Pathology Practical Book for Dental Students Harsh Mohan, Sugandha Mohan
INDEX
ABCDEFGHIJKLMNOPQRSTUVWZ
The letter “t” after page number in the index below denotes Table and the letter “f” stands for Figure on that page.
A
Abscess lung, 80–1
Absolute values, 63
Accumulations, intracellular, 73–6
Actinomycosis, 87–8
Adenocarcinoma, colon, 93–4
Adenoma, rectum, 93–4
pleomorphic, 107–8
Albuminometer, 24
Alcohol, grades of, 7–8
Ameloblastoma, 107
Amyloid, stain for, 15, 75–6
Amyloidosis,
kidney, 74–5
spleen, 75–6
Anaemia, 43
Anuria, 22
Appendicitis, acute, 81
Artery, thrombus, 79
Ascitic fluid, cytology of, 38
Aspergillosis lung, 87–9
Atheroma, coronary artery, 102–3
Ayre spatula, 36
B
Barr bodies, 38
Basal cell carcinoma, 98
Basophilia, 58t
Basophils, 55t, 56, 58
Bence Jones' proteinuria, 25
Benedicts' test, 25–6
Benzidine test, 28
Bile derivatives in urine, 27–8
Bleeding time, 64–5
Blocking, 9
Blood film (PBF), 51–3
Blood vessels, tumours of, 103–5
Blueing, 11
Bones, common diseases of, 109–12
Brain,
cysticercosis, 88–90
liquefactive necrosis, 71–2
Breast,
duct carcinoma, 40f
fibroadenoma, 40f
FNA in carcinoma of, 39
Bronchoalveolar lavage (BAL), 38
Brown induration lung, 77
Buccal smears, 38
Bouin's fixative, 7
C
Calcification, dystrophic,
in tuberculous lymphadenitis, 83f
Candidiasis, 35f
Carbon dioxide, 12–3
Carcinoma,
basal cell, 98
colon, 93–4
infiltrating duct, breast, 40f
metastatic, lymph node, 100–1
squamous cell, 91–3
Cardice, 13
Carnoy's fixative, 7
Casts, urinary, 30–2
Cervical cancer,
cytology of, 37f
Chronic venous congestion (CVC),
liver, 78–9
lung, 77
Clearing, 7–8
Clotting time, 66
Collagen, stain for, 14f, 15
Colon, adenocarcinoma, 93–4
Colorimeter, 44
Congo red, 14f, 15, 75f, 76f
Coronary artery, atheroma, 102
Cryostat, 13
Crystals in urine, 32–4
Cyanmet Hb method, 43–4
Cyst, radicular, 106
Cysticercosis,
brain, 88–90
Cytopathology, 36–40
exfoliative, 36–9
fine needle aspiration (FNA), 39–40
Cytospin, 38f
D
Dacie's fluid, 49
Dark ground illumination (DGI), 5
Degenerations, 69–71
Differential leucocyte count (DLC), 54–8
normal values of DLC, 55t
Differentiation, staining, 11
DPX, 11
Drabkin's fluid, 43–4
Dry ice, 13
Duct carcinoma, NOS, breast, 40f
Duke's method, 65
E
Effusion for malignant cells, 38
Ehrlich's test, 27
Ehrlich, Paul, 19
Electron microscope, 5
Embedding, 9
Embedding centre, 9
Eosinopenia, 58t
Eosinophilia, 58t
Eosinophils, 55t, 56, 57
Esbach's albuminometer, 24
ESR, 59–61
Exfoliative cytology, 36–9
F
Fat, stain for, 14f, 14–5
Fatty liver, 73–4
Fibroadenoma breast, 40f
Fine needle aspiration (FNA), 39–40
Fixation, 6–7
Fixatives, 6–7
Fluid cytology, 38
Fluorescent microscope, 5
Formaldehyde, 7
Formalin, 7
Fouchet's test, 27–8
Franzen handle, 39f
Freezing microtome, 13
Frozen section, 12–3
G
Gerhardt's test, 26
Giant cell tumour, bone, 110–1
Giemsa stain, 39, 53
Glucosuria, 25–6
Glutaraldehyde, 7
Glycogen, stain for, 14f, 15
Granulation tissue, 81–2
Granulomatous inflammation, 83–6
H
H&E staining, 11
rapid, 13
Haemangioma,
capillary, skin, 103–4
cavernous, liver, 103–4
Haematocrit, 62–3
Haematoxylin, 11
Haemocytometer, 47–8
Haemoglobin estimation, 43–6
Hay's test, 27
Hayem's fluid, 49
