Microscopic Anatomy

By | March 13, 2015

The adenomatous (precancerous) colonic cells on the left show subtle derangements in cell architecture as compared to the normal cells on the right.

The adenomatous (precancerous) colonic cells on the left show subtle derangements in cell architecture as compared to the normal cells on the right.

I have to admit that histology was one of my least favorite courses during the first year of medical school. The endless list of hard to see and hard to remember microscopic structures were bewildering in and of themselves, but I was especially annoyed by the demands of the instructors that I identify the tissue of origin from only a single microscopic slide. What I didn’t understand then, when it was simply an academic exercise, but what I began to appreciate as a senior and took an elective course in surgical pathology was that first of all you can find a metastatic deposit of tissue anywhere in the body, often far from the site of origin and secondly and far more importantly is that subtle disruptions of the tissue architecture and cellular anatomy are often the first signs of malignancy. Over the years as I have attended tumor board conferences both at Providence Saint Joseph Medical Center and at Glendale Adventist Medical Center I have learned that health is an orderly process and that every loss of microscopic structure was likely to be associated with a corresponding loss of physiologic control. In general the more disordered the microscopic slide appears the more aggressively the tumor is likely to behave. This is the reason why the better oncologists will always want to review the microscopic slides on their patients just as I always want to review the X-Rays and MRIs on my patients here at Schlesinger Pain Centers.


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