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1 Target Notes / Description / Size Picture / Illustration Tissue or Source 1 Picture / Illustration Tissue or Source 2 Picture / Illustration Tissue or Source 3 Picture / Illustration Tissue or Source 4 Picture / Illustration Tissue or Source 5 Picture / Illustration Tissue or Source 6 Alternate Tissues Classification Imaging Technology or Magnification 1 Imaging Technology or Magnification 2 Imaging Technology or Magnification 3 Imaging Technology or Magnification 4 Imaging Technology or Magnification 5 Imaging Technology or Magnification 6 Connective Fibrous Loose Areolar Areolar tissue is the most widely distributed connective tissue and is highly variable in appearance according to its different locations in the body. The fibers in this tissue are predominantly collagenous, though reticular and elastic fibers are also present. These fibers commonly appear as an entwined, loosely arranged network, as clearly depicted in Slide2 and 6. Contained within this web of fibers are scattered cells of various types (including fibroblasts which secrete fiber-generating proteins), numerous blood vessels and significant empty space (which allows for uninhibited movement of pathogen-foraging leukocytes). Areolar tissue cushions and secures internal organs, vessels and nerves, attaches epithelial tissues to other underlying tissues, and serves as a reservoir of nutrient/waste exchange for nearly all cells. It is found beneath the epithelium of the digestive, respiratory, reproductive and urinary systems and encountered in tissue sections of nearly every part of the body. Adipose tissue is formed primarily by adipocytes, cells which contain fat droplets. Slide3, 4 and 5 present good examples of collections of adipocytes. Adipose tissue also contains in smaller proportion macrophages, small blood vessels, endothelial cells and fibroblasts. Its primary function is to store energy in the form of fat, but it also cushions, protects and insulates the body. Adipose tissue plays an important role in endocrine function by its production of specific hormones such as leptin and resistin. Adipose tissue is found beneath the skin as subcutaneous fat, in bone marrow, breast tissue and around visceral organs. It is further subdivided into white and brown adipose. Areolar tissue with cross section; small blood vessels and skeletal muscle Label Reticular Thoracic areolar tissue Spleen, areolar tissue that is lined by stratified cuboidal epithelial tissue Elastic Uterine serous carcinoma Mesotheloma asbestos lung cancer Stained adipose cells Fat cells Adipose tissue and areolar tissue with sweat ducts Adipose tissue with areolar with sweat ducts Adipose tissue with artoriels, capillaries mesentary Pancreas, Fatty infiltration Adiposopathy "Sick Fat" Pathological 3 Notes / Description / Size / Differences between Normal and Pathological Other Information / Notes on Diseasae Genetic Causes Prevalence / Incidence Other Information / Notes on Therapies / Treatments Medical Research Lymph node Lymph node Liver, reticulin stain, reticular fibers forming mesh like network Reticular forming stroma of a lymph node to support soft tissue Tendon cross section Teased apart to show fibers Tendon cut longitudinally Dense regular connective tissue, logitudinal section Skin, subcutaneous Irregular dense connective tissue meets the periosteum line of the bone Dense irregular connective tissue with collagenous fibers Dense irregular connective tissue running in all directions eg.h Stellate reticular cell of the lymph node Dendritic reticulum cell sarcoma Hodgkin's Lymphoma of the spleen Hairy cell luekimia of the spleen High powered view of the aorta, TI is the tunica intima where Elastic artery, the light wavey lines are lamella of elastin and the elastin is located smooth muscle histology/english/cardiovascular/histologybloodvessels.htm# Dermis of skin Dense irregular connective tissue seen between loose tissue with secretory ducts Solar Elastosis Erythema Nodosum Granuloma annulare Arrow pointing to internal elastic lamina of artery Artery, arrow pointing at elastin lamellae Artery dark purple ribbons are the elastic connective tissue Large aneurysm of the thoracic aorta, tunica adventitia Syphilitic aortitis htm m?tutorialid=8&conceptid=30&imageid=68 Treatment of lipoma usually involves surgical excision. Causes and treatment generally depend on the specific type of lipoma encountered. An individual with this condition may also have a family medical history of tumors or a minor bruise or burn can trigger a lipoma, but there is still no definitive answer on what causes this abnormality. Hodgkin s lymphoma is kind of pathology that affects the spleen, which is largely composed of reticular tissue (see PathoSlide2). Microscopic examination of Hodgkin s lymphoma reveals large scattered multinucleate malignant cells that destroy surrounding tissue structure, usually starting with the effacement of lymph nodes. Hodgkin s lymphoma is a kind of cancer that originates from lymphocyte white blood cells. The disease spreads from one lymph node to another, destroying their histological architecture and the integrity of nearby tissues. The cause of this pathology is unknown or multifactoral. Risk factors include having a family history of the disease, being of the male sex, being either or over 55 years of age, having a weakened immune system (including the presence of HIV/AIDS), prolonged use of human growth hormone and exposure to exotoxins like Agent Orange. Survival rate is high for early stage Hodgkin s lymphoma, but it is not yet possible to predict long-term effects of treatment as some pose a risk of secondary cancers or later affects. Treatment currently includes radiation, chemotherapy drugs and newer modern developments. Most patients are young and live well for at least 40 more years post successful treatment. Fibromatosis is a pathological condition that affects dense regular tissue, as it tends to be adjacent to or infiltrate deep skeletal muscle (which is supported by dense regular tissue forming ligaments and tendons). PathoSlide3 shows fibromatosis occurring at a nonjoint location (palmar). A fibroma is a benign soft tissue tumor. It usually lacks cytologic and clinically malignant features, but histological examination shows proliferation of clearly defined fibroblasts which display an invasive growth pattern, aggressive behavior and frequent local recurrence. The exact cause of fibromatosis is unknown, but it is thought that trauma or tearing of tissues, genetic predisposition (those with northern European descent have a higher incidence), medicines and supplements that can cause excess collagen production and other chronic conditions such as liver disease or diabetes, may all contribute the formation of a fibroma. Treatment of fibromatosis includes prompt and radical excision of the affected area with a wide margin. Radiation may accompany or be an alternate to this procedure. Despite the aggressive behavior and