Heart failure cells, 77
Heat and acetic acid test, 23
Heller's test, 23
Histopathology techniques, 1–17
Hyaline change, 69–70
I
Impregnation, 8
Imprint cytology, 40
Immunohistochemistry, 16–7
Infarcts,
brain, 71–2
kidney, 69–71
Infections, 87–90
Infestations, 87–90
Infiltrating duct carcinoma, breast, 40f
Inflammation,
granulomatous, 83–6
Intestine,
tuberculosis, 84–6
Involucrum, 110
Ivy's method, 65
J
Juvenile polyp, 93
K
Ketonuria, 26–7
Kidney,
coagulative necrosis, 69–71
L
Lardaceous amyloidosis, 75
Lee and White method, 66
Leiomyoma, 69–70
Leishman's stain, 52–3
Leuckart's (L) moulds, 9
Leucocytes, identification of, 55–6
counting of, 47–8
Leucocytosis, DLC of, 55–8
Leuwenhoeck, Anthony van, 1
Liver,
cavernous haemangioma, 103–4
fatty change, 73–4
nutmeg, 78
Lungs,
abscess, 80–1
aspergillosis, 87–9
CVC, 77
fibrocaseous tuberculosis, 84–5
metastatic sarcoma, 101
Lymph node,
caseous necrosis, 83
dystrophic calcification, 83f
metastatic carcinoma, 100–1
tuberculosis, 83–4
Lymphangioma, tongue, 104–5
Lymphocytes, 55t, 55, 57
Lymphocytosis, 57t
Lymphopenia, 57t
M
Masson's trichrome, 14f, 15
Melanin, 96–7
Melanoma, malignant, 97
Metachromasia, 14f, 15
Metastatic carcinoma, lymph node, 100–1
Metastatic sarcoma, lung, 101
Methyl violet, 14f, 15
Microhaematocrit, 62
Microscopy, various types, 3–5
Microtomy, 9–11
freezing, 13
rotary, 9f
Monocyte, 55t, 55, 57
Monocytosis, 57t
Mordant, 11
Mounting, 11
Muscle stain for, 14f, 15
Mycobacterium tuberculosis, 84f
N
Naevus, 96–7
Necrosis,
caseous, 83–4
coagulative, 69–71
liquefactive, 71–2
Neubauer's chamber, 47–8
Neutropenia, 56t
Neutrophilia, 56t
Nocturia, 21
Normal values, 113–20
clinical chemistry, 115t
haematogical, 118t
other body fluids, 117t
Nose, rhinosporidiosis, 88–9
Nutmeg liver, 78
O
Oedema, pulmonary, 78
Oil red O, 14f, 14–5
Oliguria, 22
Osmium tetraoxide, 7
Osteoclastoma, 110–1
Osteomyelitis, 109–10
chronic pyogenic, 109–10
tuberculous, 110
Osteosarcoma, 111–2
P
Packed cell volume (PCV), 62–3
Pap smear, 36–7
Papilloma, squamous cell, 91
Parotid tumour, mixed, 91–2
Particle counter in haematology, 45f
Periodic acid Schiff (PAS), 14f, 15
Peripheral blood film (PBF),
DLC for, 54–8
examination of, 51–3
preparation of, 51–3
staining of, 52–3
Perl's stain, 14f, 15–6
pH of urine, 22
Picric acid, 7
Platelet count, 49–50
Pleomorphic adenoma, 107–8
Polarising microscope, 5
Polymorphonuclear neutrophil (PMN), 55, 56, 55t
Polyuria, 21–2
Pott's disease, bone, 110
Processors, tissue, 8
Proteinuria, 23–5
Prussian blue, 14f, 15–6
Pseudocartilage, 107–8
Pus cells, urine, 30
Q
Quality control in Hb estimation, 46
R
RBC count, 49–50
Reticulin stain, 14f, 15
Rhinosporidiosis, nose, 88–9
Ripening, 11
Rodent ulcer, 98
Romanowsky dyes, 52
Rothera's test, 26
Rouleaux formation, 59
S
Sahli's method, 45–6
Salivary, mixed tumour, 107–8\
Sarcoma,
bone, 111–2
metastatic, lung, 101
soft tissue, 100f
Schiff's reagent, 15
Scott's tap water, 11
Section cutting, 9–10
Sediment, urine, 29
Sequestrum, 110
Silver impregnation, 15
Skin,
actinomycosis, 87–8
basal cell carcinoma, 98
capillary haemangioma, 103–4
epidermoid carcinoma, 91–3
melanoma, 97
naevus, 96–7
papilloma, 91
