Medical Gross Anatomy


	Medical Gross Anatomy Pathology

The following images and descriptions are provided courtesy of Dr. Gerald Abrams, Department of Pathology. If you encounter tissue that you would like to have examined by Dr. Abrams, please see Dr. Tom Gest to receive a specimen vial and instructions for specimen collection.

Table 2-1 Lymph node The left side of this field is represented by adipose tissue, while the remainder is occupied by a lymph node. The architecture of the node, as seen in this low magnifcation, has been effaced; i.e. the usual array of lymphoid nodules, sinusoids, etc. cannot be seen.

Lymph node - higher mag. In this higher magnification of the previous field, it can be seen that the cells are much too large to be normal lymphocytes. The node has been replaced by a population of malignant cells having large, pleomorphic nuclei, and varying amounts of cytoplasm. While the degree of anaplasia makes precise diagnosis difficult, the amount of cytoplasm in the malignan cells and the (subtle) tendency of the cells to cluster suggest that the neoplasm is of epithelial origin, hence a metastatic carcinoma. The origin cannot be determined precisely from this sample alone. While primary lymphoid malignancies (lymphomas) do exist, the cytologic features seen here do not suggest lymphoma. That unlikely possibility cannot be entirely ruled out without additional information.

Table 2-6 Tissue from foot Low power view of the lesion which was a small cyst containing "cheesy" material. At the top of the field is the cavity of the cyst, completely filled during life with a fluid not unlike synovial fluid. The amorphous. flaky material just above the dense connective tissue wall of the cyst is a remnant of that fluid, precipitated during the embalming process.

Tissue from foot Medium power of cyst wall. The cyst wall consists of densely collagenous connective tissue. The pale, amorphous material lying on the surface is precipitated cyst content, fluid during life. Note that the space has no discrete lining and therrefore is not a "true" cyst as narrowly defined. This type of lesion is generally referred to as a "ganglion cyst". Such lesions are thought to reflect a degenerative change in connective tissue associated with joint capsule or tendon sheath (possibly due to trauma). A common location for ganglion cysts is in the wrist, but they occur in other locations as well. Clinically, they appear as slightly fluctuant nodules 1.0-1.5 cm in diameter which may pose mechanical or cosmetic problems.

Tissue from foot This small artery was in the connective tissue adjacent to the ganglion cyst. The lumen contains a partly recanalized, organizing mass of fibrin. There appears to be no significant atherosclerosis to explain thrombus formation in the artery; and the lesion may thus represent an embolus, or could conceivably be the result of local trauma.

Table 2-8 Necrotic tissue This specimen was taken from an area of necrotic tissue. This field shows diffusely infiltrating malignant cells, singly and in clusters, in a dense, fibrous background (a so-called desmoplastic response to the malignant cells). Normal tissue cannot be seen. The clusters or nests of cells, particularly near the top of the field, suggest that the malignant cells are of epithelial origin; and the neoplasm is therefore a carcinoma. The site of origin cannot be determined from the microscopic appearance. This could be metastasis from any of several sites.

Necrotic tissue - higher mag. This is a higher magnification of the previous field. Whle details are somewhat obscured by artifact, the nuclear pleomorphism and increase in nucleus/cytoplasm ratio characteristic of malignant cells is evident.

Table 3-2 Breast tissue In this low magnification of breast tissue, three atrophic lobules are seen (4 o'clock, 6 o'clock, and 11 o'clock). The intervening stroma is densely collagenous, much more so than normal. Such stromal fibrosis is a componenet of "fibrous changes" that are very common. The condition is completely benign, but may be manifested as firm areas on palpation that could be confused with neoplasm.

Table 3-2 Seborrheic keratosis Toward the left side of the field, a thin, normal epidermis is seen over the surface of the dermal connective tissue. Across most of the field, however, folds and projections of proliferating keratinocytes (epidermal cells) produce an elevated lesion.

Seborrheic keratosis - higher mag. A higher magnification in another field of the elevated lesion again shows the sheets. folds, and projections of epidermal cells. The bottom fifth of the field represents dermis. The space between the epidermal cells and the dermis is an artifact of shrinkage; but it illustrates the non-infiltrative, benign character of the lesion. The ovoid to circular spaces within the epidermis are filled with desquamating, keratinized cells. This feature is typical of a seborrheic keratosis. Such lesions are common in older individuals and appear as pigmented, slightly greasy or dirty elevated plaques. While perhaps cosmetically unpleasant, they are generally trivial biologically.

Table 3-6 Green blood This specimen of "green blood" from the internal thoracic artery consisted of finely divided fragments, one of which is shown in this field. The pink material is fibrin and serum with a distinct layer of red cells toward the top.

Green blood Another of the fragments has a layer rich in leukocytes. This layering of formed elements of the blood is typical of post-mortem clots; where, as contrasted with in-vivo thrombi, settling of the non-flowing blood occurs before coagulation, which is typically slow post-mortem. The green color seen grossly was probably a post-mortem artefact.

