L1 : introduction to the unit

Question 1

pathology definition

Answer 1

the science of the cause and effects of disease (but acts as a synonym for the disease itself)

Question 2

what are examples for potential tests that can be requested for

Answer 2

• immunohistochemistry test
• immunofluorescence test
• genetic test ( available in most NHS labs and part of the general treatment plan)

Question 3

how did medical students learn about normal anatomy

Answer 3

with anatomical models (wax, wood), dissections, post mortems and anatomical theatres where you can have a corpse preserved in formalin

Question 4

what is a teratoma

Answer 4

a tumour composed of different types of tissue not normally present at the site e.g. hair, muscle, bone or teeth (it is multipotent and can show cells deriving from different lineages)

Question 5

how many lines of cell differentition are there in an embryo

Answer 5

3

Question 6

what are the 3 lines of differentition in an embryo

Answer 6

1. endodermal
2. ectodermal
3. mesodermal

Question 7

what is the endodermal layer

Answer 7

The inner layer that forms the linings of the digestive and respiratory systems, as well as organs like the liver and pancreas.

Question 8

what is the ectodermal layer

Answer 8

The outer layer that gives rise to the skin, hair, mammary glands, and part of the nervous system.

Question 9

what is the mesodermal layer

Answer 9

The middle layer that forms muscle, cartilage, bone, the heart and circulatory system, gonads, and the urogenital system.

Question 10

where are teratomas most commonly found in men and women

Answer 10

in the ovaries in women (usually benign) and in testicles for men (rarer and even if it looks mature it can be aggressive)

Question 11

what are possible causes of disease

Answer 11

• tumours
• metabolic imbalances
• infection
• Genetic predisposition ( somatic or germline)
• Environmental factors
  (usually diseases are caused by many factors interconnected (although it can be caused by one) which is why individuals exposed to the same risk factor can have different outcomes)

Question 12

What are some examples of specialty teams

Answer 12

• Gastrointestinal Pathology
• Pulmonary Pathology
• Dermatopathology
• Breast pathology
• Gynaecopathology
• Head and neck pathology
• Hematopathology
• Uropathology
• Nephrology
• Soft tissue pathology
• Orthopaedic pathology
• Endocrine pathology
• Paediatric and perinatal pathology

Question 13

what samples are assessed in a cell pathology lab

Answer 13

• core biopsy for superficial (not epidermal) or deep lesions. The biopsy can be guided by ultrasound or CT imaging
• Organs
• Soft tissue
• Bone and marrow

Question 14

what now happens for most cytological samples

Answer 14

The cell samples are taken and put in formalin, fixed, and put in blocks with paraffin

Question 15

pros and cons of using formalin and paraffin for cytological samples vs smearing and staining

Answer 15

Pros :
more accurate, rapid and being in paraffin you can cut through the sample so you can repeat the tests

cons:
more labour intensive, expensive and time consuming

Question 16

when are punch vs core biopsies taken

Answer 16

punch
when a small biopsy is required e.g. for eczema you take a small sample of the skin, (small and superficial that doesn’t generally go deeper than the dermis / epidermis)

Core
involves collecting a much larger tissue sample, typically when the sample goes much deeper. this involves using a biopsy needle that goes through the mass to collect the sample e.g. bone or breast and get a representative image of what you have

Question 17

what are some implications of having a biopsy taken

Answer 17

the margin around the area might be compromised (want to make sure you don’t compromise treatment options later on). There is also a chance that you can seed malignant seeds along the track so to prevent this you mark the area of the biopsy and go beyond this point.

Question 18

what does the processing of bone biopsies usually involve and what is the issue with this

Answer 18

typically involves decalcification. this could cause damage and affect the immunochemistry or genetics (therefore need to be thorough and careful with how the decalcification process is carried out)

Question 19

example biopsies for superficial, epidermal or dermal lesions

Answer 19

punch biopsy and shaving

Question 20

example biopsies for deep and superficial lesions

Answer 20

incisional biopsy and excisional biopsy

Question 21

what are endoscopic biopsies and where are they carried out

Answer 21

a procedure that involves using a long, thin tube called an endoscope to obtain tissue samples from inside the body. It is carried out in the gastrointestinal tract, large bowel, abdomen, bladder, oral cavity …..

Question 22

what is a resection specimen

Answer 22

tissue sample or organ removed during a surgical resection procedure

Question 23

how is looking at a resection specimen useful

Answer 23

just by looking at the specimen you can have an idea of what is happening e.g. polyps, skin lesion or pigmentation, odd profiling …. without knowing the full case you can be informed.