أسئلة الأولي باثو PPPM (قبل التعديل) .pdf

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Questions and Answers

What is the primary role of surgical pathology in healthcare?

  • To identify diseases through macroscopic and microscopic examination of tissues. (correct)
  • To determine the stage of a disease using blood samples.
  • To prescribe medication based on patient symptoms.
  • To perform surgical procedures on patients.

A clinician submits a biopsy to the pathology lab. What is the pathologist's main task?

  • To provide a prognosis for the patient’s overall health.
  • To prepare the patient for surgery.
  • To identify any present diseases from the biopsy sample. (correct)
  • To determine the cost of the surgical procedure.

Which activity falls under the scope of surgical pathology?

  • Analyzing tissue samples at a microscopic level. (correct)
  • Developing new surgical instruments and techniques.
  • Monitoring patient vital signs during surgery.
  • Administering vaccinations to prevent infectious diseases.

A surgeon removes a suspicious growth during an operation. What is the next step involving pathology?

<p>The sample is sent to the lab for pathological analysis. (C)</p> Signup and view all the answers

What is the purpose of submitting a specimen for pathological examination?

<p>To identify diseases or abnormalities present in the tissue. (B)</p> Signup and view all the answers

What term describes additional pathological changes that worsen an existing disease, occurring during or after its typical course?

<p>Complication (A)</p> Signup and view all the answers

A patient recovering from pneumonia develops a secondary bacterial infection in the lungs. Which of the following terms best describes this new infection in relation to the original pneumonia?

<p>Complication (C)</p> Signup and view all the answers

An individual experiences kidney failure as a result of long-standing diabetes. What is the kidney failure considered in relation to the diabetes?

<p>A complication (D)</p> Signup and view all the answers

A patient is diagnosed with a viral infection and subsequently develops a secondary bacterial pneumonia. Which factor primarily differentiates the pneumonia as a complication rather than a co-infection?

<p>The pneumonia occurs after the onset of the initial viral infection. (B)</p> Signup and view all the answers

Which scenario exemplifies a disease complication rather than a natural progression or expected outcome?

<p>A patient with a skin laceration developing a localized staph infection. (D)</p> Signup and view all the answers

What is the primary distinction between examining a biopsy and an autopsy specimen?

<p>Autopsy specimens are collected post-mortem, while biopsy specimens are collected during life. (A)</p> Signup and view all the answers

In the context of tissue examination, what does 'gross' examination refer to?

<p>Examination of tissue with the naked eye. (A)</p> Signup and view all the answers

A doctor suspects a patient has a rare form of cancer. Which type of tissue examination is MOST appropriate for initial diagnosis and why?

<p>Biopsy, to examine the living tissue for cancerous cells. (B)</p> Signup and view all the answers

A researcher is comparing tissue samples from a living patient's tumor and from the same patient after death. What information can they GAIN ONLY from the autopsy sample that they cannot get from the biopsy?

<p>The immediate cause of the patient's death. (C)</p> Signup and view all the answers

If a pathologist observes an abnormality during a gross examination of a biopsy, what is the MOST likely next step?

<p>Conduct microscopic examination to further investigate the abnormality. (B)</p> Signup and view all the answers

Which sampling method is most likely to provide a comprehensive representation of cellular changes within a lesion?

<p>A stiff bristle brush, because it samples cells from all epithelial layers. (B)</p> Signup and view all the answers

When might a superficial scraping be preferred over a brush sample technique?

<p>When the goal is to minimize disruption to the underlying tissue. (C)</p> Signup and view all the answers

A researcher aims to study early-stage cellular changes in a potentially malignant lesion. Which sampling method would likely be more effective?

<p>Superficial scraping, to detect initial changes on the surface epithelium. (A)</p> Signup and view all the answers

Given that a stiff bristle brush collects cells from all layers of the epithelium, what is a potential disadvantage of using this method compared to scraping?

<p>It may cause more discomfort or minor trauma to the patient. (B)</p> Signup and view all the answers

In what scenario would sampling from all epithelial layers be most critical for accurate diagnosis?

<p>When evaluating a potentially cancerous lesion with possible invasion into deeper layers. (D)</p> Signup and view all the answers

What is the primary function of immunohistochemistry in identifying cellular components?