common recurrence of these tumors, mortality is virtually nonexistent. Dense irregular tissue forms the dermis of the skin and is therefore affected by various dermatological abnormalities, such as granuloma annulare (shown in dense irregular tissue in PathoSlide3). Granuloma annulare is a chronic skin condition appearing as reddish lesions and form bumpy ring patterns. This usually occurs on the hands, feet, elbows and knees, though in severe cases it may be more widespread. Granuloma annulare is associated with diabetes mellitus, though most people with the condition are otherwise healthy individuals. The condition produces no symptoms other than the reddish, slightly-itchy lesions. In most cases, these lesions voluntarily disappear within two years, and there is no long term impact on the health of the individual. Although lesions eventually disappear on their own, treatment is sometimes chosen for cosmetic reasons. In such cases, corticosteroids may be prescribed to improve the appearance of the skin and speed the disappearance of lesions. Elastofibroma (shown in slide3) is a kind of pathological condition that affects dense elastic connective tissue. It is a benign and slowly progressive lesion caused by abnormal elastogenesis. The lesion is characterized by an amorphous mixing of deposited collagenous fibers and elastic fibers that show irregular serrated margins. The fibers may also display abnormal globoid arrangement. Elastofibroma commonly occurs in the lower subscapular area and is thought to be caused by friction between the inferior edge of the scapula and the underlying chest wall. The lesion usually occurs in elderly patients and Elastofibroma is usually treated by complete surgical slightly more common in females. The individual usually excision. The condition bears little tendency to recur, has a long history of manual labor. It is thought to be though spontaneous regression has been observed in genetic or related to enzymatic defection. cases without treatment. Palmar Fibromatosis Lipomas like hibernoma are benign and non-cancerous, occurring in the subcutaneous fat between the skin and muscles. It can occur in both males and females regardless of age, but are most common at middle age. Causes vary by case. Lipomas commonly appear as a palpable, soft fatty lump growing under the skin in any part of the body. Dense elastic connective tissue is dominated by elastic fibers. Elastic fibers tend to be smaller in diameter than collagen and in this tissue and are often positioned in regular formation (as shown in high-power magnification in Slide3). Elastic fibers are able to stretch quite beyond their individual length and snap back to their original dimension when not stimulated. This creates expansion and stretch capabilities that are important in structures like arteries that are subject to constant changes in volume and pressure, or tendons and ligaments that also undergo significant pulling and stretching. Slide1 and 2 show the presence of dense elastic connective tissue within the aorta, a structure for which the ability to flex and stretch are vital to its functional success. Aorta, dark lines are elastic fibers seen with smooth muscle Lipoma is a one kind of pathology associated with adipose tissue, more specifically brown fat. PathoSlide3 shows a kind of lipoma known as hibernoma. It is a rare benign subcutaneous tumor that consists of large foamy distended cells (shown in PathoSlide3 as large flattened adipocytes). These cells are polyhedral and bear multiple lipid-filled vacuoles. Lipoma is generally oval shaped and may grow from 2 to 10cm diameter. Hibernoma Dense irregular connective tissue is hallmarked by randomly arranged, densely packed collagen fibers. This lack of structural uniformity grants effective resistance to multiple non-linear forces in areas of the body that are subject to continual and highly variable impaction. The irregularity of this tissue enables non-directional strength and durability in the epithelial lining of digestive organs, heart valves and other areas where forces and pressures are dynamic and variable. Dense irregular connective tissue acts as an anchor where other tissues attach, e.g. where integument fuses with underlying muscle, where muscle is anchored to underlying bone, where joint capsules are movable but securely connected. logy/a&p201/connective_tissues/connective_tissues.htm Symptoms of mesothelioma include shortness of breath, chest pain, weight loss, cough, swelling, bowel obstruction, anemia, fever, blood clotting abnormalities, and build up of fluid in the mesothelium surrounding the effected body cavities (effusion). Treatment includes surgery, radiation, chemotherapy, immunotherapy and multimodality therapy. Dense regular CT with fibroblasts and collagen fibers, to the Histopathology of giant cell tumor of the tendon sheath arising 82-year old woman shows femoral neck fracture, micrograph left skeletal muscle in hand finger. Hematoxylin and eosin stain. shows calcium deposition was caused by calcific tendinitis heath_histopathology(1).jpg Mesothelioma is usually caused by exposure to asbestos. Most people who develop this disease have had an occupation in which they were exposed to asbestos dust or inhaled particles. Even family members of those exposed to asbestos are at higher risk for this condition (being exposed to asbestos on clothing, etc.) Symptoms may not appear until 20 to 50 or more years after exposure to asbestos. The connection between asbestos and mesothelioma is so common that the two are considered indisputably associated, although in rare cases mesothelioma has resulted from irradiation, inhalation of other silicates and exposure to thorium dioxide. Benign Papillary Mesothelioma of Tunica Vaginalis Dense regular connective tissue consists primarily of collagen fibers aligned in parallel fashion. This formation provides linear, unyielding resistance to applied cross-force. The strength and stability resulting from this longitudinal organization of fibers lends tendons, ligaments and aponeuroses their durability and structure. Dense regular tissue provides integrity and support between other tissue layers. It is an important component of perineurium, periosteum, perichondrium and perimysium. Slide1 displays a fine representation of the parallel bundling of collagen fibers in a tendon. Note that though Slide2 also shows dense regular tissue in a tendon, its even linear organization is not apparent in cross-section. Mesothelioma is one kind of pathology that affects areolar tissue. It is a rare form of cancer that develops in the mesothelium, the protective lining that covers many of the body s internal organs. X-ray scans may reveal thickening of the mesothelial tissue in affected areas (see PathoSlide2). If a significant amount of fluid is present in the tissues and it is removed and examined, abnormal cells may be detected (shown in PathoSlide3 as irregular whitish spaces). Unfortunately diagnosis by cytopathological examination alone is difficult. D86&h=378&w=504&sz=74&tbnid=K2cumma64EiCDM:&tbnh Reticular tissue resembles areolar tissue, but its fibers are exclusively reticular, made of type III collagen. In this tissue, reticular fibers form a fine interconnected mesh (see Slide4) that provides supportive structure and an internal framework for soft tissues in the liver, spleen, bone marrow and lymph nodes. Reticular fibers also hold adipose tissue together. Though reticular fibers are distributed throughout the body reticular tissue is more localized to certain sites (mentioned above). Tendon, longitudinal Stretched areolar tissue cancer.com/information/images/meso888b.jpg Irregular Logitudinal section of small intestine Adipose tissue around uterine Spleen, black reticular fibers gives support to soft tissue Regular Skin cutaneous layer /keyfeatures/adipose1.htm h h Dense Pathological 2 Label source / reference MAIN Adipose Pathological 1 Elastrofibroma, subscapular, thought to be caused by years of manual labor

