histology of liver disease Flashcards
describe neutrophils
polylobate nuclei - 3-5
key cells of acute inflammation - eg in appendicitis
this is reflected in the blood and in the tissue
describe lymphocytes and plasma cells
have big nucleus - small cytoplasm
bigger than RBC
part of chronic inflammation
if lots of lymphocytes - think lymphoma
when would you have lots of neutrophils and lymphocytes
when there is acute on chronic inflammation ie acute exacerbations
appearance of lymphoma
Sheets of lymphocytes that all look the same = monoclonal proliferations – genetically identical
macrophages with debris inside are present
describe eosinophils
o Bilobed
o Granules
when would you see eosinophils
o Allergic rn – asthma, hayfever, drugs – eosinophil in tissue and eosinophilia
o Parasitic infections – because of T cell reaction, in tissue and in blood
o Tumours – hodgkins disease – has background of reactive cells, response to the disease – part of immune response to tumour
describe eosinophilic oesophagitis
rings down oesophagus lymphocytes granulocytes with bilobed nuclei form microabscess (in pic) allergy to ingested ag treated by dietry modulation and steroids
describe mast cells
granulated
large nuclei
sheet of uniform mast cells = allergic
what can you see on the skin from condition with raised mast cells
Raised red, flat lesions – urticaria – kind of allergic rn
describe macrophages
o Cells lots of cytoplasm
o Major func – phagocytosis, clear debris, ingest bacteria
o Late acute inflammation – clear debris
o Chronic inflamm – including granulomas
how can you tell whether a sputum specimen is from the mouth or the bronchi
Macrophages black – because carbon debris taken into lungs phagocytosed by macrophages
If see them in sputum – know actual specimen – macrophage from alveoli
summarise granulomas
cells are derived from macrophages
in chronic inflammation
driven by Th cells
macrophages become secretory - get more protein synthesising organelles (golgi and RER) = more cytoplasm = look like epithelial cells
therefore called epithelioid macrophages = epithelioid granuloma
giant cells
lymphocytes - chronic inflammation
what are giant cells
have multiple nuclei
feature of granuloma
derived from macrophafes - fused together to form giant cells
what are the necessary characteristics of granuloma
epithelioid macrophages
giant cells are extra - it is granuloma with or w/o them
what is Ziehl Neelson
Acid fast stain
see acid fast bacilli in the granulomas
what are the types of tumours
carcinomas sarcomas lymphoma melanoma etc
types of carcinomas
squamous cell carcinoma
adenocarcinoma
summarise squamous cell carcinoma
Keratin production (in moist env, eg oesophagus, the cells don't normally make keratin but they can) Intercellular bridges - barrier cells
sites of common squamous cell carcinomas
skin head and neck oesophagus anus cervix vagina
summarise adenocarcinoma
tumour of the glandular epithelium - secrete and form glands
mucin production - if do mucin stain you can see the mucin production
sites of adenocarcinoma
lung breast stomach colon pancreas
summarise transitional cell ca
Ureter, bladder, prox urethra – in urinary tract
summarise pigmented skin
melanocytes are scattered along the BM
characteristics of malignant melanoma
irregular edge, raised, itchy, bleeding, grown
how can you tell it is a pigmented tumour on biopsy
full of pigment
Fontana stain for melanin - +ve
what are the 2 different types of stain
(Histo)Chemical
Immunohistochemical
what are histochemical stains
dye
based on the chemical reaction between the stain and a specific component of the tissue
product of reaction has a specific colour or property that can be identified
example of histochemical staining - cirrhotic liver
brown pigment – iron – genetic haemochromatosis – liver contains large amounts of iron = cirrhosis
histochemical stain - iron appears blue, also see that iron is present in connective tissue outside the liver nodules
V sensitive, specific and cheap stain
stain for amyloid
congo red stain
what does congo red stain do
dyes amyloid red - seen in chronic inflammation - eg RA, tumours of B cells
what is Apple green birefringence
when you examine congo red under birefringent light = amyloid stains apple green
summarise immunohistochemical stains
Based on using an antibody specific to an
antigen in the tissue.
monoclonal Ab find specific features - based on Ab specific to Ag in the tissue
• Need a detection system to make this binding
visible.
summarise immunofluorescence
Have Ag that rabbit has already made Ab to, but rabit serum on the cells
wash it off and the Ab that bound to Ag A would stay
add detection system which is another Ab that is made by goat and is anti-rabbit - goat has florescent tag so we can recognise this easily
sensitive
summarise immunoperoxidase
primary Ab
secondary Ab has a biotin attached (ie is a biotinylated Ab)
secondary binds to the primary Ab - add Avidin/Biotinylated enzyme complex (ABC)
then add substrate
what do you do if you cant tell what type of cancer it is
stain it
why is staining used in infections
Identification of aetiological agent
histology of herpes
multinucleate cells, clear centres
ulcers on low power
immunohistochem stain
why dont you just tag the primary Ab
o Goat will work with all anti rabbit, otherwise would need to tag all diff anti-rabbit
o More steps add, more sensitivity – can add strong or multiple tags – make the whole thing more sensitive