<p>To identify specific cell products or surface markers using monoclonal antibodies. (A)</p> Signup and view all the answers

In what scenario would immunohistochemistry be most useful?

<p>Identifying the presence and location of a specific protein within a tissue sample. (A)</p> Signup and view all the answers

How do monoclonal antibodies contribute to the specificity of immunohistochemical staining?

<p>Monoclonal antibodies are engineered to bind selectively to a single, specific epitope on a target molecule. (B)</p> Signup and view all the answers

Which of the following is a potential limitation of relying solely on special stains without immunohistochemistry?

<p>Special stains may lack the specificity needed to identify particular proteins or markers. (C)</p> Signup and view all the answers

If a researcher aims to study the expression of a novel cancer marker, what is the most appropriate technique?

<p>Immunohistochemistry with a monoclonal antibody specific to the novel marker. (A)</p> Signup and view all the answers

During surgery, a pathologist performs a rapid microscopic examination of a tissue sample. What is the primary purpose of this intraoperative consultation?

<p>To guide the surgeon in making immediate decisions about the extent of the surgical procedure. (D)</p> Signup and view all the answers

A surgeon requests a frozen section during an ongoing surgery. What does this service primarily enable?

<p>Allows for immediate assessment of tissue margins to determine if cancerous tissue extends to the edge of the removed tissue. (B)</p> Signup and view all the answers

Which of the following best describes the role of imprint cytology during surgical procedures?

<p>To assess the cellular details of a tissue sample rapidly by directly applying the tissue to a slide. (A)</p> Signup and view all the answers

What is the main advantage of using a frozen section over a permanent section in surgical pathology?

<p>Frozen sections can be prepared and examined much more rapidly, providing immediate diagnostic information. (A)</p> Signup and view all the answers

In which of the following scenarios would an imprint cytologic slide be MOST useful during a surgical procedure?

<p>To immediately assess if a suspicious lesion contains malignant cells. (B)</p> Signup and view all the answers

Which of the following scenarios best exemplifies a disease directly caused by a congenital factor?

<p>An infant is born with a heart defect due to abnormal development during pregnancy. (A)</p> Signup and view all the answers

In the context of disease etiology, what distinguishes an 'exogenous' factor from other causes?

<p>It stems from environmental sources external to the body. (B)</p> Signup and view all the answers

How does the pathogenesis of microbial-induced disease differ fundamentally from that of a genetically inherited disease?

<p>Microbial diseases involve an external infectious agent, whereas genetic diseases arise from inherent genetic mutations. (A)</p> Signup and view all the answers

Which scenario presents a challenge in differentiating between a congenital condition and an early-onset acquired condition?

<p>A child developing a chronic illness shortly after birth, with no family history. (D)</p> Signup and view all the answers

In which situation would identifying the specific exogenous agent be MOST critical for effective disease management?

<p>Treating a patient with an infectious disease. (A)</p> Signup and view all the answers

Which of the following best describes the role of 'endogenous factors' in the development of a disease?

<p>Genetic predispositions and internal physiological imbalances influencing disease progression (D)</p> Signup and view all the answers

How does an 'endocrine disturbance' exemplify an endogenous factor in disease development?

<p>By disrupting normal hormonal regulation, leading to systemic physiological imbalances (A)</p> Signup and view all the answers

In the context of disease development, what is the significance of understanding the 'mechanisms and sequence of events'?

<p>It reveals the chronological order of cellular and molecular changes driving the disease (B)</p> Signup and view all the answers

Which statement best characterizes the relationship between disease development ('pathogenesis') and the changes observed in cells and organs?

<p>Pathogenesis involves the mechanisms that cause disease, leading to specific alterations in cellular and organ structure and function. (C)</p> Signup and view all the answers

Considering the interplay of factors in disease development, how do endogenous factors like endocrine disturbances differ from direct cellular injuries caused by external pathogens?

<p>Endocrine disturbances affect systemic physiological regulation, predisposing cells to damage, unlike direct pathogen-induced injuries. (A)</p> Signup and view all the answers

In the context of surgical pathology, what distinguishes a definitive diagnosis from a descriptive interpretation?

<p>A definitive diagnosis provides a specific disease identification, while a descriptive interpretation offers observations without naming a specific disease. (B)</p> Signup and view all the answers

Which of the following scenarios represents the most complex diagnostic challenge in surgical pathology?