2 Supportive Cartilge Hyaline Hyaline cartilage is extremely strong but also flexible. It is composed of cells called chondrocytes which are positioned within fluid-filled spaces called lacunae. Between the cells are collagen fibers surrounded by a rubbery matrix. This rubbery characteristic provides a sliding area that reduces friction between bones and within joints. Hyaline cartilage forms the precursor for the vertebrate skeleton and is replaced by bone during embryonic development. It is found on the sternal ends of the ribs, as structural support in the nose, trachea and other respiratory structures, and where the ends of bones form joints (articular surfaces). In slide6, pink-stained chondrocytes housed within bluish-stained lacunae found within hyaline cartilage in the trachea are clearly distinguishable at 400x magnification. Chondrosarcoma is cancer of the cartilage. It develops as a cartilage-based tumor. Diagnosis is most commonly achieved through CT imaging, which can detect abnormal chondroid matrix within and surrounding the chondrocyte lacunae (shown in PathoSlide2 and 3). Knee cartilage Elastic Fibro Bone Compact Articulating surface between two bones Epiphyseal plate Tracheal cartilage and associated tissue Developing endrochondal bone Tracheal cartilage Osteoarthritis, irregular cell growth of the articulating surface ogy/a&p201/connective_tissues/cartilage.htm External ear External ear ogy/a&p201/connective_tissues/cartilage.htm Accessory tragus (auricular) Relapsing polychondritis, external ear Epiglottic carcinoma Fibrosarcoma is a malignant tumor that originate in the fibrous tissues (fibrocartilage) surrounding bone. It invades bone and involves the surrounding cartilage, periosteum and overlying muscle. Tumor cells resemble spindle-shaped fibroblasts, collagen or more atypical polymorphic, giant multinucleated cells. It is characterized by numerous abnormal mitoses, reduced collagen production and fascicles split into a fish bone appearance. PathoSlide 1 shows the proliferation of spindle-shaped fibroblasts and PathoSlide2 demonstrates the mess of atypical cells at the site of a fibrosarcoma. Fiberous cartilage sandwiched between perichondrium and connective tissue Intervertebral disc Compact (also called cortical) bone is hard, stiff and dense. The functional unit comprising this tissue is the osteon, or Haversian system, a cylindrical structure of concentrically layered osteocytes. Compact bone consists of closely packed osteons in numerous stacked layers with little space between, lending it an extremely dense, strong structure. It forms the hard outer shell of most bones, giving them their strength and structural integrity. As such, compact bone facilitates some of the main functions of the skeletal system: to protect the internal organs, to support the whole body structure by lending its posture/position, to provide levers for the muscular system enabling movement, and to generate or store vital minerals such as calcium. The circular arrangement of osteons within compact bone are clearly visible in all the following slides, but in the higher magnification of Slide1 it is particularly possible to make out the individual osteocyte cells (the darker stained spots) and the small canals that communicate and connect them. Haversain system labeled Intervertebral disc Tendon ogy/a&p201/connective_tissues/cartilage.htm brous Polychondritis is usually treated with drug therapy. Nonsteroidal anti-inflammatory drugs are used for patients with milder cases of the disease. However, most patients require steroids for long-term use and for maintenance treatment. Often some combination of drugs and steroids are used to ease symptoms and control inflammation &second_category_id=33 2&second_category_id=33 m#spgross Fibrous cartilage is a mix of fibrous and cartilaginous tissues in varying proportions. Its fibrous components provide flexibility and toughness while its cartilaginous elements furnish elasticity. Fibrous tissues form parallel bundles with chondrocytes positioned between. The orientation of the fibers depends on the direction of stresses acting on the cartilage. This type of tissue acts as a shock absorber, deepens joint sockets and provides sturdiness without inhibiting movement. Fibrocartilage is present in the pubic symphysis, the meniscus, the temporomandibular joint, in the intervertebral discs and around the edges of articular cavities such as at the glenohumeral joint. Compact bone High powered view of Chondrosarcoma Polychondritis is an uncommon and chronic disorder of the cartilage that results in recurring episodes of inflammation of cartilage tissues in various regions of the body. These include the ears and nose (elastic cartilage- It is not known what causes polychondritis. One shown in PathoSlide2) as well as a number of other argument is that it is the result of an immune system cartilage sites. Biopsies of affected cartilage tissue show disorder in which the body s immune system becomes non-specific signs of inflammation. misguided and attacks its own tissues. Treatment is determined by the location and aggressiveness of the tumors. Surgery is the most common treatment and is usually performed at specialist hospitals due to the relative rarity of chondrosarcomas. In some cases, amputation is required. Chemotherapy and traditional radiation treatment are not very effective for most chondrosomas, though some success has been found using proton therapy to locally control of a tumor. Elastic cartilage is much like hyaline, but the rubbery matrix of elastic cartilage contains not only collagen but also an abundant network of branched elastic fibers. Slide2 shows these elastic fibers arranged between the lacunae. Elastic cartilage helps to maintain the shape and flexibility of a structure while also providing strength and support. Some examples of elastic cartilage are found in the epiglottis, parts of the larynx and the ear lobe. ogy/a&p201/bone_histology/bone_histology.htm Spongy Low power view of a chondrosarcoma Chondrosarcoma