Critical evaluation

 our visit to kelaniya university has impact grately  in our knowledge in the field of pathology .during our visit we were able to capture and examine various forms of pathological techniques.we were also able to gain a good knowledge in staining procedures,transporating and handling specimen ,microspical slides. 

exposure to varoius practicals and histopathological techiques improved our skills in hendling microtome, tissue slide preparation and tissue sectioning. 

Right hemicolectomy

 The operation is called a right hemicolectomy.the operation involves making an incision or cut in your abdomen.and removing the right side of the colon containing the cancer.surgery can be done laparoscopic keyhole the surgical technique.

Epidemiology

Overall,the life time risk of developing colorectal cancer is about 1 in 23 for men and 1 in 26 for women.however, each person risk might be higher or lower than this depending on their risk factors for colorectal cancer.

The majority of colorectal cancer occur in people older than 50. For colon cancer, the average age at the time of diagnosis for men is 68 and for women 72.

Risk factors

• Lack of regular physical activity
• A diet low in fruit and vegetable
• A low- fibre and high -fat diet,or diet high in processed meats
• Overweight and obesity
• Alcohol consumption
• Tobacco use

Pathophysiology

Right hemicolectomy involves the division of the ileocolic and right colic arteries as they branch from the superior mesenteric artery.the marginal artery of Drummond is also divided.in a formal left hemicolectomy to treat descending or sigmoid colon tumors, the inferior mesenteric artery is divided.

It's estimated that up to 80 of all sporadic CRC is due to chromosomal instability, characterized by mutational activation of oncogenes( KRAS) and the loss of tumor suppressor gene activity.

Sign and symptoms

The symptoms of right -sided colon cancer can include blood in the stool, anemia, and weight loss.in cases where the cancer is close to the cecum,the first symptoms often anemia from chronic blood loss.

Clinical features

Abdominal symptoms such as pain , bloating or rectal bleeding are often signs of an abnormal process in the left side of your colon . right -sided colon cancer tend to be asymptomatic or cause these symptoms only when they are at an advanced stage and fairly large.

Diagnosis

Usually if a suspected colorectal cancer is found by any screening or diagnosis test,it is  biopsied during a colonoscopy.in a biopsy, the doctor removes a small piece of tissue with a special instrument passed through the scope.

Treatment

Treatment usually involves surgical removal of the tumor followed by adjuvant chemotherapy.a clinical trial may also an option.the duration of adjuvant therapy depends on the risk of recurrence.the most common treatment for early stage colon cancer is surgery.

BIOPSY

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•  Types of biopsy procedures used to diagnose cancer

Biopsy ( bio- life opsis- vision)

Biopsy is introduced by Ernest besnier.

Biopsy types

• Needle biopsy
• Endoscopic biopsy
• Skin biopsy
• Bone marrow biopsy

Needle biopsy

A biopsy is a medical test which can identify the cause of an abnormal lump or mass in your body.biopsy experience is little discomfort.

There are 2types of needle biopsy.this method does not enable one to differentiate between in situ and invasive disease.currently fine needle biopsy is recommended for cystitis lesion.suspected of being recurrence in the chest wall, and lymph nodes metastases.core needle biopsy is the basic diagnosis method of brest lesions.

Endoscopic biopsy

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This endoscopic biopsy is performed through a fiberoptics endoscope ( a long,thin tube that has a close focusing telescope on the end) through the a natural body orifice ( rectum ) or a small incision ( arthroscopy) .

Example of cystoscopy to collect tissue from inside your bladder, bronchoscopy to get tissue from inside your lung and colonoscopy to collect tissue from inside your colon.

Skin biopsy

Skin biopsy is a procedure that removes a small sample of skin for testing.the skin sample is looked at under a microscope to check for skin cancer,a variety of skin conditions,or skin infection.skin biopsy risks bleeding at the biopsy site, hematoma,or infection.

Skin biopsy types

• Punch biopsy this is the most widely used techniques for skin biopsy.
• Shave biopsy here the portion of the lesion that is above the level of the surrounding skin is shaved off 
• Wedge biopsy
• Incisions biopsy
• Excision biopsy

Bone marrow biopsy

Bone marrow biopsy blood disorders,cancer, causes of unexplained fevers or infection and more.stage cancer cancer staging measures how 

Much cancer has progressed.