<p>Differentiating between a benign tumor with unusual morphology and a low-grade malignancy with subtle features. (D)</p> Signup and view all the answers

How does the integration of clinical information most significantly enhance the accuracy of a pathologist's diagnostic interpretation?

<p>It helps the pathologist narrow the differential diagnosis by providing context about the patient's medical history and presentation. (C)</p> Signup and view all the answers

In what way might the absence of a complete patient history MOST significantly compromise the accuracy of a surgical pathology diagnosis?

<p>It can obscure relevant pre-existing conditions or treatments that could alter tissue morphology and mimic or mask specific diseases. (D)</p> Signup and view all the answers

What is the MOST critical distinction between the diagnostic approach used for a routine biopsy and that used for a complex, multi-organ resection?

<p>Routine biopsies rely on standardized protocols, while complex resections demand a highly individualized and integrated assessment. (B)</p> Signup and view all the answers

Which factor most critically determines whether a punch biopsy or a core needle biopsy is the preferred method for tissue sampling?

<p>The suspected depth and extent of the lesion within the tissue. (A)</p> Signup and view all the answers

In a scenario where a dermatologist needs to assess the presence of melanoma in situ, which biopsy technique is MOST appropriate, and why?

<p>Punch biopsy, to obtain a tissue sample from the surface of the lesion. (C)</p> Signup and view all the answers

What is the MOST significant limitation of using a punch biopsy on a deep, nodular lesion?

<p>Potential for inaccurate diagnosis due to inadequate representation of deeper tissues. (B)</p> Signup and view all the answers

A radiologist uses imaging to guide a core needle biopsy of a suspicious lung mass. What is the primary reason for utilizing radiological guidance in this procedure?

<p>To precisely target the lesion, ensuring accurate tissue sampling. (B)</p> Signup and view all the answers

In which scenario would a core needle biopsy be MOST advantageous compared to a punch biopsy of the same lesion?

<p>When diagnosing a deep-seated soft tissue sarcoma. (A)</p> Signup and view all the answers

What is the primary advantage of using immunohistochemistry over routine special stains in diagnostic pathology?

<p>It allows for the identification of specific cell products or surface markers with high precision. (C)</p> Signup and view all the answers

In the context of identifying the origin of a poorly differentiated metastatic tumor, which technique offers the most targeted approach?

<p>Immunohistochemistry using a panel of antibodies against various tissue-specific markers (A)</p> Signup and view all the answers

A pathologist is examining a sample from a patient with suspected lymphoma. Which method would be most effective in classifying the specific subtype of lymphoma?

<p>Immunohistochemistry using a panel of antibodies to identify specific cell surface markers (A)</p> Signup and view all the answers

What is a potential limitation of relying solely on special stains without the aid of immunohistochemistry?

<p>Special stains lack the specificity to identify particular cell types or proteins. (A)</p> Signup and view all the answers

A researcher aims to study the expression of a specific protein involved in cancer metastasis. Which is the MOST appropriate technique?

<p>Immunohistochemistry (D)</p> Signup and view all the answers

In the context of surgical pathology, what distinguishes therapeutic surgical resection from diagnostic biopsy?

<p>Therapeutic resection aims to remove the entire lesion or affected tissue for curative purposes, whereas diagnostic biopsy involves removing a portion of the lesion to establish a diagnosis. (D)</p> Signup and view all the answers

If a pathologist's report indicates 'incomplete resection' of a malignant tumor, what is the MOST critical implication for patient management?

<p>The patient will likely require adjuvant therapy, further surgical intervention, or radiation to address residual disease. (B)</p> Signup and view all the answers

How does surgical pathology contribute to assessing the success and effectiveness of a specific cancer therapy?

<p>By analyzing resected tissue to evaluate the therapy's impact on the tumor and surrounding tissues. (C)</p> Signup and view all the answers

Which of the following scenarios illustrates the MOST direct application of surgical pathology in determining the optimal course of cancer treatment?

<p>A pathologist evaluates a tumor biopsy to identify specific molecular markers that predict response to targeted therapies. (D)</p> Signup and view all the answers

How does the role of surgical pathology in follow-up care differ between a patient who has undergone surgical resection of a benign lesion and one who has undergone resection of a malignant tumor?