can affect people of any age, though it is more common in older adults. Nearly all patients appear to be in good health, as this form of cancer usually only affects a localized area. Usually the tumor goes unnoticed until it appears as a lump or pain. Sometimes the first symptom is a broken bone that results from only mild trauma, indicating weak bone. Pubis Symphysis Fibrocartilage of tendon Fibrosarcoma, malignant tumor, characterized by the immature proliferation of fibroblasts Cavernous hemangioma 40x, blood vessel Myxoid fibrosarcoma php?f=0&sort=0&s= Human compact bone An Ostocyte Ground down bone Compact bone with a boarder of skeletal muscle Osteosarcoma, asperated from a leg mass ogy/a&p201/bone_histology/bone_histology.htm High power view of an area of myelofibrosis Well differentiated adernocarcinoma in bone Osteosarcoma (depicted in PathoSlide1) is a malignant bone tumor. It usually develops during the period of rapid growth in adolescence and tends to occur in the Boys and girls have similar incidence of this cancer until compact tissue of bones of the shin, thigh and upper arm. late adolescence, when it becomes more common in Although osteosarcoma can arise in any bone, it occurs males. The cause of this cancer is not known, though in most commonly in larger bones and in areas of fastest some cases it runs in families, linked by genes that cause growth rate. increased risk. Osteosarcoma is rare in adults. Treatment usually starts with chemotherapy. This is used to control to tumor and also to kill any cancer cells that may have spread to other areas in the body. After chemotherapy and/or drug treatment, surgery is used to remove any of the tumor that remains. Usually this can be done without hindering the limb but in rare and extreme cases amputation is required. A bone infection can start after an injury or surgery, especially if the procedure involves metal rods or plates inserted in the bone. Osteomyeletis affects both children (usually affecting the long bones) and adults (most commonly in the feet, vertebrae and hips). Risk factors are poor blood supply, diabetes, trauma and IV drug abuse. Also people who have had their spleen removed are at greater risk for contracting osteomyelitis. Antibiotics are administered to destroy the bacteria causing the infection. Often, more than one antibiotic is given to eradicate the infection and prevent it from worsening. In some cases where the infection does not go away, surgery is needed to remove dead bone tissue. The space is filled with a bone graft or material that encourages growth of new spongy bone tissue. Amputation is required in severe cases, especially in those patients with poor circulation or diabetes. The outcome of treatment is usually good, though chronic osteomyelitis generally requires extended long-term care. Osteomyeletis is an acute or chronic bone infection caused by bacteria or fungi. Infection may spread to bone from infected skin, muscles or tendons nearby. It can also spread to spongy bone through blood. While the infectious agent is typically difficult to identify, histological examinations (as in PathoSlide3) generally display clear signs of tissue inflammation. Spongy (also call cancellous) bone is less dense and stiff. It has a higher surface area, but is softer and weaker than compact bone. It is highly vascularized and contains red bone marrow, where blood cells are produced. The tissue is formed by tiny lattice-like scaffolding commonly known as trabeculae. Spongy bone is typically found on the inside of bones (surrounded by compact bone) and actually makes up a larger portion of the bone than its external counterpart. Spongy bone is found at the ends of long bones, at joints, and within the bones of the spinal column. Spongy bone Cancellous bone with bone marrow Spongy bone filled with red bone marrow Trabecular and woven lamellar bone Callcenous bone with bone marrow boarding edges Spongy bone, slide labeled High power view of a deposit of multiple myeloma in bone Cochlear otospngiosis Osteomyoletis orms/allitems.aspx?rootfolder=%2ffaculty%2fbrianbich% mmatory/source/osteomyelitis_histo.h Treatment of this condition includes surgery, chemotherapy and radiotherapy. The use of laser technology to treat fibrosarcoma is a recent practice which has been shown to increase immunity to the tumor There is no known cause of fibrosarcoma, though it may by triggering a specific tumor antigen response and to result from genetic mutations. The disease is heralded by reduce the rate of metastatic regression. This treatment local pain, swelling, heat, pathological fractures and is still under examination however, and is used primarily neurological and vascular changes. for dogs and cats. More studies are needed.

3 Fluid Blood Cells Erythrocytes Leukocytes Erythrocytes, or red blood cells, are the most common type of blood cell, accounting for slightly less than half the total blood volume and about 99% of the formed elements in blood. Erythrocytes transport both oxygen and carbon dioxide through the blood stream. Red blood cells are highly specialized, taking the shape of a biconcave disc without a nucleus, mitochondria or ribosomes. Instead, red blood cells are packed with and oxygen-binding ironrich protein called hemoglobin that is also the source of their red coloration. The biconcave structure of these cells provide strength and flexibility, allowing them to bend and flex to squeeze through small or compressed capillaries and to form stacks with one another that help to prevent logjams or blockages. Erythrocytes develop in the bone marrow and circulate in the human body for about 120 days before being consumed and recycled by macrophages. Each circulation of a red blood cell takes about 20 seconds. As the principal means of delivering oxygen to the body tissues, erythrocytes make up about a quarter of all the cells in the human body. Red blood cells with one white blood cell Red blood cell in capillary Smear of human peripheral blood Human blood smear Blood human smear, in center Sickle Cell erythrocytes Malaria, photomicrograph of cellular parasites Surrounding granules are primarily histamine and heparin on basophil One large basophil and three neurophil ic leukemia ic leukemia High power, the reason for the basophilia is clear: the thymus is packed with lymphocytes with darkly stained nuclei ml-m2ba-acute-basophilic-leukemia-100x2-website.jpg logy/a&p203/circulatory_system/circulatory_sys_histology.h logy/a&p203/circulatory_system/circulatory_sys_histology.h arge/23/2324.jpg Blood human smear Eosinophil Eosinophil (pink) in areolar connective tissue Eosinophil with a few platelets surrounded by red blood cells Human bone marrow smear with many leukocytes Hairy cell leukemia, hematological malgninancy logy/a&p203/circulatory_system/circulatory_sys_histology.h Hypereosinophilic syndrome (HES) shown here in PathoSlide3, is a rare blood disease in which the body produces too many eosinophils. Due to the excess number of these cells, eosinophils