Difference between revisions of "Basics"

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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.
===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. (???)


===Signet ring cells===
===Signet ring cells===
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*Rheumatoid nodules.
*Rheumatoid nodules.


==Granular crap DDx==
==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.
==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.
==Infectious stuffs==
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.


==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==
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