<p>Follow-up is generally less intensive for benign lesions, primarily focusing on symptom recurrence, while malignant tumors require monitoring for local recurrence and distant metastasis. (C)</p> Signup and view all the answers

Flashcards

What is a biopsy?

Tissue specimen taken from a living being for examination.

What is an autopsy?

Tissue specimen taken post-mortem for examination.

Biopsy

A specimen from a lesion during life

Autopsy

A specimen from a lesion post-mortem.

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What does 'gross' mean in pathology?

Refers to the macroscopic examination of tissue, visible to the naked eye.

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Complication (in disease)

Additional pathological changes that worsen the original disease.

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Timing of complications

Can occur while the disease is active or after its typical course.

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Effect of complications

The original disease becomes more severe.

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Nature of complication

A new, separate health problem arises due to the original disease.

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Disease timeline and complications

Complications can arise at any point during the course of the original disease or even after it's 'over'.

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What is Pathology?

The study of disease, involving examination of tissues and biopsies.

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What is Gross Examination?

Visual inspection with the unaided eye.

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What is Microscopic Examination?

Looking at cells and tissues with a microscope.

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What are Biopsies?

Samples taken from living tissue for diagnostic examination.

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What is Diagnosis in Pathology?

To pinpoint and name a disease based on pathological findings.

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Surface epithelium scraping

Collecting cells from the surface layer of tissue.

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Epithelium

The outer layer of tissue in the body.

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Full-thickness sampling

Retrieving cells from all layers of a tissue, using a tool.

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Bristle brush

A tool with short, stiff hairs used to collect cells.

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Lesion

An area of tissue that has been damaged or altered by disease or injury.

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Intraoperative Consultation

Examination of fresh tissue during surgery to help guide decisions.

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Frozen Section Technique

A rapid method for preparing tissue slides for microscopic examination.

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Imprint Cytologic Slide

A slide made by pressing fresh tissue onto a slide.

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Rapid Microscopic Examination

A microscopic examination done rapidly on fresh tissue.

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Frozen Section Purpose

Used for important decisions during surgery.

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Special Stains

Special stains used in histology to highlight specific tissue components or microorganisms.

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Immunohistochemistry (IHC)

Technique using antibodies to detect specific antigens in tissue samples.

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Monoclonal Antibodies

Antibodies produced from a single clone of cells, ensuring high specificity.

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Cell Products

Substances produced by cells, such as proteins or enzymes, that can be identified via IHC.

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Surface Markers

Molecules located on the cell surface that can be targeted by antibodies in IHC.

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Congenital/Hereditary Diseases

Factors present at birth, either inherited genetically or due to issues during fetal development.

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Acquired Diseases

Diseases acquired after birth.

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Exogenous Factors

Environmental factors originating from outside the body that cause disease.

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Microbes as Exogenous Factors

Microscopic organisms, like bacteria, viruses, fungi, or protozoa, that can cause infectious diseases.

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Directly Responsible

Something that directly causes a disease.

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Pathogenesis

The sequence of events and mechanisms involved in the development of a disease.

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Disease-Induced Changes

Changes in cells and organs caused by a disease.

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Endocrine disturbance

Disturbances in the endocrine system affecting the body.

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Disease Process

The method a disease uses to develop.

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Gross Examination

The macroscopic examination of tissue specimens, visible to the naked eye.

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Microscopic Examination in pathology

The microscopic evaluation of tissue samples.

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Pathology's Diagnostic Role

Surgical pathology identifies the type of disease.

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Surgical Specimens

Samples taken from a patient for examination by a pathologist.

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Medical Treatment

Using medical treatments such as medication to address a disease.

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Surgical Treatment

Using surgical procedures to remove, repair, or reposition tissues or organs.

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Radiotherapy

Using high-energy radiation to shrink or eliminate cancerous cells.

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Chemotherapy

Using drugs to destroy cancer cells or slow their growth.

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Complete Surgical Resection

Therapeutic removal of all of a lesion through surgery.

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Punch Biopsy

A tissue sample taken from superficial lesions using a punch tool.

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Core Biopsy

A tissue sample obtained using large-bore needles, often guided by radiology.

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Superficial Lesion Sample

Tissue obtained from near the surface.

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Radiologically Guided Core Biopsy

Uses needles to extract tissue, often guided by imaging techniques.

