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CYTOLOGICAL DIAGNOSIS

CYTOLOGICAL DIAGNOSIS. Prof. Dr. Dilek Yılmazbayhan Istanbul University Istanbul Faculty of Medicine Dept. of Pathology 12 th Annual Congress of Turkish Thoracic Society 2009 ANTALYA. Brief History of Pathology. Autopsy: Aristo ( BC 384-322)

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CYTOLOGICAL DIAGNOSIS

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  1. CYTOLOGICAL DIAGNOSIS Prof. Dr. Dilek Yılmazbayhan Istanbul University Istanbul Faculty of Medicine Dept. of Pathology 12th Annual Congress of Turkish Thoracic Society 2009 ANTALYA

  2. Brief History of Pathology • Autopsy: Aristo (BC 384-322) • Giovanni Battista Morgagni: first autopsy in medicine (1761), described “organ”. • Bichat (1771-1802) each organ has its own “tissue” and it is necessary to examine the “tissue”. • Schleiden (1838) and Schwann (1839) described “cell” in plants and animals. • Virchow (1871): the theory of cellular pathology • In time cellular pathology ends up with molecular pathology

  3. SHALL WE TELL THEM THAT THEY CAN BENEFIT FROM OUR MILK AND MEAT? WHO CARES?! Selçuk Erdem

  4. First there was “organ”- Autopsy/Gross examination • Then “tissue” came into prominence • “Cells” were recognized • “Organelles” of the cell- Electron microscopy • Immunohistochemical techniques • Molecular techniques • Genetic studies

  5. The origin was “morphology”-Science of image • Macromorphology-micromorphology • The elemental tool: EYE • Microscope- Light microscope, electron microscope, phase contrast microscope ve computers! • Highlight cellular organelles and cellular products- Immunohistochemistry • Highlight genetic alterations

  6. Mind • Defects of human brain as a knowledge machine can lead to have various advantages in being a thinking machine. • Human brain has a stock of broad and blurry images because it cannot quickly form complete and detailed images. This feature is useful in thinking. Rudolph Arnheim, Visual Thinking

  7. Ultrastructural Examination • Examine cells in ultrastructural level • Long, expensive, difficult!

  8. Immunohistochemical analysis • Antigen • Antibody • Antigen-antibodycomplexes • Highlight immuncomplexes

  9. Calretinin

  10. PSA

  11. TG- TİROİD PAPİLLER CA EGFR

  12. Ki 67

  13. Flow cytometry • Examine various features of cells in a heterogeneous cell population • Record optical features of cells under a beam of light (laser light) by computerized systems • Cell count, cell volume, cellular morphology, chromosome analysis, DNA/RNA quantities, localization and expression of various proteins, transgenic products, intracellular and nuclear antigens, enzymatic activity ....

  14. Molecular Analysis • Molecular biology, geneticsand pathology • Examine nucleic acids and proteins • Target: DNA/RNA proteins • Carcinogenes-viruses, protooncogenes and oncogenes, proteins • In cells and body fluids

  15. Molecular Pathology • Contribution to pathogenesis • Determine personal and social risks • Prevention (chemoprevention, geneticcorrection) • Early diagnosis, treatmentand prognosis

  16. Molecular Pathology Techniques • Three main techniques: • Amplification • Hybridization • Blotting

  17. Amplification • Multiple copies of small segments of DNA/RNA • Various procedures, e.g. PCR

  18. Hybridization • Process of joining two complementary strands of nucleic acid molecules • Various methods to highlight this joint: Florescein, radioactivity, chromogen, metal ions, ……

  19. Blotting • Detect particular subset of macromolecules (fragments of DNA/RNA/proteins) by the length of the molecule under the influence of an electric field • Southern blot (DNA), Northern blot (RNA), Western blot (protein), …

  20. Molecular pathology in lung cancer • “At least 900 genes are differentially expressed between lung cancers and normal lung samples and at least 44 are consistently overexpressed at levels 100 fold or greater compared with normal lung”. (Bunn 2002) • Not widely used for diagnostic purposes yet! • Targeted therapies: e.g. EGFR antagonists for BAC • ERCC-1: Prognosis and drug resistance

  21. Attention!! • Errors in technical based procedures • Quality control and quality assurance systems • Coordination with conventional techniques • Pathology based studies

  22. Escher

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