Gattuso's Differential Diagnosis in Surgical Pathology

Vijaya B. Reddy, Odile David, Daniel J. Spitz, Meryl H. Haber

• Publisher: Elsevier
• Year: 2021
• ISBN:
  9780323661669
• Edition: 4
• Topic: Medicina
• Subtopic: Patología

Widely used by residents, fellows, and practicing pathologists around the world, Gattusso'sDifferential Diagnosis in Surgical Pathologyprovides a user-friendly road map to themain criteria to consider in order to differentiate between a variety of potential diagnosesthat all have a very similar appearance. This comprehensive guide helps you make informed decisions for even your most complex and challenging cases, presenting acomprehensive differential diagnosis list and comparisonsfor every entity discussed. The 4th Edition brings you fully up to date withupdated diagnostic techniques, new classifications, and new content throughout—perfect for quick reference at every microscope in the sign-out room.

• Providesbrief descriptions of both common and uncommon disorders, with an emphasis on differential diagnosis, along with excellent illustrative examples of the pathology and carefully selected references.
  
  

• Streamlines the differential diagnosis process by offering a series ofbullet point checkliststhat detail the respective features of the entities being considered.
  
  

• Discusses a complete range of tumors and tumor-like conditions in all organ systems.
  
  

• Contains updated information onpersonalized/precision medicineespecially as it pertains to the immunotherapies; for example, PDL-1 targeted therapies in many cancers.
  
  

• Includesnew classificationof neuroendocrine tumors, new classification and updates of follicular variant of papillary thyroid carcinoma, and anew section on the most common metastatic tumorsand utilization of ancillary techniques for diagnosis and molecular studies.
  
  

• Uses areader friendly, outline formatfor each diagnosis that details clinical information, epidemiology, gross and microscopic findings, ancillary stains and tests, differential diagnoses, and pearls of wisdom.
  
  

• Features1, 400 full-color macro- and micrographsthat provide a realistic basis for comparison of what you see under the microscope.
  
  

Chapter 1: Special Diagnostic Techniques in Surgical Pathology

Alexandra N. Kalof, Mark F. Evans, Kossivi Dantey, and Kumarasen Cooper

Abstract

The chapter inventories key diagnostic tools used in surgical pathology with a view towards practical guidance on their use. Methods for light, florescence, and electron microscopy, immunohistochemistry, flow cytometry, cytogenetic analysis, and a diverse set of molecular pathology methods are reviewed. The chapter includes 26 figures that illustrate techniques and comprehensive summary tables of immunohistochemical panels to use in daily surgical pathology practice.

Keywords

cytogenetics; electron microscopy; histology; immunofluorescence; immunohistochemistry; molecular pathology

Chapter Outline

1. Light Microscopy
   1. Tissue Processing Overview
   2. Fixation
   3. Histologic Stains
2. Fluorescence Microscopy
3. Electron Microscopy
   1. Technical Overview
   2. Ultrastructure of a Cell
4. Immunohistochemistry
   1. Introduction
   2. Technical Overview
5. Flow Cytometry
   1. Introduction
   2. Technical Overview
6. Cytogenetic Analysis
7. Molecular Pathology Methods
   1. Introduction
   2. Nucleic Acid Extraction Methods
   3. Tissue Microdissection Methods
   4. Gel Electrophoresis Methods
   5. Blot Hybridization Methods
   6. Amplification Methods
   7. Nanostring Technology
   8. Microarray Technology
   9. Nucleic Acid Sequencing
   10. In Situ Hybridization
   11. Protein Analytic Methods
   12. Emerging Developments
   13. Resources

Light Microscopy

Tissue Processing Overview

1. • Fixation
2. 1. • Preserves tissues in situ as close to the lifelike state as possible
   2. • Ideally, fixation will be carried out as soon as possible after removal of the tissues, and the fixative will kill the tissue quickly, thus preventing autolysis
3. • Dehydration
4. 1. • Fixed tissue is too fragile to be sectioned and must be embedded first in a nonaqueous supporting medium (e.g., paraffin)
   2. • The tissue must first be dehydrated through a series of ethanol solutions
5. • Clearing
6. 1. • Ethanol is not miscible with paraffin, so nonpolar solvents (e.g., xylene, toluene) are used as clearing agents; this also makes the tissue more translucent
7. • Embedding
8. 1. • Paraffin is the usual embedding medium; however, tissues are sometimes embedded in a plastic resin, allowing for thinner sections (required for electron microscopy [EM])
   2. • This embedding process is important because the tissues must be aligned, or oriented, properly in the block of paraffin
9. • Sectioning
10. 1. • Embedded in paraffin, which is similar in density to tissue, tissue can be sectioned at anywhere from 3 to 10 μm (routine sections are usually cut at 6 to 8 μm)
11. • Staining
12. 1. • Allows for differentiation of the nuclear and cytoplasmic components of cells as well as the intercellular structure of the tissue
13. • Cover-slipping
14. 1. • The stained section on the slide is covered with a thin piece of plastic or glass to protect the tissue from being scratched, to provide better optical quality for viewing under the microscope, and to preserve the tissue section for years

...