spill out of the blood and gather in the tissues and organs, causing enlargement and damage. Individuals with HES may have different symptoms depending on which parts of the body are affected and the extent of damage caused to a particular organ or tissue. The cause of HES is unknown. Genetic disposition is most commonly indicated, as researchers have found Treatment of HES depends on which organs or regions of that in some people with HES, 2 particular genes fuse and the body are involved and how severe the damage. The form a combination gene that causes the body to make most common treatment is high doses of steroids. more kinase protein, which in turn triggers the Medications that suppress the immune system and some multiplication of some blood cells. anticancer therapies are also used. ic leukemia Reed-Sternberg cells, lymphocytes that contain more than one nuclei, found in Hodgkin lymphoma Hypereosinophilic syndrome (HES) Lymphocytic leukemia is a type of cancer of the blood and bone marrow that specifically affects lymphocytes (shown in PathoSlides1, 2 and 3). The disease typically progresses more slowly than other types of leukemia. Abnormal and ineffective lymphocytes are produced through genetic mutation. These cells fail in their normal task of helping the body fight infection, and accumulate in the blood and in certain organs, causing complications. These abnormal lymphocytes crowd healthy cells out of the bone marrow and interfere with the continuous production of normal blood cells. Human, air dried blood smear Blood human smear e0453.sh Macrophage one on each side of photo with engulfed particles of blue dye in there cytoplasm Human blood smear, monocytes and neutrophils Neutrophil The cause of leukemia is not understood, though it is thought to be a combination of genetic and environmental factors. Among the many effects of this disease are fatigue, weight loss, leukocytosis and Treatment of basophilic leukemia may include radiation degeneration of bone marrow. The disease occurs in both therapy and chemotherapy. Antihistamines are used if children and adults. heightened inflammation in the body s tissues develops. Lymphocyte in late prophase Lymphocyte a little larger than leukocytes A large lymphoocyte Lymphocyte with cytoplasmic extensions h Acute lymphatic leukemia Acute lymphatic leukemia Acute lymphatic leukemia Macrophages are produced by the differentiation of monocytes. They are phagocytic white blood cells containing lysosomes, enzymes and toxic peroxides that digest pathogens and bacteria. Macrophages provide both nonspecific immune defense and adaptive immunity. Macrophages are either fixed or mobile. They Macrophage (histocytes) digest pathogens and foreign substances while stimulating lymphocytes and other cells to assist in the immune response. Stationary macrophages are often located at strategic positions in the lungs, liver, neural tissue, bone, spleen and connective tissue, where they ingest foreign material and remove dead cell materials. After digesting a pathogen a macrophage will present the antigen to a helper T-cell, which eventually results in the production of antibodies. Macrophages accumulate in tissues during healing and are known to promote tissue repair after an injury. Monocytes ic leukemia, shown here in PathoSlide1, 2 and3, is a rare form of myeloid leukemia characterized by the presence of abnormal basophils in all stages of differentiation, but with a marked increase of maturing basophils. Electron microscopy may show basophils whose granules display an abnormal speckled pattern, hypersegmentation of basophil nuclei, and the presence of mast cell and myeloid antigens. ic leukemia is rare and poorly characterized. Alveolar Macrophage, pulmonary alveolus, near the pneumocytes, separated from the wall Myeloid Cell, spinal cord, CNS Langerhans Cells histocytosis, epithelial macrophages, PNS Kauffer cells are specialized macrophages in the liver, PNS Thymus, macrophage in center with immature T-lymphocytes Granuloma without necrosis in a lymph node of a person with sarcoidosis. Acute Myeloid Leukemia, blood smear _-_very_high_mag.jpg A scanning electron microscope (SEM) image of normal Human monocyte, air dried blood smear Human blood smear Monocyte largest of the leukocytes Promonocyte, Bone marrow smear, May-Giemsa stain, x1000 circulating human blood. One can see red blood cells, several e0453.sh u.ac.jp/atlas/doc/node8.h#section Immature monocytes, cytoplasmic fragments, M-5 leukemia Acute myeloid leukemia A blood smear showing a neutrophil granulocyte 3 Neutrophils Neutrophil, Human blood smear One Hyposegmented Neutrophil. One has an attached fragment that is similar to the abnormal platelets in the field Sea-Blue Histocyte Syndrome is a condition that occurs when macrophages in the blood are overloaded by lipids and functionally inhibited (stuffed!) High lipid content in the blood leads to excessive loading of lipids within the cytoplasm of macrophages. The macrophages are unable to fully digest these lipids and subsequent lipid pigmentation occurs. The lipid-laden macrophages appear blue when stained (see the striking example in PathoSlide3) and is thus the source of the name for this syndrome. Sea-Blue Histiocytosis occurs in patients with genetic lipid metabolic or storage diseases. It is associated with genetic sources and inborn errors of lipid metabolism, as well as with acquired conditioning. More severe cases No clear or singular treatment has been found for this include serious neurological involvement. Long-term disease, though a number of key drugs and important parenteral nutrition is also associated with Sea-Blue biological agents have undergone clinical trials including Histocyte Syndrome. immunoglobins, apolipoproteins and enzymes. Myeloid leukemia is cancer of the blood cells. It is a chronic and acute disease that is characterized by the replacement of healthy blood-cell producing bone marrow by malignant cancer cells. Many of these rogue cells can be found circulating in the blood, starving or damaging blood cells (like the monocytes in PathoSlide3). Leukemic cells can also cause enlargement of affected organs like the liver and spleen. This disease is usually diagnosed by the identification of a specific chromosome, which is the result of a fused hybrid gene that signals for uncontrolled cell growth. Myeloid leukemia occurs in both children and adults of all ages, and the cause of the disease is currently unknown. Research shows that certain risk factors such as having a sibling with leukemia, being Hispanic, male, smoking or being exposed to smoke and alcohol before birth, having had past chemotherapy or radiation treatment, having certain genetic disorders or having a history of blood disorder can increase the possibility of developing the condition. Acute myeloid leukemia progresses rapidly and usually becomes fatal if left untreated. Treatment consists primarily of chemotherapy which is administered in phases. For patients with relapsed myeloid leukemia, the