Introduction to Biopsy Interpretation and Surgical Pathology

1 Diagnostic Histopathology.- Origins of Histopathology.- The Objectives of Histopathology.- Clinical Diagnosis.- Epidemiology.- Treatment Selection and Monitoring.- Clinical Research.- Autopsies and Clinicopathological Correlation.- Medicolegal Aspects.- The Histopathological Diagnosis.- Diagnosis and Disease.- Diagnostic Processes.- Diagnostic Fallibility.- Adverse Effects of Biopsy.- Prospects for Histopathology.- 2 Macroscopy, Microscopy and Sampling.- Sampling Error.- Sampling Biopsies and Surgical Resections.- Suspected or Proven Neoplasia.- Ischaemic and Vascular Lesions.- Infection and Inflammatory Lesions.- Metabolie and Degenerative Diseases.- Specific Types of Biopsy.- Needle Biopsies.- Mucosal Biopsies.- Curettings.- Cone Biopsies.- Specimen Radiology.- Section Thickness.- Thick Sections.- Thin Sections.- Imprints and Smears.- Information and Magnification.- 3 The Use of Stains.- Principles of Staining.- Indications for Special Stains.- Identification of Specific Substances and Cells.- Connective Tissues.- Carbohydrates.- Nucleic Acids.- Fats.- Minerals and Pigments.- Organisms.- Specific Cells.- Autoradiography.- 4 Immunohistology.- Techniques for Immunohistology.- Direct Method.- Indirect Method.- Tracer-Complex Method.- Avidin-Biotin Method.- Hapten Method.- Enzyme-Bridge Method.- Labelled-Antigen Method.- Primary Antibodies.- Bridging Reagents.- Tracer Substances.- Fluorochromes.- Enzymes.- Gold Particles.- Double-Labelling Techniques.- Fixation.- Use of Enzymes to Unmask Antigens.- Endogenous Peroxidase.- Controls.- Common Applications.- Investigation of Lymphoproliferative Disorders.- Determination of Tumour Histogenesis.- Renal Biopsies.- Problems of Interpretation.- Immuno-electron Microscopy.- 5 Interpretation of Histological Appearances.- Artifact of Sections.- Basic Microscopy.- Artifacts in Sections.- Methods of Interpretation.- Heuristic Analysis.- Pattern Recognition.- Clinicopathological Integration.- Morphology of Disease Processes.- Evolution of Lesions.- Modification by Treatment.- Significance of Specific Morphological Features.- Morphological Overlap Between Diseases.- 6 Cytology.- Relative Merits of Cytology and Histology.- Cytological Preparations.- Exfoliation.- Aspiration.- Fine-Needle Aspiration Cytology.- Miscellaneous Methods.- Stains for Cytology.- Haematoxylin and Eosin.- Romanovsky Stains.- Papanicolaou.- Special Investigations.- Immunohistochemistry.- Electron Microscopy.- Flow Cytometry.- Interpretation.- Applications.- Epithelial “Dysplasias” and Malignancy.- Serous Effusions.- Infective Lesions.- Solid Tumours.- Fat Embolism.- Inflammatory Lung Diseases.- Living Cells.- Reporting Cytology.- 7 Borderline Lesions, Pseudomalignancy and Mimicry.- Borderline Lesions.- Discrete Versus Continuous Diagnostic Categories.- Use of Criteria.- Mimicry of Histological Features.- Pseudomalignancy and Related Diagnostic Problems.- Skin.- Soft Tissues.- Lymphoid Tissues.- Bone.- Breasts.- Urinary Tract.- Thyroid.- Male Genitalia.- Female Genital Tract.- Gastrointestinal Tract.- Respiratory Tract.- Serosal Surfaces.- Central Nervous System.- Conclusions.- 8 Rapid Frozen Section Diagnosis.- Clinical Indications.- Methods.- Interpretation.- Common Applications.- Breast Lesions.- Thyroid.- Parathyroid Glands.- Gastrointestinal Tract.- Respiratory Tract.- Urinary Tract.- Bone and Soft Tissues.- Skin.- Reliability.- 9 Diagnostic Electron Microscopy.- Principles of Transmission Electron Microscopy.- The Electron Microscope.- Specimen Processing.- Diagnostic Value of Electron Microscopy.- Renal Disease.- Tumour Histogenesis.- Virus Identification.- Miscellaneous Applications.- Scanning Electron Microscopy.- X-ray Microanalysis.- 10 Quantitative Methods.- Stereological Principles.- Stereological Methods.- Volumetrie Analysis.- Surface Area.- Surface-to-Volume Ratios.- Particle Size and Density.- Automatic and Semi-automatic Image Analysis.- Microspectrophotometry.- Flow Cytometry.- Practical Applications.- Metabolie Bone Disease.- Jejunal Biopsies.- Respiratory Tract.- Tumours.- 11 Reporting and Classification of Biopsy Diagnoses.- The Biopsy Report.- Gross Description.- Histology.- Other Investigations.- Summary.- Reporting Tumours.- Disease Classification.- “Lumping” and “Splitting”.- Nomenclature and Codes.- Problems in Tumour Classification and Grading.- Data Storage and Retrieval.- Clinical Assimilation.- 12 Quality Assessment and Control.- Sources of Diagnostic Error.- The “Correct” Diagnosis.- Evaluation of Diagnostic Methods.- Evaluation of Performance.- Illustrative Examples.- Liver Biopsy Interpretation.- Bladder Tumour Grading.- Breast Carcinoma Grading.- National and Institutional Schemes.- Self Assessment.- Assessment of Errors of Procedure and Communication.- Conclusions.- 13 The Autopsy.- History of the Autopsy.- The Autopsy and Clinical Audit.- Role in Medical Education.- Hazards in the Autopsy Room.- Consent.- General Techniques.- Special Methods.- Microbiology.- Post-mortem Biochemistry.- The Needle Autopsy.- The Frozen Section Autopsy.- Post-mortem Histology.