LAB 1
DISEASE AT THE CELL AND TISSUE LEVELS

INFLAMMATION/NEOPLASIA AND CANCER


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Go to Microscope Slide Lists

Objectives

1. List and define 5 types of necrosis and be able to recognize those types exemplified in lab specimens (gross and microscopic).

2. List and describe 3 fates of necrotic tissue and be able to recognize them on lab specimens.

3. Recognize the differences between normal tissue and those showing necrosis, inflammation, wound healing and scar tissue.

4. Know the 5 cardinal signs of inflammation and be able to recognize these on lab specimens when present.

5. List and describe the various types of noncellular and cellular exudates. Define and contrast exudate and transudate.

6. Describe a granuloma.

7. Recognize the differences between normal and neoplastic tissues.

8. Know the various characteristics which are used to distinguish between benign and malignant neoplasms. Be able to apply these characteristics to lab specimens to determine whether they are benign or malignant.

9. Know "Cancer's Seven Warning Signals"

10. Know the 3 means by which cancers spread throughout the body.

11. Know the 4 main types of cancer therapy commonly used.

12. Know all underlined terms and all starred (*) questions.

MICROSCOPE SLIDE NOTES

Genetic disease - Sickle Cell Anemia (PH 1015) (p. 19) Click here 

While many of the red blood cells have the normal donut appearance of biconcave discs, notice that some are irregular in shape, often looking like grains of rice or sickles (hence the name). Move the slide slightly, looking at individual normal and sickle cells. As body oxygen level decreases, more and more cells change from normal to sickle shape, blocking small blood vessels. The sickle cells are also more fragile and break apart quickly causing anemia.

        Normal RBCs      Sickle cell RBCs     Sickle cell RBCs      Sickle cell trait RBCs

        Web-list photos for genetics

* What is the cause of sickle cell anemia?

Development of Cirrhosis of the Liver - Normal Liver (PH 8145), Fatty Metamorphosis (PH 1525) and Cirrhosis of the Liver (PH 1520) (pp. 35-36, 385) Click here

First study the slide of normal liver. Notice the size and shape of the liver cells, the purple nuclei and pink cytoplasm. Notice the pale colored sinusoids (specialized capillaries) situated between strands of liver cells.

On the slide of fatty degeneration (fatty metamorphosis), you will note large clear bubbles or vacuoles within the liver cells. Notice how these vacuoles occupy a large proportion of the cell's volume and push the cytoplasm up against the cell membrane, forming "signet ring cells". These vacuoles contain fat which has accumulated due to abnormal biochemical reactions within the cell. These changes occur with various types of injury to the liver, including the early stages of cirrhosis.
   
           1. Normal liver in situ, gross (CT)
           2. Normal liver, external, gross (VHP)
           3. Normal liver, cut surface, gross
           4. Normal liver zones, microscopic *
           5. Fatty metamorphosis of liver, gross (CT)
           6. Fatty metamorphosis of liver, gross
           7. Fatty metamorphosis of liver, microscopic *
           8. Fatty metamorphosis of liver, microscopic *

* Is fatty degeneration a reversible or irreversible change?

With continued assault to liver cells, cells will die and be replaced by scar tissue. On the slide of cirrhosis of the liver, notice bands of fibrous scar tissue which extend through the liver and separate lobules of functioning liver cells. The many small blue cells are inflammatory cells, which are WBCs that invaded the area and indicate that inflammation is occurring. (See also the photograph of Liver/Cirrhosis).

           9. Macronodular cirrhosis of liver, gross - from hepatitis
           10. Macronodular cirrhosis of liver, gross - from hepatitis
           11. Macronodular cirrhosis of liver, gross - from hepatitis
           53. Viral hepatitis C, liver, low power microscopic* - from hepatitis
           54. Viral hepatitis with collapse, liver, Trichrome stain, microscopic* - from hepatitis
           16. Cirrhosis of liver, microscopic *
           17. Micronodular cirrhosis and fatty change of liver, microscopic *
           18. Mallory's hyaline, liver, microscopic *

* What is a common cause of cirrhosis?