only potentially curative therapy is a stem cell transplant. Megaloblastic anemia is a blood disorder in which blood cells become enlarged and the nuclei of neutrophils become hypersegmented (as visible in PathoSlide3), as a result of anemia. D synthesis in red blood cells is inhibited which leaves to continued cell growth without division. This disorder is most typically characterized by large, immature and dysfunctional red blood cells accompanied by multisegmented or hypersegmented neutrophils. It is thought that megaloblastic anemia is caused by certain vitamin deficiencies, specifically folic acid and B12. It is also argued that it is caused by specific antimetabolites that directly prevent D production. Chemotherapeutic or antimicrobial agents (medical drugs) are possible examples of these antimetabolites that essentially poison D production in the blood cells. Treatment of megaloblastic anemia may include vitamin B12 injections and dietary guidelines focused on high intake of folic acid/b12. More specific treatments, medical procedures or drug therapies are usually determined on an individual-case basis. Blue sea histocytes Mott Cell, plasmacytoid lymphocyte, alcoholic liver disease Three Abnormal Late Neutrophils showing dense chromatin, hyposegmentation (Pelgeroid) and Lymphocytic leukemia is most common in older adults and rare in children, though it may occur at any age. It is Treatment may not be necessary and is usually not uncertain what triggers the process, but something applied in early stages of lymphocytic leukemia. causes a genetic mutation within blood-producing cells. Treatments for later stages of the disease include The mutated cells then produce abnormal and ineffective chemotherapy, targeted drug therapy and bone marrow lymphocytes. stem cell transplants. Clinical trials are currently involved in the development of new therapies and help enable greater understanding Neutrophils are the most abundant type of white blood cell and play an essential role in the immune system. Neutrophils are recognized by their dense, multi-lobed nucleus and are among the first to arrive at a site of inflammation. Neutrophils contain lysosomal enzymes and bactericidal compounds by which they actively phagocytize and digest bacteria. During infection, neutrophils migrate from their location within the circulating blood stream, travel through vessels, then enter interstitial tissue following chemical signals to the site of inflammation. They are a predominant component in pus, giving it its whitish coloration. A scanning electron microscope image of a single neutrophil Neutrophil, platelets, erythrocytes Granularcyte review (yellow), engulfing anthrax bacteria (orange) world.com/photoalbum/displayimage.php?album=search&cat nal_images s?img=2 Sickle cell disease requires ongoing treatment even when the patient is not in a crises episode. Episodes are treated with pain medication and hydration. Supplements like folic acid are recommended. In addition to drug therapy, vaccines and antibiotics are given to prevent infections and blood transfusions are used to treat a patient in crisis. Other treatments include dialysis, irrigation or surgery, and removal or replacement of more critically affected organs. Neutrophils are the most abundant type of white blood cell and play an essential role in the immune system. Neutrophils are recognized by their dense, multi-lobed nucleus and are among the first to arrive at a site of inflammation. Neutrophils contain lysosomal enzymes and bactericidal compounds by which they actively phagocytize and digest bacteria. During infection, neutrophils migrate from their location within the circulating blood stream, travel through vessels, then enter interstitial tissue following chemical signals to the site of inflammation. They are a predominant component in pus, giving it its whitish coloration. Monocytes are a type of agranular white blood cell. They are the largest white blood cell and contain a large oval bilobate nucleus that occupies much of their cytoplasmic space. Monocytes can move quickly to sites of infection where they differentiate into tissue resident macrophages and dendritic cells that signal for immune response. Monocytes are produced in bone marrow by monoblasts. Some monocytes are free macrophages with many internal vesicles for processing foreign material; others are immobile and fixed within connective tissues protecting the tissues from foreign substances. Nearly half of the monocyte population is stored as reserve in the spleen. While phagocytizing, monocytes secrete chemical substances that attract other phagocytic cells and lure fibroblasts to the area (which form scar tissue). In addition to their main action of phagocytosis, monocytes are also responsible for antigen presentation and production of cell-signaling molecules called cytokines. Sickle cell anemia is caused by an abnormal type of hemoglobin, Hemoglobin S, which distorts the shape of the red blood cells. This misprinting is rooted in genetic inheritance. Sickle cell anemia is inherited from both parents (the individual receiving the gene from one parent merely carries the trait), and is most common in people of African and Mediterranean descent. Almost all individuals with sickle cell anemia experience painful episodes (crises) that vary in length and frequency. Sickle cell anemia, obstructing a capillary Eosinophils are granulocytic white blood cells with a bi-lobed nucleus. They are phagocytic cells attracted to foreign substances, dramatically increasing their numbers during immune responses to infection, parasitic invasion and in allergic or asthmatic reactions. Eosinophils are found in the lower gastrointestinal tract, ovary, uterus, spleen, lymph nodes, medulla and in the thymus region. Eosinophils in other organs such as in the lung or skin are a veritable sign of disease. Lymphocytes Human blood smear. Leishman stain s are members of the granulocyte family of white blood cells. They are the least common, representing less than half a percent of circulating white blood cells. s display numerous cytoplasmic granules which obscure the cell s nucleus. During injury or infection, basophils accumulate within damaged tissues and discharge histamine, which promotes blood flow to the area. s also release the anticoagulant heparin to prevent blood from clotting and increase the inflammation response by sending chemical signals that attract other white blood cells to the site. s participate in many specific inflammatory responses such as in an ectoparasitic reaction to a tick bite, but they are particularly known to be involved in allergic reactions. Eosinophil Red blood cells in a hypotonic environment m#labrbc s s?img=15 Sickle cell anemia is a disease passed through family genetics in which red blood cells take an abnormal crescent shape instead of the typical form of biconcave disc. These fragile, sickle-shaped cells are unable to deliver the normal amount of oxygen to the body s tissues. They can also clog more easily in smaller blood vessels and capillaries, where normal red blood cells stack and from into roleaux to prevent backlog. PathoSlide1 shows the classic sickle shaped cells that herald this condition. PathoSlide3 shows sickle cells disrupting the normal flow of blood through smaller blood vessel spaces. Megalobblastic anemia

