin, Foreign, Bile, Hemosiderin. | ||
===[[Stains]] that can help sort it out=== | ====[[Stains]] that can help sort it out==== | ||
*Prussian blue for hemosiderin. | *Prussian blue for hemosiderin. | ||
*Melan A for melanin. | *Melan A for melanin. | ||
*Kluver-Barrera for lipofuscin. | *Kluver-Barrera for lipofuscin. | ||
==Staining== | ==Staining== | ||
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==Immunohistochemistry== | ==Immunohistochemistry== | ||
{{main|Immunohistochemistry}} | {{main|Immunohistochemistry}} | ||
If the special stains don't help... there is immunohistochemistry. | |||
==Food and pathology== | ==Food and pathology== | ||
{{main|Pathology and food}} | {{main|Pathology and food}} | ||
==General surgeon talk== | ==Clinician talk== | ||
===General surgeon talk=== | |||
*"[[R2 resection]]" = macroscopic tumour left. | *"[[R2 resection]]" = macroscopic tumour left. | ||
*"[[R1 resection]]" = microscopic tumour left. | *"[[R1 resection]]" = microscopic tumour left. | ||
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Generally, positive margins suck; in locally advanced rectal cancer survival, in one study,<ref>{{cite journal |author=Larsen SG, Wiig JN, Dueland S, Giercksky KE |title=Prognostic factors after preoperative irradiation and surgery for locally advanced rectal cancer |journal=Eur J Surg Oncol |volume=34 |issue=4 |pages=410–7 |year=2008 |month=April |pmid=17614249 |doi=10.1016/j.ejso.2007.05.012 |url=}}</ref> five year survival was found to be 60%, 31% and 0% for R0, R1, and R2 resections respectively. | Generally, positive margins suck; in locally advanced rectal cancer survival, in one study,<ref>{{cite journal |author=Larsen SG, Wiig JN, Dueland S, Giercksky KE |title=Prognostic factors after preoperative irradiation and surgery for locally advanced rectal cancer |journal=Eur J Surg Oncol |volume=34 |issue=4 |pages=410–7 |year=2008 |month=April |pmid=17614249 |doi=10.1016/j.ejso.2007.05.012 |url=}}</ref> five year survival was found to be 60%, 31% and 0% for R0, R1, and R2 resections respectively. | ||
==Oncologist talk== | ===Oncologist talk=== | ||
*ECOG - score from 1-5 for performance status.<ref name=pmid7165009>{{cite journal |author=Oken MM, Creech RH, Tormey DC, ''et al.'' |title=Toxicity and response criteria of the Eastern Cooperative Oncology Group |journal=Am. J. Clin. Oncol. |volume=5 |issue=6 |pages=649–55 |year=1982 |month=December |pmid=7165009 |doi= |url=}}</ref> | *ECOG - score from 1-5 for performance status.<ref name=pmid7165009>{{cite journal |author=Oken MM, Creech RH, Tormey DC, ''et al.'' |title=Toxicity and response criteria of the Eastern Cooperative Oncology Group |journal=Am. J. Clin. Oncol. |volume=5 |issue=6 |pages=649–55 |year=1982 |month=December |pmid=7165009 |doi= |url=}}</ref> | ||
**ECOG = Eastern Cooperative Oncology Group. | **ECOG = Eastern Cooperative Oncology Group. | ||
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*ECOG 5: dead. | *ECOG 5: dead. | ||
==Fixation & lifestyle== | ==Pathology & pathologists== | ||
===Fixation & lifestyle=== | |||
Pathologist have a great lifestyle 'cause tissue takes long to fix; the penetration of tissue by formalin is 1 mm/hour.<ref>Gross rounds. 14 August 2009.</ref> | Pathologist have a great lifestyle 'cause tissue takes long to fix; the penetration of tissue by formalin is 1 mm/hour.<ref>Gross rounds. 14 August 2009.</ref> | ||
===Malignancy & inflammation=== | |||
If there is lots of inflammation... and you're thinking cancer you should probably back-off, i.e. tend toward benign. Inflammation can make cells look more malignant than they might be if left alone. | |||
==Miscellaneous== | |||
===Infectious stuffs=== | |||
{{main|Microorganisms}} | |||
Images: [http://www.uphs.upenn.edu/bugdrug/antibiotic_manual/Gram3.htm http://www.uphs.upenn.edu/bugdrug/antibiotic_manual/Gram3.htm] | |||
*Staphylococcus - in clusters. | |||
*Streptococcus - in chains. | |||
==Microscopes== | ==Microscopes== | ||