           12. Micronodular cirrhosis of liver, gross [MRI]  - from alcoholism
           13. Micronodular cirrhosis and fatty change of liver, gross [CT]  - from alcoholism
           14. Micronodular cirrhosis and fatty change of liver, gross  - from alcoholism
           15. Micronodular cirrhosis and fatty change of liver, gross  - from alcoholism

* Is cirrhosis reversible or irreversible?

Inflammation - Chronic gastritis (PH 1410) (pp. 44-48 ) Click here

Compare the slide with the diagram of normal stomach mucosa. Notice that on the slide, the mucosa is thinned and flattened and there is exudate (clear spaces with pink structureless material) present within the submucosa. Notice also that the lymph nodes are greatly enlarged and there are large numbers of white blood cells (stained blue) within the submucosa.

       1. Erythema, gross
        2. Erythema and edema, gross
        13. Edema in larynx, gross
        5. Exudation, microscopic *
        Neutrophil in action, GIF animation
        6. Margination and diapedesis of neutrophils, microscopic *
        8. Neutrophil ingestion of bacteria, gram stain, microscopic *
        3. Neutrophilia, peripheral blood, microscopic *

* What is meant by gastritis?

        Stomach, normal, gross (CT)  
            Notice that the lining of the stomach is smooth. Observe its color.
        Stomach, pylorus, normal, gross  
            Notice that the lining of the stomach is smooth. Observe its color.
        Acute gastritis, gross (CT)  
            Notice that the lining of the stomach appears swollen or puffy. Observe its color.
        Gastric erosions, gross  
            With severe gastritis, hemorrhaging may occur, as seen here.

* Which of the 5 cardinal signs of inflammation is shown?

* What has attracted the lymphocytes into this area?

        Stomach, fundus, normal, medium power microscopic *
            Notice that since there is no inflammation here, there are few if any small blue lymphocytes among the stomach cells. 
        Acute gastritis, microscopic *
              Notice that with inflammation there are many small blue lymphocytes among the stomach cells. 

Abscess - Chronic Subcutaneous Abscess (PH 2335) (pp. 53-54) Click here

Notice the spherical mass of unorganized cells and cell debris surrounded by a capsule of fibrous connective tissue within the dermis of the skin. Compare its appearance with the normal dermis by moving the slide back and forth. Observe the abscess with both the compound and dissecting microscopes and then return slide to original position.

          27. Abscess formation, lung, gross  
          28. Abscess formation, lung, gross  
          Lung, abscesses, gross [XRAY] 
          Breast abscess, gross 
          Odontogenic (tooth) abscess, head CT scan 
          31. Abscessing bronchopneumonia, microscopic *
          32. Abscessing bronchopneumonia, microscopic *

* What is the name of the material filling the abscess?

Granuloma - Ghon Tubercle (PH 1225) (pp. 55-56, Fig 4-13) Click here

Notice that an area of lung tissue has been displaced by a dense spherical mass of necrosis surrounded by a capsule of fibrous connective tissue.

         34. Lung, tuberculosis with granulomatous inflammation, gross (X-ray)
         35. Lung, tuberculosis with granulomatous inflammation, gross
         36. Lung, granulomatous inflammation and caseation, gross (X-ray)
         39. Lung, Ghon complex with primary tuberculosis, gross
         40. Lung, granulomas, low power microscopic *
         41. Lung, granulomas, low power microscopic *
         44. Lung, M. Tuberculosis, acid fast stain, high power microscopic *
         45. Lung, miliary tuberculosis, gross (X-ray)
         46. Lung, miliary tuberculosis, gross (X-ray)

* What type of necrosis is present in this lesion?

Compare the dense arrangement of material in the granuloma with the open, air-filled normal lung tissue surrounding it by moving the slide from one area to another.

* What effect does this lesion have on gas exchange in this area?

* With what disease are Ghon tubercles associated?

