Robbins Basic Pathology, Ch 4: pp. 99-100, 109-124, 135-138

Slide 34 [WebScope] [ImageScope]

This lesion was found incidentally at autopsy of a 56-year-old man and had nothing whatever to do with his demise. The lesion was a large yellow nodule beneath the intact mucosa of the colon. Looking at the slide, you can see the mucosa (consisting of a simple columnar epithelium) along the top edge of the slide. Underneath the mucosa, the mass appears as a collection of cells, each containing a single, large vacuole surrounded by a thin rim of cytoplasm [example].

1. Identify the vacuolated cells (i.e. name the cell type, e.g. macrophages, lymphocytes, fibroblasts, etc.)

2.The lesion is certainly an "-oma" of some sort. Name the "-oma" and indicate whether it was benign or malignant.

Slide 36 [WebScope] [ImageScope]

This section is from a bulky neoplasm in the thigh of a 49-year-old woman.m from the thigh of a 49-year-old woman.

• At low magnification, you can see part of a lightly staining nodular lesion that is bordered by more deeply pink-staining tissue.

• Close inspection reveals a rather cellular neoplasm, lobules of which extend into adjacent, distorted skeletal muscle. Despite its light-staining quality, the neoplasm itself is extremely cellular and has a finely vascular background.

• Some of the cells in this lesion a more or less similar to those in slide 34 above. Other cells are rather peculiar, with multiple cytoplasmic vacuoles that characteristically indent their darkly-staining nuclei. Still others are rather nondescript-appearing, less well differentiated cells that have a more or less spindled shape.

1. This lesion is also an "-oma." Name the lesion and indicate whether it is benign or malignant.

Slide 33 [WebScope] [ImageScope]

This slide contains a biopsy of the uterus from a 38-year-old woman who presented with irregular menstruation and intesne, episodic uterine cramping. Grossly, the myometrium was distorted by numerous circumscribed nodules ranging in size from 2 to 6 centimeters. As you inspect this slide at low magnification, you will note a roughly circular area in the center of the tissue section that stains more deeply than the surrounding myometrium. This area is not really encapsulated, but it looks different, and seems to be separated from the adjacent myometrium along at least part of its circumference.

• Note that this circumscribed area is more densely cellular, with a higher concentration of nuclei and a bluer color.

• Note the structure of the surrounding normal myometrium -- interlacing bundles of spindle-shaped cells that run in fascicles. Some of these fascicles are cut longitudinally, and others in cross-section.

• You will see that the neoplasm is also composed of interlacing bundles of spindle shaped cells. While not actually encapsulated, the nodule is easily distinguished from its surroundings by its denser cellularity and darker color.

• Compare the nuclei in the neoplasm with those in the normal myometrium and note that they are essentially identical (although more closely packed).

1. Identify the primary cell type making up the neoplasm.

2. The lesion is also an "-oma" of some sort. Name the "-oma" and indicate whether it is benign or malignant.

Slide 35 [WebScope] [ImageScope]

This slide contains a section of the uterus from a 32-year-old woman who also presented with irregular menstruation and intense, episodic uterine cramping. As part of her initial workup, a biopsy was taken from which it was determined that the best course of action was to perform a radical hysterectomy along with medical treatment. The tissue shown here is from the outer wall of the uterus that was removed (the outer, fibrous capsule can be noted along the margins of the section). The underlying myometrium consists entirely of abnormal tissue.

1. Identify the primary cell type making up the neoplasm.

2. The lesion is also an "-oma" of some sort. Name the "-oma" and indicate whether it is benign or malignant.

II. Histology Practical Review Materials

Listed below are several different tools available for individual or small group review. We do NOT want to overwhelm you, so please just use the items that are helpful for your review for the Practical Exam. We suggest that a good review exercise is to try to identify unknown cells and tissue from the resources listed below while writing down the key structural characteristics of each cell or tissue. Working with a colleague can be helpful. Ask your instructor for help if you have trouble with identifications.

(1) Molecules, Cells, and Tissues Brief Review of Lab Material: This document lists all of the cells and tissue we've covered thus far and briefly describes the key features that may be used to identify them.

(2) Review Powerpoints and other materials: Drs. Carbrey and Velkey have prepared study notes and orientation images for each lab. For your convenience, they have been collated into the drop-down menus below:
Dr. Carbrey's Lab Notes Lab 2: Epithelial Tissue Lab 3: Connective Tissue Lab 4: Cartilage and Bone Lab 5: Nerve Tissue Lab 6: Muscle Tissue Molecules and Cells Review Dr. Velkey's Lab Orientations Lab 1: Cells and Organelles Lab 2: Epithelial Tissue Lab 3: Connective Tissue Lab 4: Cartilage and Bone Lab 5: Nerve Tissue Lab 6: Muscle Tissue

Suggested Slides for Review (with tissues they display):

Webslide 0012_A:  Monkey Ear
[Aperio ImageScope] [Aperio WebScope]

• stratified squamous epithelium keratinized
• cartilage
• dense irregular CT (under epithelium)
• nerve
• adipose tissue (unilocular)
• endothelium (simple squamous epithelium lining blood vessels)
• striated muscle

Webslide 0065_G: Thick Skin
[Aperio ImageScope] [Aperio WebScope]

• stratified squamous epithelium keratinized
• collagen fibers (increasing diameter with depth from surface)
• fatty CT
• vasculature with smooth muscle, simple squamous epithelium

Webslide 0054_G: Gastro-Esophogeal Junction
[Aperio ImageScope] [Aperio WebScope]

• simple columnar epithelium
• stratified squamous epithelium, non-keratinized
• smooth muscle
• both loose (cellular) CT and dense irregular CT

Webslide 0301_A: Fetal Finger
[Aperio ImageScope] [Aperio WebScope]

• stratified squamous epithelium keratinized
• cartilage
• dense irregular CT (under epithelium)
• bone
• adipose tissue (unilocular)

UMich Slide 265: Nipple, Human, H&E
[Aperio ImageScope] [Aperio WebScope]

• stratified squamous keratinized epithelium
• stratified cuboidal epithelium (ducts and sebaceous glands)
• smooth muscle
• dense irregular connective tissue

UMich slide 250-1: Vagina, Human, H&E
[Aperio ImageScope] [Aperio WebScope]

• stratified squamous non-keratinized epithelium
• dense irregular connective tissue
• smooth muscle
• adipose tissue
• nerve
• parasympathetic ganglia

UMich slide 250-2: Vagina, Human, Masson trichrome
[Aperio ImageScope] [Aperio WebScope]

Same as slide 250-1 above, but this slide is stained with trichrome in which connective tissue and nerve stain BLUE; muscle and epithelia stain RED 

Example of Possible Exam Format:

Some students wonder about the format of the final exam.  The following illustrates a method that we have used in the past, where we label several tissues or cells (“A”, “B”, “C”, etc.) on a webslide of an organ.  Using the virtual microscope, the student examines the section and is then asked to identify, describe, and sometimes draw a picture of each tissue or cell.  (The student is NOT required to identify the organ, which we will cover in the Normal Body course.)

Click on one of the links below to open the practice exam slide.
[Aperio ImageScope] [Aperio WebScope]

For items A through H labeled on the slide (see below for an orientation image), identify the predominant tissue type for each label in the image, listing key structural features.  For each tissue, provide a drawing labeling the key cell types.  Be sure to include a scale marker.