4 Platelets Plasma Platelets are not individual cells, but fragments from precursor megakaryocytes. They are small flattened membrane-enclosed packets filled with enzymes. Platelets play a central part in hemostasis, which leads to the formation of blood clots, prevents blood loss and establishes a framework for tissue repair. Platelets clump together and form a plug along with fibrin strands that creates a temporary patch in the walls of damaged blood vessels. They also release a multitude of growth factors that help to regenerate connective tissues. Platelets are identifiable by their relatively small size compared to the other formed elements in blood, as in Slide3 where they are seen as very small purple-stained dots scattered in a field of larger cells. 2 platelets can be seen amoung the red blood cells Erythrocyte, platelet, leukocyte Erythrocytes, lymphocytes and platelets Clotting an injury, erythrocytes and platelet Plasma cell with eccentric nucleus Plasma cell Muscle Skeletal Smooth Cardiac Lymph Mature Neutrophils, Platelet Satellitism One large Plasma Cell, oval in shape, with a very low nuclear/ cytoplasmic ratio, deep basophilic cytoplasm with numerous One large Plasma Cell, triangular in shape, with a low nuclear/cytoplasmic ratio, deep blue cytoplasm which One Grape Cell - a plasma cell with multiple vacuoles which represent packets of stored immunoglobulin. These vacuoles Tri-nucle3ated plasma cell, blasts, Acute myeloid leukemia One plasma cell with vacuoles (Mott Cell), 1 mature neutrophil, 1 smudged band neutrophil, 1 Plasmacytoid Lymph node, circle of lymphocytes Lymphocytes in lymph nodes Palantine Tonsils Spleen, red pulp Thymus, It is composed of a cortex (C), medulla (M), and several Hassall's corpuscles (arrows). etic/spleen_red_pulp_40x.htm Lymph Node with septem and germinal centers present Burkitt's lymphoma, malignant B-cell lymphocytes Teased skeletal muscle Skeletal muscle Anal sphincter Skeletal muscle Skeletal muscle with motor end plate Cross section of skeletal muscle Atrophied, stroke patient l Skeletal muscle with interstitial edema and rare inflammation. cases/mscase3/mscase3part3.htm Smooth muscle at pointer, small intestine Vaginal tissue, smooth muscle and epithelium Kidney to bladder Cross section of intestine Human, duodenum, cross section Artheroscelosis of aorta Uterus Leiomyoma Adenocarcinoma of small intestine e0582.sh Cardiac muscle tissue consists of cells that are striated like those in skeletal muscle, only these cells are shorter and branched and usually house a single nucleus. Each individual cell bears an intrinsic rhythm of contraction and relaxation reflecting its basic function in the muscles surrounding the heart. Cardiac muscle cells are connected at their branched ends by intercalated discs. Gap junctions within the intercalated discs synchronize function. Cardiac muscle tissue is only found at the heart, where it circulates blood and maintains blood pressure. Cardiac muscle Bundle of His, modified myocardium. Longitudinal cardiac muscle Human myocardim Human cardiac muscle, longitudinal section muscle16.htm e0580.sh e0576.sh Treatment of Burkitt s lymphoma includes specific dosages of the drug EPOCH with Rituxan. Chemotherapy is also used, but the cancer s rapid response to chemotherapy can be hazardous to the patient in that it can result in tumor lysis. Effectiveness of treatment depends on the timing of diagnosis. Edema (shown in PathoSlide2 in the interstitial spaces within skeletal muscle) is swelling caused by an abnormal accumulation of fluid in the small spaces that surround the body s organs and tissues. It is most common in the lower legs, hands, abdomen and chest, but can occur nearly anywhere in the body. Peripheral edema which would occur in skeletal muscle (PathoSlide2) often signals a more serious condition. Under normal healthy conditions, the amount of interstitial fluid is regulated in homeostasis, but increased secretion or impaired movement of fluid can cause edema. The excess fluid is deposited into connective tissues and held in small extracellular spaces where it compresses and pressurizes the cells. Causes of edema are increased hydrostatic pressure, reduced oncotic pressure within blood vessels, increased tissue pressure, increased permeability of blood vessel walls, changes in water retaining abilities of the tissues and obstruction of fluid clearance through lymphatic draining. Not all kinds of edema require treatment. For example, edema related to menstrual cycles or pregnancy is not commonly treated. When treatment is needed, it includes reducing the amount of dietary salt, use of diuretic medications and treatment of underlying causes. In peripheral regions such as the legs where skeletal muscle tissue may be affected, elevation of the limb and compression stockings (which apply pressure to the affected area) are common treatments. Atherosclerosis is a condition in which fatty material is deposited along the walls of arteries, distorting and limiting the flexibility of the smooth muscle that lines these vessels. The fatty deposits thicken, harden and calcify and may eventually result in blocked arteries, causing serious and often critical obstruction of normal blood circulation. PathoSlide1 shows an example of atherosclerosis in which the aortic passage is nearly completely obstructed. A number of habits and conditions are considered risk factors for atherosclerosis. These include obesity, smoking, alcohol abuse, high blood pressure and high cholesterol levels, high-fat diet, increasing age, diabetes or a family history of heart disease. Prevention of atherosclerosis is the first mode of (preemptive) treatment. This involves lifestyle changes like avoiding fatty foods, limiting alcohol, not smoking, seeking regular blood pressure and cholesterol checks, exercising and maintaining a healthy body weight. In more advanced cases of atherosclerosis (usually a heart attack or stroke calls attention to the severity of the condition) one of a number of different surgeries is performed to recover normal blood flow. Drugs that regulate blood pressure, cholesterol levels and blood clotting are also common recommendations. A myocardial infarction (the histological effects of which are shown here in all three PathoSlides) is a heart attack. It occurs when the plague buildup of atherosclerosis block one of the coronary arteries that supply blood to the heart itself, preventing oxygen from getting to cardiac muscle tissue. As a result, cells within the cardiac muscle tissue die or become permanently damaged. Atherosclerosis is the primary cause of myocardial infarction. However in occasional cases, myocardial infarction is