Observe the granuloma with both the compound and dissecting scopes and then return the slide to the original position.

Benign Neoplasm - Intradermal Nevus (Mole) (PH 2300) (pp. 111-112, 116-117, Table 8-1, p. 117) Click here 

Note that the stratified squamous epithelium of the epidermis has undergone proliferation. The epidermis is very thick and contains excessive accumulations of brown melanin. Compare the thickness of the epidermis in the mole with that of the normal epidermis at the edges of the section. Move the slide back and forth to do this. Then return the slide to the original position.

        Normal skin, microscopic *
        Normal adnexal structures, low power microscopic *
        Benign nevi, gross  
        Benign halo nevus, gross  
        Benign junctional nevus, medium power microscopic *
        Benign intradermal nevus, low power microscopic *
        Benign intradermal nevus, high power microscopic *

This neoplasm is considered benign if it does not spread but if it invades into the dermis it would be considered malignant and called a melanoma. (Fig. 8-3, p. 111)

        Melanoma, gross  
        Melanoma of upper eyelid, gross  
        Melanoma, resection, gross  
        Melanoma, resection, gross  
        Atypical melanocytic hyperplasia, high power microscopic *
        Melanoma, high power microscopic [IPX] *
        Melanoma, Fontana-Masson silver stain, high power microscopic *
        Melanoma, melanosomes, electron micrograph *
        Melanoma, premelanosomes, electron micrograph *

* To which of the cancer warning signs does this relate?

* Name one important etiological factor in the development of malignant melanoma.

Benign Adenoma - Adenomatous Polyp of the Colon - Benign (PH 1435) (pp. 114, 116, Table 8-1, p. 117) Click here 

Note that the mucosal cells have undergone massive proliferation. However, they remain in their normal though expanded arrangement, remain attached to one another and therefore form a benign tumor. (Compare with Fig. 8-10, p. 115). Compare the thickness of the adenoma mucosa with that of the short piece of normal mucosa.

        Colon, adenomatous polyp (tubular adenoma), low power microscopic [XRAY]*
                This slide looks just like the one in lab at very low power.
        Colon, villous adenoma, composite low power microscopic *
                The left side of this is slide looks just like the one in lab at higher magnification.
        Colon, adenomatous polyp (tubular adenoma) compared to normal mucosa, medium power microscopic *
        Colon, adenomatous polyp (tubular adenoma), gross [XRAY]  
        Colon, adenomatous polyp on long stalk, gross [XRAY]  
        Colon, multiple adenomatous polyps, gross  
        Colon, familial adenomatous polyposis, gross  
        Colon, familial adenomatous polyposis (Gardner's syndrome), gross  
        Colon, villous adenoma, composite gross (X-ray)  

* Why is this called an adenoma?

Also observe the endoscopic photograph of a polyp of the colon.

Adenocarcinoma - Adenocarcinoma of kidney (PH 1720) (pp. 114-116, Table 8-1, p. 117) Click here 

Note that tubular cells have undergone extensive proliferation and have lost their characteristic appearance. They look more like undifferentiated cells and there is extensive stroma filled with red blood cells between the cancer cells. See Fig. 8-9. This situation is very different from that of the benign adenoma of the colon. Compare the tumor with the normal kidney structure (tubules and glomeruli) by moving the slide back and forth. Note that the tumor is displacing and invading into the normal kidney tissue. There is no sharp boundary between normal and malignant tissue. Return the slide to the area of the tumor.

           Normal renal cortex, low power microscopic *
                Notice the glomeruli and tubules are regular, with little material between the tubules.
            Normal renal cortex, medium power microscopic *
                Notice the glomeruli and tubules are regular, with little material between the tubules.
            Normal corticomedullary junction, low power microscopic *
                Notice the glomeruli and tubules are regular, with little material between the tubules.
            Normal kidney, medium power microscopic *
                Notice the glomeruli and tubules are regular, with little material between the tubules.
            Renal cell carcinoma, gross (Angio)  
                This slide shows a gross view of the disease in the microscope slide. 
            Renal cell carcinoma, gross [MRI]  
            Renal cell carcinoma, gross [MRI]  
            Renal cell carcinoma with renal vein invasion, gross (CT)  

* Why is this called an adenocarcinoma?

