Week 3: Gross & Microscopic Pathology

This week, I got to learn a little more about gross pathology. This is not the kind of gross that means disgusting (at least not to some people); it’s like the total specimen kind of gross. The gross examination includes a basic description of what the specimen is like when it arrives. The pathologists (actually, usually the residents) will make note of the size, shape, color, weight, and general appearance of a specimen. Then they cut it up and prepare for the microscopic analysis.

Here is a (long) video from Weill Cornell about the steps that go into grossing a bladder (a very valuable skill for everyone):

Today, I attended an autopsy conference that happens almost every Friday. The pathologists present an autopsy case including the history and final diagnosis of the patient. I learned that autopsies are performed when the family of the deceased patient requests one, usually to find or confirm a diagnosis. 

After that, there was a gross conference. This is kind of like an educational game the residents play where pictures of a specimen are displayed and somebody describes what they see to determine a diagnosis. I learned a lot from this activity about various ways to describe different specimen and identify the organs that are shown.

I also had the chance to continue attending daily sign-out sessions. I went to the genitourinary sign-out each morning to get a better idea of the tissues they look at. I have been starting to recognize differences between normal and abnormal cells, but I still have a lot to learn!

One last thing I got to learn about this week was the difference between immunohistochemistry and FISH (fluorescence in situ hybridization). I learned that immunohistochemistry involves the binding of antibodies on proteins and can look something like this [1]:
  
Instead of proteins like immunohistochemistry, FISH is used when you want to look at nucleic acids. This technique uses a fluorescent marker and may look something like this [2]:
   
These techniques are both part of the microscopic side of pathology and are used to help determine a diagnosis or figure out what caused a disease.

With the fourth of July on Tuesday, I didn’t have quite as much time to spend in pathology, but I did enjoy spending time in New York City. I am really looking forward to learning much more about pathology in the next four weeks!

[1] Fred Hutchinson Cancer Research Center. (2011). Immunochemistry. Retrieved July 7, 2017, from https://sharedresources.fredhutch.org/galleries/immunochemistry
[2] Abnova Corporation. (2017). HER2/CEN17q FISH Probe. Retrieved July 7, 2017, from http://www.abnova.com/products/products_detail.asp?catalog_id=FG0006
 

Rose Buchmann

Comments

Post a Comment

Popular posts from this blog

Week7

With the end of our summer immersion approaching, I feel sad to say goodbye to all the persons I've met in the hospital during this summer. The past 7 weeks has been very fulfilling and exciting to me, and I will never forget my experience here. As a student will electrical engineering background, I never thought that I can be able to go to a real operation room in the hospital and observe doctors operating on surgeries. But in the past 7 weeks, I was able to go to OR every week, and there's always surgery techniques that are impressing to me. Beside clinical experience, I also had a research project, automatic segmentation of zebra fish neuron images. As I have presented in my previous bloggers, for my project, I have tried several different algorithms. The first is simple thresholding. It is usually used as a preprocessing step in image analysis. The second method is watershed algorithm. It works pretty well, but, it's very sensitive to noise, resulting in over segmenta...
Read more

Week 5: Prostates & Autopsies

Image
This was a fun and interesting week! The prostate biopsy chip slides from last week were evaluated, and more testing was done. On Wednesday and Thursday, two people from the company were here to do some trials with the new chips. This time, real prostate biopsies were taken, and sections were used to evaluate the quality of the tissue. Each chip holds up to 6 biopsies inside the little grooves. The color of the dividers (blue, yellow, and black) orient each sample to distinguish where in the prostate each biopsy came from. It also allows six biopsy cores to be placed on one slide which saves space and resources [1]: Instead of all 12 of the slides on the left (although that is a little excessive), you just need two with the BxChip. It also seems to keep the cores flat and aligned. This is what a magnified core might look like [2]: The tissue fits right inside the little grooves (although it can be slightly difficult to get them in there), and then the whole chip can be ...
Read more

Week 5: Spine Surgeries and Excel Files

Image
On the context of my clinical research project, I continue extracting the different demographic and skeletal specific factors for the patients of our study. I was also able to attend an additional spinal fusion surgery under the supervision of Dr. Kim at HSS. During this week, I was particularly interested in the surgical equipment that he uses for the procedure. Dr. Kim uses the Zimmer Biomet Vitality Spinal Fixation System for his spine surgeries. The components of the system are made from medical grade titanium alloy and medical grade cobalt chromium alloy. In summary, these were the main steps of the process for installing the screws into the patient spine which, personally, was the most interesting part of the procedure.  Initially, the pedicle area of the vertebrae is localized, and an insertion is made in the cortical shell. Then, a probe, included with the system, creates a pathway for the polyaxial pedicle screw to be inserted into the pedicle and the vertebral body. ...
Read more