Macroscopic pathology 1 2 PDF

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The aim of this museum class is to introduce you to specimens preserved as ‘pots’ and the study of macroscopic pathology....

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MACROSCOPIC PATHOLOGY I: Museum induction and macroscopic pathology

Aim The aim of this museum class is to introduce you to specimens preserved as ‘pots’ and the study of macroscopic pathology. Learning outcomes At the completion of this class, you should be able to: 1. know the location of the Museum of Human Disease and understand how to safely handle macroscopic specimens in the museum and practical classes 2. explain the fundamental approach to describing and analysing macroscopic specimens of diseased tissue 3. To develop competence in navigating and making annotations on macroscopic images in slice viewer

Task 1: museum induction • Listen to the induction provided by the Museum staff. • Go to SafeSYS (safesys.unsw.edu.au) – zPass required • Search for “Pathology Teaching Laboratory” or “MED-SOMS-SWP-6092” • Read through the practical class SAFE WORK PROCEDURE and click on “Declare as Read” at the bottom of the form. Task 2: Approaches to describing macroscopic specimens Step 1: Name the organ. • What is the anatomical dissection (e.g. coronal/ sagittal/ horizontal section/ bisected) • Is the size unusual? (e.g., paediatric specimens are small!) Step 2: Identify the abnormality. • Is it focal/multifocal or diffuse? o If focal or multifocal, describe: site (e.g., if in the lung, which lobe, whether it is near the hilum or pleura)- size- shape (e.g., in a solid organ, is it circumscribed – i.e., well-demarcated; in a hollow organ is it polypoid, i.e. raised, or ulcerated)- cut surface (e.g., colour; uniform versus variable – variability usually is due to necrosis and haemorrhage; solid/cystic). o If diffuse, consider: size of the organ, its colour (e.g., yellow in fatty liver)- texture (e.g., greasy in fatty liver, or solidified in lobar pneumonia). Step 3: Examine the rest of the organ (turn the pot over!) • Observe major blood vessels, or the lining of an organ. These are anatomically distinct. e.g., brain - look at the meninges: e.g., lung - look at the pleura, at lymph nodes, at hilar bronchi and blood vessels. • There may be clues to the aetiology/ risk factors for disease. - e.g., lung cancer - black carbon in the lungs of a smoker. • There may be complications of the disease. - e.g., lung cancer may cause obstruction and bronchopneumonia.- e.g., a cancer may spread into local lymph nodes or into adjacent fat. Macroscopic pathology I 1

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It is worthwhile mentioning risk factors or complications that are NOT present – i.e., “There is no evidence of …”. These are called significant negatives.

Step 4: Identify the pathological process • Is there evidence of acute inflammation? • Is there evidence of chronic inflammation? • Is this a vascular disease? • Could this be an example of disordered growth? Step 5: Make a tissue diagnosis (if possible) • On occasion, it may be difficult to make a diagnosis on a macroscopic specimen, however an attempt is acceptable. • If you have a good idea about what the diagnosis is, take the initiative.Try to show the relationship between multiple abnormalities.

Click on the links below which will log you into BEST and take you to the relevant image. Note: If this is the first time you have used this link, you may need to enter the student key: VSlides You will also need to be logged into Moodle for these links to work correctly. Examine specimen 2446.8 1. Name the organ: Brain _______________________________________________________ 2. Identify and describe the abnormality: Diffuse process, dilated blood vessels, purulent exudate, haemorrhage _______________________________________________________ 3. Note any additional/relevant features: _______________________________________________________ 4. Identify the pathological process: Acute inflammation - meningitis _______________________________________________________ 5. Diagnosis: Acute bacterial meningitis _______________________________________________________

Examine specimen 2435.24 1. Name the organ: Liver _______________________________________________________ 2. Identify and describe the abnormality: Multifocal lesions pale in colour, dark border - haemorrhage, exudate- fuzzy _______________________________________________________ 3. Note any additional/relevant features: Turned brown due to fixation process not pathological _______________________________________________________ 4. Identify the pathological process: Acute inflammation _______________________________________________________ 5. Diagnosis: Abcess of liver _______________________________________________________

Macroscopic pathology I 2

Examine specimen 2468 1. Name the organ: Kidney ___________________________________________________ 2. Identify and describe the abnormality: Multifocal lesion - yellow nodules ranging 1mm-20mm in diameter ___________________________________________________ 3. Note any additional/relevant features: Pussy lesions all over kidney ___________________________________________________ 4. Identify the pathological process: Neoplasia - irregularly shaped cells ___________________________________________________ 5. Diagnosis: Metastatic tumours in kidney ___________________________________________________

Task 3: review activity Complete the Smart Sparrow interactive lesson: Introduction to macroscopic specimens

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