triggered by an episode of sudden overwhelming stress. Factors that increase the risk of myocardial infarction are too much dietary fat, unhealthy cholesterol levels, high blood pressure, smoking, genetic or hereditary factors, being male, increasing age, diabetes and kidney disease. A myocardial infarction results in hospitalization, often in the ICU. Irregular heartbeats (arrhythmias) are treated with medications or electrical defibrillation. Oxygen is administered so that tissues can be fully supplied. IVs pass medicines and fluids into the patient. In critical cases, further intervention is required and can be one of a number of different procedures including angioplasty, stent placement, thrombolytic therapy, coronary artery bypass surgery and drug therapy. Bone from pubic ramus with osteonecrosis Small intestine The condition is associated with chromosomal translocation of a specific gene. The endemic variant of this disease occurs in equatorial Africa. The sporadic type of Burkitt lymphoma is similar to the previous form but occurs not only in Africa. Immunodeficiency-associated Burkitt lymphoma is liked to HIV infection in patients taking immunosuppressive drugs. The exact cause of the disease is unknown. e1part4.htm Heart muscle cells Burkitt s lymphoma (shown in PathoSlide1) is a cancer of the lymphatic system whose malignant B-lymphocyte cells are transported by lymph fluid. The tumor consists of sheets of medium sized lymphoid cells that are highly proliferative. The malignant cells typically possess a small cytoplasm and the outer cellular form usually appears slightly square-like. Syphilitic Lymphadenitis : Vasculitis Smooth muscle cells are spindle-shaped, relatively short, and non-striated. Each cell has a single, central nucleus. Smooth muscle is found in many places throughout the body, in the walls of blood vessels, in the arrector pili of the skin, the iris of the eye and in respiratory, digestive, urinary and reproductive organs. Smooth muscle can tense and relax like striated muscle, but bears greater elasticity and stretch capabilities. Smooth muscle is involuntary and triggered by neural activity. Acute myeloid leukemia progresses rapidly and usually becomes fatal if left untreated. Treatment consists primarily of chemotherapy which is administered in phases. For patients with relapsed myeloid leukemia, the only potentially curative therapy is a stem cell transplant. Skeletal muscle tissue consists of thin, long threadlike cell fibers. Skeletal muscle cells contain many nuclei which lie around the periphery of the cell and numerous mitochondria to supply the high energy needs required for muscle movement. Inside each cell are neatly organized actin and myosin filaments, the orderly arrangement of which creates a characteristic striated appearance. Skeletal muscle cells are collected in parallel bundles called fascicles, which are grouped into larger bundles that form the muscle organ. Each consecutive grouping is wrapped in thin layers of connective tissue. Skeletal muscle tissue forms those muscles that move the skeleton, protects internal organs, guards the openings to the digestive, respiratory and urinary tracts and generates heat. Myeloid leukemia occurs in both children and adults of all ages, and the cause of the disease is currently unknown. Research shows that certain risk factors such as having a sibling with leukemia, being Hispanic, male, smoking or being exposed to smoke and alcohol before birth, having had past chemotherapy or radiation treatment, having certain genetic disorders or having a history of blood disorder can increase the possibility of developing the condition. Apoptosis, reactive hyperplasia of follicle in lymph node Myeloid leukemia is shown again here in PathoSlide1 and 3. Being a cancer of the blood that affects all related components, it can naturally be found throughout blood plasma as well as at specific site of malignant cell accumulation. Myeloid leukemia is identified as the rapid growth of abnormal white blood cells that interfere with the production of normal blood cells. Many of these rogue cells can be found circulating in the blood, starving out or damaging other blood cells and constituents. Essentially, leukemic cells wreak havoc within bone marrow and throughout circulating plasma. Plasma cell, multiple vacuoles, anemia of chronic infection Lymph is an interstitial fluid which resembles blood plasma but with lower concentration of proteins and dissolved gases (namely oxygen and carbon dioxide). It carries white blood cells, particularly lymphocytes, but few red blood cells and no platelet clotting factors. It is normally clear and coagulable, passing through intercellular spaces within tissues, entering circulation through ducts, filtering through pores in capillary walls, travelling through the lymph nodes before eventually mixing back into the blood. Lymph picks up bacteria and foreign substances and delivers them to the lymph nodes where they are then destroyed. Lymph not only transport cells, but also bathes the cells with water and nutrients. There is no physical treatment but to use another anticoagulant other than EDTA when drawing a sample. Many Late Neutrophils surrounded by Platelets. The earlier neutrophils, NRBC and lymphocytes are unaffected. This Plasma is the fluid part of whole blood, contributing just over half of the total volume of blood. Plasma is 92% water, the rest consists of dissolved constituents including proteins, electrolytes, organic nutrients, clotting factors, hormones, lipids and vitamins. It is also the main medium for excretory transportation of metabolic waste products. Plasma is the fluid base within which the formed elements of blood (red and white blood cells and platelets) are suspended. The liver is the primary source of plasma proteins. Being a medium rather than a specific structure, plasma appears in these slides as a collection of cells and formed particles rather than as a distinctive individual substance. Plasma cell with collegan fibers Lymph Small mature megakaryocyte with a single large nucleus and A string of platelets or Platelet Ribbon. This is the appearance Pathologic rouleaux formation, Multiple myeloma, Much lightly granulated cytoplasm. These are termed of normal platelets when being shed by a megakaryocyte into rouleaux formation of the red cells in this thick area of red cell Platelet satillitism is one type of pathology that affects clotting abilities. This is found to be about 0.3% of the population demonstrating to have these phenomena occur. The platelet satillitism slide shows one huge clump of numerous neutrophils each surrounded by platelets, it is most likely the adhesive properties of the platelets that enhances the clumping. This clumping may make the Platelet satellitism can be due to EDTA Anticoagulant, white cell count to be erroneously low. thus leading to artificially low platelet counts. Contraction band necrosis, myocardial infarction Acute Myocardial Infarction Healing myocardial infraction