squamous cell carcinoma, 91–3
Smears
cytologic, 36–40
peripheral blood, 51–8
Specific gravity, urine, 22–3
Spermatozoa, 35f
Spleen,
lardaceous, 75
miliary tuberculosis, 85–6
sago, 75
Sputum examination, 38
Squamous cell carcinoma, 91–3
Squamous cell papilloma, 91
Staining, routine, sections, 11
immunohistochemical, 16–7
special, 14–6
Stains for blood film, 52–3
Strip method for urine, 24f
Sulfosalicylic acid test, 23
T
Thrombocytopenia, 50
Thrombocytosis, 50
Thrombus artery, 79
Tissue processor, automated, 8
TLC, 47–8
Toluidine blue, 13
Trichomonas, 35f, 37f
Tuberculosis,
bones, 110
fibrocaseous, 84–5
FNA in, 40f
intestine, 85–6
lymph node, 83–4
lung, 84–5
spleen, 85–6
Ziehl-Neelsen stain in, 84f
Tuberculous osteomyelitis, 110
Turbidimetry for proteinuria, 24
Turk's fluid, 47
U
Ulcer, rodent, 98
Urine, examination, 21–35
analysers, 28
bile derivatives, 27–8
blood, 28
candida in, 35f
casts, 30–2
chemical examination, 23–8
colour of, 22
crystals in, 32–4
epithelial cells, 30
glucosuria, 25–6
ketonuria, 26–7
microscopy, 29–35
pH of, 22
physical examination, 21–3
preservatives, 21
proteinuria, 23–5
pus cells in, 30
RBCs in, 29–30
reaction of, 22
specific gravity of, 22–3
spermatozoa in, 35f
urobilinogen, 27
WBCs in, 30
Urinometer, 22
V
Vacuum tissue processor, 8f
van Gieson stain, 14f, 15
Virchow, Rudolf, 67
W
WBC count, 47–8
DLC, 54–8
WBC, normal morphology of, 55–8
Weights and measurements of normal organs, 113t
Westergren's method, 60
Wintrobe method, 60–2
Wintrobe, MM, 41
Z
Zahn, lines of, 79
Ziehl-Neelsen staining, 84f
×
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1PATHOLOGY PRACTICAL BOOK for Dental Students2
The photographs on the cover of the textbook depict images of diseases as follows:
3PATHOLOGY PRACTICAL BOOK for Dental Students
Harsh Mohan MD, FAMS, FICPath, FUICC Professor and Head Department of Pathology Government Medical College Sector-32 A, Chandigarh-160 031 INDIA E mail: drharshmohan@gmail.com Sugandha Mohan BDS E mail: sugandha1987@gmail.com
4
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© 2011, Harsh Mohan, Sugandha Mohan
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This book has been published in good faith that the contents provided by the author(s) contained herein are original, and is intended for educational purposes only. While every effort is made to ensure a accuracy of information, the publisher and the author(s) specifically disclaim any damage, liability, or loss incurred, directly or indirectly, from the use or application of any of the contents of this work. If not specifically stated, all figures and tables are courtesy of the authors(s). Where appropriate, the readers should consult with a specialist or contact the manufacturer of the drug or device.
Publisher: Jitendar P Vij
Publishing Director: Tarun Duneja
Editor: Richa Saxena
Cover Design: Seema Dogra, Sumit Kumar
Assistant Editors: Praveen Mohan, Tanya Mohan
Pathology Practical Book for Dental Students
First Edition: 2011
9789350254950
Printed at
5Preface
There is nothing in the world equal in purity to knowledge, the person who is perfected by yoga, finds it of himself in the self by the course of time.