Sarcoma - Sarcoma of the Uterus (PH 2007) (pp. 116-117, Table 8-1, p. 117) Click here 

Compare the normal and neoplastic cells in this slide of the uterine wall (myometrium). The normal smooth muscle cells are long, strap-like (spindle-shaped) cells with oval nuclei and much pink cytoplasm. The neoplastic cells are rounder, vary in size and have nuclei of various shapes and staining intensities. These cells are anaplastic.

      Uterus, leiomyosarcoma, gross  

* What is meant by the term anaplastic?

Note that the neoplastic cells are invading into the normal tissue. There is no sharp border between normal and neoplastic cells. Invasion into surrounding normal tissue is one of the hallmark characteristics of a malignant neoplasm (cancer).

* Name 5 other characteristics of malignancy.

* Why is this neoplasm called a sarcoma?

Leukemias - Normal Blood Smear (G 510), Chronic Lymphocytic Leukemia (PH 1070) and Chronic Granulocytic Leukemia (PH 1050) (pp. 116-117, Table 8-1, p. 117), also see photographs of normal blood cells. Click here 

First study the normal blood smear by scanning the slide. Note the relative abundance of red blood cells and white blood cells. Neutrophils are the most common type of WBC in normal blood.

        Normal red blood cells on smear, microscopic *
        Normal lymphocyte and neutrophil on smear, microscopic *

Now study the smear from a patient with chronic lymphocytic leukemia. Note the relative abundance of RBCs and WBCs (observing a number of fields) and note that almost all the WBCs are lymphocytes.  

        Chronic lymphocytic leukemia on smear, microscopic *

On the slide of the chronic granulocytic leukemia, note that there are more WBCs than RBCs and that the WBCs are abnormal in size, shape and nuclei. Compare these WBCs with those in the normal blood smear.

        Chronic myelogenous leukemia on smear, microscopic *
        Chronic myelogenous leukemia on smear, microscopic *
        Chronic myelogenous leukemia on smear, microscopic *

* What is a general term for a cancer involving WBCs? (pp. 116-117, 96)

* What is a general term for a cancer involving lymphoid tissue? (pp. 116-117)

PRESERVED SPECIMEN NOTES
Go to Specimen Photo Index

Normal and Cirrhotic Liver - Plastinated specimens (pp. 35-36, 385)

Compare the color of the 2 liver specimens. The paler color of the cirrhotic liver is due to the accumulation of fat within the liver cells. Look closely at the cirrhotic liver to observe the bands of scar tissue which extend throughout the specimen separating small lobules of liver cells. Compare the edge of the 2 liver specimens; the edge of the normal liver is smooth, whereas that of the diseased liver is lumpy.

        1. Normal liver in situ, gross (CT)
        2. Normal liver, external, gross (VHP)
        3. Normal liver, cut surface, gross
        9. Macronodular cirrhosis of liver, gross - from hepatitis
        10. Macronodular cirrhosis of liver, gross - from hepatitis
        11. Macronodular cirrhosis of liver, gross - from hepatitis

* What is responsible for the lumpy edge of the cirrhotic liver?

On a physical exam, a physician can often detect if a liver exhibits fattydegeneration or cirrhosis. How?

        5. Fatty metamorphosis of liver, gross (CT)
        6. Fatty metamorphosis of liver, gross (CT)

Liquefactive Necrosis - Human brain sections (Fig 3-6, p. 37)

Compare the 2 frontal sections of human brain. Look for the white and gray matter in each. What do white and gray matter represent in the human brain? Look closely at the section of abnormal brain. Draw an imaginary midsagittal line through the specimen and compare left and right halves. Notice the difference in the size of the halves caused by chronic low blood flow to the smaller half. A thrombus (blood clot) in the cerebral arteries cut off the blood supply to a portion of the brain and the patient suffered a stroke. The patient survived for a number of months following the stroke.