The biopsy needle may also cause a brief usually dull,pain.

Microtome

 Microtome is specialized cutting instrument which accurately and repeatedly slices section from a block of embedded tissue.different kinds of microtomes are used to section paraffin and plastic embedded tissues.microtome also know as chondriosome or sacrosome.

Main parts of microtomes.

There are different microtomes.

• Base(microtome body)
• Knife attachment and blade
• Material or tissue holder 

Types of microtomes

Rocking microtome

The rocking microtome is an extremely reliable instrument comprising of three moving parts.the lead screw mechanism incorporates quality precision engineering and the cutting stroke is controlled by a single control lever which minimises the operator skill required.

Rocking microtome allows you to cut section of plant and animal in block or batches.its simple,easy, and affordable, however it's light weight structure makes it difficult to prepare thin section.

Rotary rocking microtome

The rotary microtome made by is a manually operated cutting device for all types of work with paraffin and hard cutting technology in a field of biology, medicine and industry.it is used for making microscopic preparation for subsequent illumination.example human tissue.

Sledge microtome

A sledge microtome is a device where the sample is placed in to a fixed holder ( shuttle) which mean then moves backwards and forwards across a knife.modern sled microtome have the sled place upon a liner bearing,a microtome to readily cut many coarse section.

Used primarily for large blocks, hard tissue or whole mounts.

Cryo microtome

Cryo microtome is a sectioning instrument that allows for the cutting of extremely thin section upto 20 micron of frozen tissue or scaffold for microscopy and other applications.its used for cut histological slides.

Ultra microtome

The ultra microtome is designed for cutting by a mechanism similar to the paraffin microtome, but but it's much more sophisticated and precise.its mainly used for as a sample preparation method for transmission electron microscopy.

Vibrating microtome

Vibrating microtome operates by cutting using a vibrating blade, allowing the resultant cut to be made with less pressure than would be required for a stationary blade.its used for cut thin slices of tissue for examination under a microscope.

Laboratory safety rules, procedure & regulations

 

Laboratory is a facility that provides controlled conditions in scientific or technological research experiments and measurements.

Safety rules

Personal protective equipment

• Long hair must be pulled back and properly restrained
• Wear the cotton lab coat & nitrile gloves
• Wear full sleeve pants or full length skirt
• Wear closed shoes.no open shoes.

Safety precautions.

• No food or drink
• Wear your PPE and proper lab attire
• Good hygiene
• Use proper storage containers
• Label your work space
• Don't work alone
• Stay focused and aware of your surroundings
• Participate in safety exercises

MSDS

What is the purpose of MSDS

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Microscopic examination of tissue sample

 

Alicia blue stain 
It's used to stain acidic mucus and acetic mucin excessive amounts of non-sulfated acidic mucus are observed in mesothelioma.

Secretory endometrium 
It's considered as a non cancerous thickening in the endometrium of the uterus.

Appendix 
It's a small, finger- shaped organ that comes out of the first part of the large intestine.it need to be removed when it becomes swollen or infected.if appendix is not removed.it can leak bacteria and infect your entire belly.

Normal colon mucosa 
It's pale pink, smooth, and glistening.and submucosal blood vessels are commonly seen throughout the colon.scattered lymphoid follicles,2 to 3mm in diameter.often with umbilicated centers,occur in the rectum and cecum

Endometrial carcinoma
It's a disease in which malignant ( cancer) cells form in the tissue of the endometrium.

Pap smear 
Involves collecting cells from your cervix the lower.narrow end of your uterus that's the top of your vagina.a pap smear can also detect changes in your cervical cells that suggest cancer may develop in the future.

Specimen examine in pathology museum

Specimen examine in pathology museum 

1. Tuberculosis
2. Renal calculi
3. Intercerebral hemorrhage 
4. Thrombosis
5. Blood vessels 

         

Tuberculosis 

   Intercerebral humerage 

   Blood vessels

     Heart thrombosis

    Renal calculi 

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