Table 2-1	Lymph node	The left side of this field is represented by adipose tissue, while the remainder is occupied by a lymph node. The architecture of the node, as seen in this low magnifcation, has been effaced; i.e. the usual array of lymphoid nodules, sinusoids, etc. cannot be seen.
	Lymph node - higher mag.	In this higher magnification of the previous field, it can be seen that the cells are much too large to be normal lymphocytes. The node has been replaced by a population of malignant cells having large, pleomorphic nuclei, and varying amounts of cytoplasm. While the degree of anaplasia makes precise diagnosis difficult, the amount of cytoplasm in the malignan cells and the (subtle) tendency of the cells to cluster suggest that the neoplasm is of epithelial origin, hence a metastatic carcinoma. The origin cannot be determined precisely from this sample alone. While primary lymphoid malignancies (lymphomas) do exist, the cytologic features seen here do not suggest lymphoma. That unlikely possibility cannot be entirely ruled out without additional information.
Table 2-6	Tissue from foot	Low power view of the lesion which was a small cyst containing "cheesy" material. At the top of the field is the cavity of the cyst, completely filled during life with a fluid not unlike synovial fluid. The amorphous. flaky material just above the dense connective tissue wall of the cyst is a remnant of that fluid, precipitated during the embalming process.
	Tissue from foot	Medium power of cyst wall. The cyst wall consists of densely collagenous connective tissue. The pale, amorphous material lying on the surface is precipitated cyst content, fluid during life. Note that the space has no discrete lining and therrefore is not a "true" cyst as narrowly defined. This type of lesion is generally referred to as a "ganglion cyst". Such lesions are thought to reflect a degenerative change in connective tissue associated with joint capsule or tendon sheath (possibly due to trauma). A common location for ganglion cysts is in the wrist, but they occur in other locations as well. Clinically, they appear as slightly fluctuant nodules 1.0-1.5 cm in diameter which may pose mechanical or cosmetic problems.
	Tissue from foot	This small artery was in the connective tissue adjacent to the ganglion cyst. The lumen contains a partly recanalized, organizing mass of fibrin. There appears to be no significant atherosclerosis to explain thrombus formation in the artery; and the lesion may thus represent an embolus, or could conceivably be the result of local trauma.
Table 2-8	Necrotic tissue	This specimen was taken from an area of necrotic tissue. This field shows diffusely infiltrating malignant cells, singly and in clusters, in a dense, fibrous background (a so-called desmoplastic response to the malignant cells). Normal tissue cannot be seen. The clusters or nests of cells, particularly near the top of the field, suggest that the malignant cells are of epithelial origin; and the neoplasm is therefore a carcinoma. The site of origin cannot be determined from the microscopic appearance. This could be metastasis from any of several sites.
	Necrotic tissue - higher mag.	This is a higher magnification of the previous field. Whle details are somewhat obscured by artifact, the nuclear pleomorphism and increase in nucleus/cytoplasm ratio characteristic of malignant cells is evident.
Table 3-2	Breast tissue	In this low magnification of breast tissue, three atrophic lobules are seen (4 o'clock, 6 o'clock, and 11 o'clock). The intervening stroma is densely collagenous, much more so than normal. Such stromal fibrosis is a componenet of "fibrous changes" that are very common. The condition is completely benign, but may be manifested as firm areas on palpation that could be confused with neoplasm.
Table 3-2	Seborrheic keratosis	Toward the left side of the field, a thin, normal epidermis is seen over the surface of the dermal connective tissue. Across most of the field, however, folds and projections of proliferating keratinocytes (epidermal cells) produce an elevated lesion.
	Seborrheic keratosis - higher mag.	A higher magnification in another field of the elevated lesion again shows the sheets. folds, and projections of epidermal cells. The bottom fifth of the field represents dermis. The space between the epidermal cells and the dermis is an artifact of shrinkage; but it illustrates the non-infiltrative, benign character of the lesion. The ovoid to circular spaces within the epidermis are filled with desquamating, keratinized cells. This feature is typical of a seborrheic keratosis. Such lesions are common in older individuals and appear as pigmented, slightly greasy or dirty elevated plaques. While perhaps cosmetically unpleasant, they are generally trivial biologically.
Table 3-6	Green blood	This specimen of "green blood" from the internal thoracic artery consisted of finely divided fragments, one of which is shown in this field. The pink material is fibrin and serum with a distinct layer of red cells toward the top.
	Green blood	Another of the fragments has a layer rich in leukocytes. This layering of formed elements of the blood is typical of post-mortem clots; where, as contrasted with in-vivo thrombi, settling of the non-flowing blood occurs before coagulation, which is typically slow post-mortem. The green color seen grossly was probably a post-mortem artefact.

Medical Gross Anatomy Pathology

Medical Gross Anatomy
Pathology