(The Bhagvatgita: Ch IV, Verse 38)
Students of dentistry in India (and in many other countries) learn pathology in two phases—General Pathology in second year and Oral Pathology in their third year of the course. As an experienced teacher (HM) and as a BDS student until recently (SM), it has been our common observation that BDS students who are studying in shared campuses for BDS and MBBS, get much less attention from their teachers of medical college in general medical subjects than the attention and care they get from their teachers of core dental subjects from their dentistry teachers for various reasons which we are not delving into. Similarly, until a few years back, there were no separate books in general medical subjects taught to dental students. Thus, while there has been a main course book Essential Pathology for Dental Students by the first author for about 15 years, there has not been any separate practical book in pathology for BDS students so far anywhere. This has resulted in lack of uniformity in teaching and training for the reason that it is left to the discretion of teacher and examiner to decide what to teach and evaluate and what to leave out for dental students.
An attempt has been made to bridge this lacuna by bringing out separately the present book, Pathology Practical Book for Dental Students, structured as per requirements prescribed by the Dental Council of India (DCI) in the revised syllabus of Pathology for second year BDS students.
Some highlights of this book are as under:
Updated and well-organised contents: The book is organised systematically into 4 Sections, each section having certain number of practical exercises (in all 25) patterned on the format of practical class of students. These are: Techniques in Pathology (Exercise 1–4), Clinical Pathology and Basic Cytopathology (Exercise 5–7), Haematology (Exercise 8–13) and Histopathology (Exercise 14–25).
Hone your diagnostic skills: The book is structured in a way that it aims to hone the practical and diagnostic skills of the learner in pathology in a user-friendly manner. All exercises have listed key features point-wise for easy understanding and reproducibility, leaving out theoretical details for learning from the main course book so as not to lose focus on key diagnostic and practical points.
Brevity with beauty: Brief and point-wise text in each exercise is richly supported by labelled line-drawings with corresponding specimen photograph and microscopic image for conceptual learning. Thus, the book may become a must-take to practical class by the students to learn the subject effectively and to revise the entire matter quickly for their examination and viva.
Wish to learn more? For those students desiring to learn more, the book has many additional exercises over and above those given in the revised syllabus by the DCI in the opening pages of the book.
Although the book is primarily prepared as per DCI recommendations given in the revised syllabus in Pathology for second year students of BDS, it is also expected to be useful for practising clinicians and other students of medicine such as those pursuing course in physiotherapy, pharmacy, nursing, laboratory technology and alternate systems of medicine.6
In preparing this book, we have been helped and supported by various friends and colleagues and our family, which is gratefully acknowledged. A word of special thanks to Ms Agam Verma, MSc (MLT), Senior Laboratory Technician, for liberal and skilful technical assistance and her valuable suggestions in chapters on laboratory technology.
We thank profusely the entire staff of M/s Jaypee Brothers Medical Publishers (P) Ltd. for their ever smiling support and cooperation in completion of this book in a relatively short time.
Finally, although sincere effort has been made to be as accurate as possible, element of human error is still likely; we shall humbly request users to continue giving their valuable suggestions and feedback directed at further improvements of its contents.
Government Medical College
Sector-32 A, Chandigarh-160030
INDIA
Harsh Mohan, md, fams, ficpath, fuicc
Professor and Head
Department of Pathology
E mail: drharshmohan@gmail.com
Sugandha Mohan, bds
E mail: sugandha1987@gmail.com
Revised Syllabus in Pathology for BDS Students as per Recommendations of the Dental Council of India
COURSE CONTENTS IN PRACTICAL
Urine—Abnormal Constituents: Sugar, albumin, ketone bodies.
Urine—Abnormal Constituents: Blood, bile salts, bile pigments.
Haemoglobin (Hb) Estimation
Total WBC Count
Differential WBC Count
Packed Cell Volume (PCV), Erythrocyte Sedimentation Rate (ESR)
Bleeding Time and Clotting Time
Histopathology: Tissue processing, staining.
Histopathology Slides: