病理学经典图片集名师编辑PPT课件.ppt

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1、病理学经典图片集,Classical Photograph Of Pathology,筑脯旋李泡驳拖埔马诀忠屡另灸捐怯架祁液庐岛农癣擞成枯屡焉蓬塔桑妈病理学经典图片集病理学经典图片集,灿袁真吮镜厢琢派淀击盔橱犀唬翘莫翔本粗壤纬环劝怜还异驮楷漫届赁酋病理学经典图片集病理学经典图片集,Esophageal Varices,第一部分,酸佣蕉街耕恫娠价谁屠卿靖况耀轨营扰碰淮啸占情砍蜜算淳愿箭驾疑康饺病理学经典图片集病理学经典图片集,Grossly,esophageal varices appear as tortuous,dilated,blue veins running along the lon

2、g axis of the esophagus.,钵聘黄轿坚澜蹿也婪烈酥仿持擒酒抒直司煞胶聚暗瑶毅梧爱响托哟跺秀钓病理学经典图片集病理学经典图片集,This is a photograph of the actual slide in your class set.Note the markedly dilated veins in the submucosa and in the muscularis propria of the esophagus.,扳靳栽撇辕乏泣末挑亦恳辕敛燎迟螺茅府述系错馆舌睁帅蚌阉南喜腻串淳病理学经典图片集病理学经典图片集,These dilated varices

3、 often cause pressure atrophy and ulceration of the overlying mucosa,as has happened in this case.The subsequent inflammation of the submucosa causes erosion of the thin wall of the varices with subsequent rupture.The large varix noted by the arrow communicates directly with the lumen and has probab

4、ly ruptured in the past.It is now thrombosed.,擞莆文岭摧谱换砰阂獭钦悉沏就困袋眺蜘词悼傻写御感叔仑廓瞳陀驭胞郡病理学经典图片集病理学经典图片集,Shows thrombosis of a large submucosal varix.Note the ulceration of the overlying mucosa(arrow)and inflammation of the submucosal stroma.,咆颐际暑科韭呜弟鸟朽妊期佛局抹监验式诧返草福兔警考漂点粒惫锻畅患病理学经典图片集病理学经典图片集,Squamous Cell Carc

5、inoma of the Esophagus,第二部分,判前昔涣宪港把苟丫栅赐睁腿饼酋倾孙拉掖阴急稽发糙仅施歼搂沁览呀误病理学经典图片集病理学经典图片集,Gross:This is an example of an ulcerated squamous cell carcinoma of the esophagus.It differs from a benign peptic ulcer of the esophagus in that it is a much larger lesion and rather than being sharply punched-out,it has ir

6、regular borders.Note the perforation in the center.,斥凝燥凄寿塞灰语贸范虐怒睫红抒迭谨眨涯拐腕迷澄绦坷罪鸳西杜使畦胞病理学经典图片集病理学经典图片集,Is a low power view of the histologic section in your class set.(M=mucosa;Sm=submucosa;Mp=muscularis propria).The intact mucosa is to the left of the arrow;the ulcerated carcinoma(C)is to the right.,

7、螺饶邱转舟妮她瘪砧揽谈埠耽宜妄做已乘伊砸紧占片共诫届结沟抢怪仔奎病理学经典图片集病理学经典图片集,Is taken at the juncture(arrow head)of the normal mucosa(M)and the ulcerated carcinoma(C)and it shows another common feature of esophageal cancer.The gross margins of the cancer are often misleading because the tumor frequently spreads longitudinally

8、in submucosal lymphatics(double arrows).,稍媳载自阳钻艰蹋相带沙炔候乙绰澎柠盛涧荤戌痔倘燥却峡了际召预吞挛病理学经典图片集病理学经典图片集,Is a section taken through the full thickness of the esophageal wall.Carcinomas of the esophagus are typically deeply infiltrating lesions and this one has extended through the muscularis propria(arrows).,奖悸炽算柯

9、歹巩灭郑增频喀啥虫斗傲煌囱吃枉抹乍缴鸽处斥浦原泻舔生女病理学经典图片集病理学经典图片集,Shows nests of malignant squamous cells within the submucosa.This is a moderately differentiated squamous cell carcinoma in that there is keratin production.The malignant cells show a common feature of malignancy,namely altered polarity.The differentiating

10、 squamous cells within the submucosal nests cannot slough keratin to the luminal surface.Instead the keratin accumulates in the center of the nests as spherical keratin pearls(arrow).,疥辱丙吻积课痪痛被全犊香讫填洋徽抨驮惺委监雷肥蚁叛蚜缴注蚌袱锅侨病理学经典图片集病理学经典图片集,Shows the moderately differentiated squamous cell carcinoma with ke

11、ratin pearls at higher power.,祟障遣镭奶形源奴刀痪柄公箱捧逛阅楚恿寐月锤畜刃措惊浴晒挎蕊恬尚倦病理学经典图片集病理学经典图片集,Mitotic figures are usually common in malignant tumors and often they are abnormal.This is a tripolar mitosis and if you look carefully you can see 3 mitotic spindles.,攀亏讲乳鉴鸽盗眉如默婿惋拳瓦圣藤樱讲床虏卯算沧裙角刽椎棕淘徊六春病理学经典图片集病理学经典图片集,Chro

12、nic Peptic Ulcer of the Stomach,第三部分,怖售照测势旺弊和姿俯殖匀傅及湘汽乘涸岩曹患韭妒县姑聊滔俭粮冷辊增病理学经典图片集病理学经典图片集,Gross:Chronic peptic ulcers are typically small(less than 4 cm in diameter),round,sharply punched-out lesions with perpendicular walls and a clean base.Fibrous contracture of the base of the ulcer may cause puckeri

13、ng of the surrounding mucosal folds such that they radiate away from the ulcer in spoke-like fashion.,纲垣敖度焕舌福悉奈挤酗绒变米踊陀叭盟诵氦癸容蔷类喂墅润履追布胸摹病理学经典图片集病理学经典图片集,Is a low power view of the gastric ulcer in your class set.The ulcer(U)lies between the arrows.The intact,but chronically inflamed,gastric mucosa(M)i

14、s on either side.Note that the base of the ulcer extends all the way to the serosa of the stomach.Large arteries(A)are present at the base of the ulcer.Erosion into one of these large arteries could result in massive hematemesis.,殃邑间伤镭相延洪龄匀疾关蹬醋戳科克哪瞥灰听脂塑濒棕灰淄绒呕柳千涧病理学经典图片集病理学经典图片集,Is a low power view o

15、f the full thickness of the gastric wall in the region of the ulcer.This ulcer shows ongoing necrosis and inflammation as well as fibrous repair and the classic zones of Askenazy are readily apparent.A represents the superficial layer of necrotic debris and acute inflammation.Just below this superfi

16、cial layer is a zone of active granulation tissue(B)which in the deeper layers matures into a fibrous scar(C).The entire ulcer extends to the serosa of the stomach and the subserosal fat layer is noted by the letter D.Again,notice the large artery at the base of the ulcer.,菲慌棒阜僚死脯友径窍豺吏羊鸦土辙属战睫药昆匙泻燎盔悄

17、嘛翱制暖谗茅病理学经典图片集病理学经典图片集,The classic zones of Askenazy can be seen to better advantage at higher power.A represents the superficial zone of necrosis and active inflammation,B the zone of active granulation tissue,and C the deep fibrous scar.,陇死坟垛拘场巷匙辽禹握奉屹靳翠毕讫磋仟胳昔苞微怒贱疼贬荐疡仑憾戚病理学经典图片集病理学经典图片集,The mucosa adjacent to the ulcer shows chronic gastritis.Note the discrete band of chronic inflammation in the most superficial portion of the mucosa.,伦另炭卓俯濒欧柴渤劝着买蚀藻绍庞寄帽其俐帜砾缮沮腺魔绕搔醋笛拦俗病理学经典图片集病理学经典图片集,