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Tissue Biopsies

Involves taking tissue samples for diagnostic examination.

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Immunohistochemistry

Technique using antibodies to identify specific proteins or markers in cells. Think of it as a lock and key.

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Study Notes

  • Pathology is the study of diseases, bridging basic medical sciences like anatomy and physiology with clinical sciences such as medicine and surgery.
  • Disease is defined as a state where an individual shows anatomical, physiological, or biochemical deviations from what is considered normal.

Classification of Diseases

  • Congenital and hereditary diseases are one category.
  • Acquired diseases include degeneration, inflammation, circulatory disturbances, and tumors.

Key Aspects of Diseases

  • Definition of the Disease
  • Epidemiology: Study of the distribution and determinants of health-related states or events in specified populations
  • Etiology: The causes of the disease
  • Pathogenesis: How the disease develops
  • Pathologic Changes (Morphology): Structural alterations in cells or tissues
  • Symptoms and Signs (Manifestations): Subjective and objective indications of disease

Epidemiology

  • Prevalence is the total number of cases in a population.
  • Incidence is the count of new cases within a specific time frame in a population

Etiology Components

  • Predisposing factors increase susceptibility to disease, like obesity or poor ventilation.
  • Exciting factors are directly responsible for a disease.
  • Congenital or Hereditary factors: Defective fetal development in uterus.
  • Acquired factors come after birth, including exogenous (environmental) factors like microbes and endogenous (internal) factors like endocrine disturbance.

Pathogenesis

  • Pathogenesis is the process by which a disease develops, including the mechanisms and sequence of events.

Pathologic Changes (Morphology)

  • Pathologic changes are alterations in cells and organs caused by disease.
  • Examined tissue can be obtained through biopsy during life or autopsy post-mortem.
  • Examination includes gross (macroscopic) and microscopic analysis using light and electron microscopy.

Clinical Signs & Symptoms

  • Clinical signs and symptoms reflect the clinical effects of pathological changes.
  • A symptom is a subjective complaint reported by the patient, like pain whose experience is not measurable.
  • A sign is an objective medical observation made by a physician, such as elevated blood pressure.

Prognosis & Fate

  • Prognosis & fate is the expected outcome or forecast of a disease's course and termination.
  • Prognosis & fate depends on the disease itself, patient-related factors, and effective management.

Complications

  • Complications are additional pathological changes that worsen the original disease.
  • These can occur during or after the original disease.

Surgical Pathology

  • Surgical pathology involves examining surgical specimens and biopsies.
  • Surgical pathology is essential for diagnosis, determining treatment, and assessing therapy effectiveness.

Types of Specimens for Surgical Pathology

  • Excision biopsy involves therapeutic surgical removal of an entire lesion.
  • Incision biopsy involves surgical removal of a part of a lesion for diagnosis.
  • Punch biopsy obtains tissue from superficial lesions.
  • Tru-cut biopsy obtains a core of tissue using large-bore needles, sometimes radiologically guided.
  • Fine needle aspiration collects fluid from a lesion using a fine needle for cytologic analysis.
  • Aspiration of body fluids examines fluids like urine for cytologic analysis.
  • Exfoliative cytology involves scraping the surface of a lesion.
  • Brush cytology collects cells from all layers of epithelium using a stiff brush.

Fixation

  • Immediate specimen fixation is mandatory to preserve morphology, prevent decomposition, minimize microbial growth, and minimize loss of molecular components.
  • Formalin (10% formaldehyde buffered to neutral pH) is a widely used fixative.
  • Good fixation is vital for satisfactory results in histopathology.

Gross Examination

  • In gross examination, recognition of the anatomic landmarks, localization of the lesion, proper sectioning for diagnosis (sampling), and detection of organ changes via radiology occur.

Microscopic Examination

  • All cut tissue samples are processed and sectioned on glass slides.
  • Sections are stained with Hematoxylin and Eosin (H&E) for microscopic examination.
  • Other special stains may be used.
  • Immunohistochemistry with specific monoclonal antibodies helps to identify cell products and surface markers.

Intraoperative Consultation

  • Rapid microscopic examination of fresh tissue is done during surgery.
  • Intraoperative consultation can direct decisions during the operation.
  • Methods include frozen section technique preparing histologic slides, and imprint cytologic slides.

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