* What cellular process resulted in shrinkage of one side of the brain?

        Cerebrum, external view, atrophy with Alzheimer's disease, gross  
        Cerebrum, external lateral view, atrophy with Pick's disease, gross (MRI)  
        Cerebrum, external vertex view, atrophy with Pick's disease, gross (MRI)  
        Cerebrum, coronal section, atrophy with Pick's disease, gross  

* What process occurred in the area of the stroke in the few months before the patient's death?

        Cerebrum, coronal section, subacute infarct, gross [MRI]  

Gangrene - Preserved foot from Diabetic patient (Fig. 3-8, p. 38)

This foot shows one of the major complications from diabetes, chronic infection. In this case, the infection resulted in gangrene and necessitated the amputation of the patient's foot. Why are feet particularly common sites of infection in diabetics?

Observe the superior surface of the foot. Note the color of the skin and nails. Compare the specimen with Fig. 3-8.

        Foot with previous healed transmetatarsal amputation and recent ulcer, gross  
        Gangrenous necrosis and ulceration, lower extremity, gross  

* What type of gangrene is exemplified?

* What distinguishes gangrene from other types of necrosis?

Abscess - Preserved lung with abscess, (pp. 53-54, Fig 4-10)

Observe the large hole in the lung. Notice that the area is surrounded by dense tissue.

        14. Lung, abscesses, gross (X-ray)  
        15. Lung, abscesses, gross (CT)  

* What material filled the abscess before the lung was removed from the body?

* What type of necrosis occurred?

* What is the dense tissue around the abscess?

Neoplasia - Dried Lung Specimens (pp. 111-117)

Compare the 3 specimens of dried lung. The specimen at left is of a normal lung (although there is some emphysema at the upper portion). Note the sponge-like quality of the lung with many air spaces separated by thin walls of lung tissue.

        2. Normal lung, cross section, gross (CT)  
        4. Normal lung, microscopic *

What is the name for a single air sac surrounded by lung tissue?

The center specimen contains a single nodule of primary neoplastic tissue. Note the differences in color, texture and density between it and the normal tissue. Note also how the neoplasm is pushing aside the surrounding normal tissue. (Although this nodule does not show any gross signs of invasion it is probably malignant because 90% of primary lung tumors are malignant).

        85. Lung, peripheral adenocarcinoma, gross (CT)  
                This specimen resembles the dry lung specimen in the glass panel in lab.
        80. Lung, squamous cell carcinoma, gross [XRAY]  
                This specimen resembles the wet specimen preserved in the jar in lab.
        79. Lung, squamous cell carcinoma, gross [CT]  
        81. Lung, squamous cell carcinoma, gross [XRAY]  
        86. Lung, bronchioloalveolar carcinoma, gross (CT)  

What effect would this tumor have on lung functioning?

The specimen on the right contains multiple nodules of metastatic cancer; the normal lung tissue is almost completely replaced by cancerous tissue. These secondary nodules are composed of cancer cells which metastasized to the lung from some other site such as the breast, kidney or gastrointestinal tract.

        93. Lung, metastatic carcinoma, gross [XRAY]  
                This specimen has small tumors, though they are not as numerous as the one in the glass panel in lab.
        94. Lung, metastatic carcinoma, gross [XRAY]  
                This specimen has much larger tumors.

* How do these cells arrive in the lungs?

How would these lesions affect lung functioning?

Neoplasia - Preserved Spleen with Tumors (pp. 111-117) Observe the large light-colored tumors. Note that there are several of them. Notice how their internal structure and texture differs from the normal spleen tissue. These tumors are lymphomas.

        Normal spleen and accessory spleen, gross (CT)  
                Notice that the main dark mass of this normal spleen is approximately 4 centimeters wide.
        Splenomegaly with myeloproliferative disorder, gross (CT)  
                Notice that this spleen is more than 30 cm wide.

