1. Microscopically Yours: A Glimpse at our Cells, in Sickness and in Health
Nina C. Zanetti
Siena College
Department of Biology

2. If it is… how serious is it? Will I need treatment? What kind?
Is it cancer ??
If it is… how serious is it?
Will I need treatment? What kind?

3. Next step in the journey….
“We need to look at the tissues. We need a biopsy.”
Is it cancer or is it benign ?
Is it invasive?
What treatments?

4. Histology will answer our questions !
Histology: study of normal tissues
Pathology: study of diseased tissues
Tissue:
Building blocks of organs
group of cells working together to carry out a specific function
Biopsy: small bit of tissue removed from patient for examination with microscope

5. Tissue:
Building blocks of organs
Group of cells working together to carry out a specific function

6. From Biopsy to Pathology report?

7. From Biopsy to Pathology report?
Biopsy specimen  microscope slide (histotechnique)
Interpretation of slide  pathology report (pathologist)

8. From biopsy specimen to microscope slide: HISTOTECHNIQUE
“why is it taking so long?”
DIAGRAM: Kessel, Basic Medical Histology, Oxford University Press.
Why “fix” and process ?
Why thin section?
Why paraffin?

9. From biopsy specimen to microscope slide: tissue fixation and processing

10. From biopsy specimen to microscope slide: infiltrations and embedding

11. From biopsy specimen to microscope slide: sectioning

12. From biopsy specimen to microscope slide: staining

13. From biopsy specimen to microscope slide: The finished microscope slide

14. Limitations of histotechnique
Tissue is dead
Only a slice: 2D
Color artificial:
Purple nuclei
Pink cytoplasm
Need to know “what is normal”

15. From microscopy slide to Pathology Report: POWER of Histotechnique
Specimen: Clinical History 49 year old female who was found to have a mass (or calcifications) on physical exam (or mammography). Stereotactic core biopsy reveale malignancy. Clinical Diagnosis: Right breast cancer Microscopic Description Slides A3- A4 consist of a portion of breast tissue in which is located an infiltrating ductal carcinoma of the breast. The malignancy is characterized by infiltrating nests of malignant cells in which there is only, focal tubule or glandular formation. The cells demonstrate a moderate degree of nuclear pleomorphism, with some of the cells having central nucleoli. However, the mitotic rate is less than 1 mitosis per 10 high power fields. Overall the carcinoma is grade II. Adjacent to the carcinoma are areas of ductal carcinona in situ. Histologically the tumor is 2mm from the inked margin. No lymphatic invasion is appreciated. Diagnosis Infiltrating ductal carcinoma of the breast, Grade II
Foci of ductal carcinoma in situ
Tumor is 2 mm from the inked margins
Metastatic cancer in 2/12 lymph nodes.
Markers The tumor is estrogen receptor positive
The tumor is Her 2 neu positive

16. From Biopsy to Pathology report?
Biopsy specimen  microscope slide (histotechnique)
Microscope slide  Interpretation of slide  pathology report (pathologist)

17. From microscope slide to Pathology Report?
“Reading” the Slide

18. From microscope slide to Pathology Report: Interpreting NORMAL Tissue structure (Histology)

19. Four basic tissue types
Epithelium
Connective tissue
Muscle tissue
Nerve tissue

20. Four basic tissue types
Epithelium : the “lining” tissue
Connective tissue : connects and supports
Muscle tissue: movement
Nerve tissue : communication

21. Epithelial tissue

22. Characteristics of epithelial tissue:
Where is it found?
Lining spaces, covering surfaces
How are cells arranged?
Tightly packed, in layers
Good at repair/regeneration?
Polarity? Cells have different surfaces
Functions? Protect, seal, secrete, absorb,

23. Connective tissue:

24. Characteristics of connective tissue:
Where is it found?
Connecting tissues and organs
Cells + fibers + jellies
How are cells arranged?
Dispersed; fibers and jellies in between
Variations?

25. Muscle tissue:

26. Characteristics of muscle tissue:
Where is it found?
Where movement is needed.
Cells: striped or dark pink “spindles”
Variations?
Yes - both structural and functional!
Functions?
Movement!

27. Nerve tissue:
neuron

28. Characteristics of nerve tissue:
Where is it found?
Brain, spinal cord, other organs
Special cells: neurons
What do neurons look like?
Large cell, extensions, owl-eye nucleus
Functions?
Communication!

29. Practice with normal histology:
Epithelium:
Lining
cells in layers, tightly packed.
Connective tissue
Cells + fibers+ jellies
Cells dispersed in matrix
Muscle:
striped or spindles
Nerve:
neurons with extensions and “owl eye” nuclei

30. Practice with normal histology: epithelium, connective tissue, muscle , or nerve?1

31. 2
Practice with normal histology: epithelium, connective tissue, muscle , or nerve?

32. 3
Practice with normal histology: epithelium, connective tissue, muscle , or nerve?

33. Practice with normal histology: epithelium, connective tissue, muscle , or nerve?4

34. From microscope slide to Pathology Report?
“Reading” the Slide

35. From microscope slide to Pathology Report: Understanding Diseased Tissue structure (Pathology)

36. What can go wrong? Right cells in the wrong place
Tissue injury: inflammation
Good cells gone bad: cancer

37. Pathology: right cells in the wrong place (Barret’s Esophagus)

38. Pathology: right cells in the wrong place (Barret’s Esophagus)
Small intestine, normal epithelium
Esophagus, normal epithelium

39. Pathology: right cells in the wrong place (Barret’s Esophagus)
Biopsy specimen
Esophagus, normal
Small intestine, normal

40. Pathology: Tissue injury (inflammation)
the body’s response to injury

41. Cells of peripheral blood, human blood smear
lymphocyte
monocyte
neutrophil
eosinophil
basophil
Cells of peripheral blood, human blood smear

42. Cells of the inflammatory response
neutrophil
monocyte
lymphocyte

43. Neutrophils in acute inflammation, stomach

44. Lymphocytes in chronic inflammation, appendix

45. Pathology: Good Cells Gone Bad CANCER
Won’t stop dividing (mitosis)
Weird nuclei
Don’t stay at home
Invade
metastasize

46. CANCER: Good Cells Gone Bad Won’t stop dividing (mitosis)
Onion root tip cancer of uterus

47. CANCER: Good Cells Gone Bad Weird nuclei
Normal epithelium bladder cancer

48. CANCER: Good Cells Gone Bad Don’t stay at home
Normal epithelium
Invasive breast cancer

49. Practice with pathology: which is normal (bladder), which is cancer?

50. Practice with pathology: which is normal (uterus), which is cancer?

51. If it is… how serious is it? Will I need treatment? What kind?
Is it cancer ??
If it is… how serious is it?
Will I need treatment? What kind?

52. The journey…. Waiting for the Pathology Report
Is it cancer or is it benign ?
Is it invasive?
What treatments?

53. From Biopsy to Pathology report?
Biopsy specimen  microscope slide (histotechnique)
Interpretation of slide  pathology report (pathologist)

54. Is it cancer?

55. Is it invasive?

56. What kinds of treatment? Are hormone receptors present?

57. The journey continues….
Is it cancer or is it benign ?
Is it invasive?
Has it metastasized?
What treatments?

58. Microscopically Yours: A Glimpse at our Cells, in Sickness and in Health