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

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

2. http://1.bp.blogspot.com/_KkXx6fq12mU/Suvqkn-xSpI/AAAAAAAAG3g/SClWSE4hgs0/s400/breast-self-exam.jpghttp://1.bp.blogspot.com/_KkXx6fq12mU/Suvqkn-xSpI/AAAAAAAAG3g/SClWSE4hgs0/s400/breast-self-exam.jpg 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? http://www.breastcancerlaw.com/counseling.jpg

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 ? http://174.129.230.70:8080/player_images/333-7-11b.gif http://img2.timeinc.net/health/images/journeys/breast-cancer/breast-cancer-interpreting-results-150.jpg

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 http://www.scuddlebutt3.co.uk/L_microscope_slide_mountant_1.jpg

13. From biopsy specimen to microscope slide: The finished microscope slide http://www.scuddlebutt3.co.uk/L_microscope_slide_mountant_1.jpg

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 History49 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:InterpretingNORMAL 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. 1 Practice with normal histology: epithelium, connective tissue, muscle , or nerve?

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

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) Inflammation: the body’s response to injury

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

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 BadCANCER • Won’t stop dividing (mitosis) • Weird nuclei • Don’t stay at home • Invade • metastasize

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

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

48. CANCER: Good Cells Gone BadDon’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? http://www.uoguelph.ca/~rfoster/repropath/surgicalpath/female/cat/F%20fel%20uterus%20duplication%20YB131414%2003wl.jpg