* What does lymphoma mean?

Neoplasia - Preserved Kidney with Tumors (pp. 111-114)

Observe the longitudinally cut surface of the kidney. Note that only a small portion shows the normal structure of cortex and medulla. The remainder is mostly tumors.

        Transitional cell carcinoma of renal pelvis, gross
        Renal cell carcinoma, gross [MRI]
        Renal cell carcinoma with renal vein invasion, gross (CT)
        Renal cell carcinoma, microscopic (X-ray) *

* Is this a benign or malignant neoplasm? Give your reasons.

Metastatic Cancer - Liver with Metastatic Colonic Cancer (Fig. 8-8, p. 114)

Note the many large lobules scattered within the normal liver tissue. These are metastases from a primary cancer of the colon. The liver is a common site for metastases from various types of cancer, including cancer of the GI tract, breast, pancreas and lung.

        Normal liver in situ, gross (CT)  
        Normal liver, external, gross (VHP)  
        Normal liver, cut surface, gross  
        Metastatic adenocarcinoma, liver, gross [CT]  
        Metastatic adenocarcinoma, liver, gross  
        Metastatic adenocarcinoma, liver, gross [CT]  
        Metastatic adenocarcinoma, liver, microscopic *

* What are 3 possible routes cancer cells may follow when they metastasize to distant organs? (pp. 112-113)

Which route do you think these colon cancer cells followed to arrive in the liver?

(Fig. 27-2, p. 370)

PHOTOGRAPHS AND DIAGRAMS

See Lecture Notes for Section 01 for Sect01-wmore illustrations of the following conditions

Photographs
demonstrating atrophy, hypertrophy, hyperplasia, metaplasia and dysplasia (pp. 109-111)

Atrophy - involves shrinkage of organs and may be due to a decrease in hormone levels (often with advancing age), as in the Testis/Atrophy; ischemia (inadequate blood supply) as in the Kidney/Focal Cortical Atrophy or disuse as in Skeletal Muscle/Neurogenic Atrophy. In some cases the atrophy of the organ involves a decrease in cell size (skeletal muscle) and in some cases a decrease in cell number (testis, kidney).
           1. Atrophy, muscle fibers, microscopic *
           3. Atrophy, cerebrum, gross

Hypertrophy and Hyperplasia

* Distinguish between hypertrophy and hyperplasia.
            hypertrophy 
                 5. Hypertrophy, heart, gross  
            hyperplasia
                   6. Hyperplasia, endometrium, gross
                   Normal prostate, medium power microscopic*
                   Normal prostate, high power microscopic *
                   8. Hyperplasia, prostate, microscopic*
                   7. Hyperplasia, prostate, gross

* Which of these is reversible?

Metaplasia

* Define metaplasia.
           9. Metaplasia, squamous, larynx, microscopic *
           4. Columnar metaplasia, esophagus, microscopic *

* What usually causes metaplasia? What caused the metaplasia of the salivary gland illustrated?

Dysplasia

* Define dysplasia. (See Fig. 64-12, p. 972)
           Normal cervix, high power microscopic  *
           6. Dysplasia, cervix, high power microscopic *
           7. Dysplasia, cervix, Pap smear, high power microscopic *

Why is detection of cervical dysplasia by a Pap smear important?

Allergic Contact Dermatitis (Type IV Reaction) - Poison Ivy

Oil from the poison ivy plant (also poison oak and poison sumac) initiates allergic contact dermatitis by activating T-lymphocytes. Note the redness, swelling and multiple blisters.

            Contact dermatitis, gross 

* What type of exudate is present within these blisters? (pp. 53-54)

WALL CHARTS

Diseases of the Male Pelvis - Necrosis and Inflammation
See Lecture Notes for Section 01 for more illustrations of the following conditions

Study examples of inflammation such as the infections with gonorrhea, syphilis, scabies and tinea cruris as well as lymphogranuloma venereum and the prostate infection. Note the color, shape and apparent texture of these areas.

* What signs of inflammation are present? What are the other signs of inflammation?

Note that necrosis and suppuration have occurred with gonorrhea and lymphogranuloma venereum.

* What do these terms mean?

Gonorrhea has produced a stricture of the urethra.

* What is a stricture? (p. 60)

Diseases of the Male Pelvis - Abnormal Cell Growth
See Lecture Notes for Section 05 for more illustrations of the following conditions

Observe the cancer of the prostate.

* What characteristic, visible on this chart, indicates that this is a malignant neoplasm? (Fig. 8-3, p. 112)

Benign prostatic hypertrophy is common in older men because the prostate grows continuously as long as testosterone is present.

* What is meant by hypertrophy? (p. 110)

What complications may occur with benign prostatic hypertrophy?

Diseases of the Female - Necrosis and Inflammation
See Lecture Notes for Section 01 for more illustrations of the following conditions

Study the examples of inflammation listed below, noting redness, swelling, necrosis, exudate and/or repair.

a. Gonorrhea has caused salpingitis or inflammation of the Fallopian tube. Note the adhesions resulting from healing.

* What is an adhesion? (p. 60)
                Adhesions of pleura, gross

b. Pelvic peritonitis shows suppuration.

* What is suppuration? What is the common name for suppurative exudate? (p. 53)

c. Note the redness, swelling and suppurative exudate which are present in the cervicitis, chancre of the vulva and gonorrhea of the uterus.

d. Note the extensive breast abscess

* What is an abscess? (p. 53)

Diseases of the Female - Abnormal Cell Growth
See Lecture Notes for Section 05 for more illustrations of the following conditions

Notice that each of the following shows abnormal enlargement and sometimes a change in the structure of the tissues involved. (metastatic cancer in lung, infiltrating breast carcinoma, adenocarcinoma, fibroids of uterus, polyps of uterus, carcinoma of cervix of uterus, fibroadenoma, endometrial carcinoma of uterus, carcinoma of vagina, cystadenoma of ovary).

* Be sure that you know and can define each of these terms. (pp. 111-117)

Diseases of the Digestive System - Necrosis and Inflammation
See Lecture Notes for Section 01 for more illustrations of the following conditions
See Lecture Notes for Section 05 for more illustrations of the following conditions

a. Fatty liver (fatty degeneration of liver cells) usually precedes cirrhosis of the liver and is found in other conditions as well. (Fig. 3-3 and pp. 35-36).

b. Cirrhosis of the liver occurs when liver cells die and are replaced with fibrous scar tissue (connective tissue).

c. The duodenal ulcer and gastric ulcer are characterized by death of the inner mucosal cells due to stomach acids and enzymes.

* What happens to the mucosal cells in an ulcer? (p. 39)

d. Note the esophageal stricture.

* What is a stricture and how is it formed? (p. 60)

e. Gastritis is an inflammatory reaction in the stomach mucosa sometimes caused by irritating chemicals like alcohol. Note that some areas of the mucosa have been lost because of cell death; this commonly occurs in chronic atrophic gastritis.

* What is meant by atrophy?

Diseases of the Digestive System - Abnormal Cell Growth
See Lecture Notes for Section 05 for more illustrations of the following conditions

The chart shows a variety of abnormalities in cell growth including neoplasia. Notice in the following examples (multiple polyps of the colon, cancers of the esophagus, stomach, pancreas, colon and rectum) that there is an increase in the amount of cellular material. Also, there is often an alteration in the structural appearance of the area because of a change in cellular differentiation.

* What is meant by " a change in cellular differentiation "? (p. 115)

* Can you think of problems caused by each of these growths?

8Copyright 2001 - Augustine G. DiGiovanna - All rights reserved.

This material may not be reproduced or distributed in any form or by any means, or stored in any data base or retrieval system without prior written permission is obtained from Augustine G. DiGiovanna, Ph.D.,  Professor of Biology, Salisbury University, Salisbury, MD  21801.