Histology for Pathologists

Title Page
Copyright
Contributors
Preface
Preface to the First Edition
Acknowledgments
Contents
SECTION I Cutaneous Tissue
1 Skin
EMBRYOLOGY
Epidermis
Dermis
Epithelial Skin Appendages
HISTOMORPHOLOGY
Epidermis
Dermis
Subcutaneous Tissue
Blood Vessels, Lymphatics, Nerves, and Muscle
HISTOLOGIC DIFFERENCES OF SKIN WITH AGE
Newborns and Children
Elderly
HISTOLOGIC VARIATIONS ACCORDING TO ANATOMIC SITES
PATHOLOGIC CHANGES FOUND IN BIOPSIES AND INTERPRETED AS “NORMAL SKIN”
SPECIMEN HANDLING
ARTIFACTS
STAINING METHODS
Histochemical Stains
Immunofluorescence
Immunohistochemical Stains/Molecular Studies
REFERENCES
2 Nail
HISTORY
EMBRYOLOGY
GENETIC AND NAIL KERATINS
GROSS ANATOMY
MICROSCOPIC ANATOMY
The Nail Plate
Proximal Nail Fold
Matrix
Nail Bed
Hyponychium
Lateral Nail Folds
IMMUNOHISTOCHEMISTRY OF THE NAIL UNIT
Nail Plate
Keratinocytes
Merkel Cells
Melanocytes
Immunology and Inflammatory Cells
ULTRASTRUCTURAL ANATOMY
CONFOCAL MICROSCOPY OF NAIL
OTHER TISSUES OF THE NAIL UNIT
Dermis
Bone
Blood Supply
NAIL GROWTH
HANDLING AND PROCESSING OF THE NAIL
REFERENCES
SECTION II Breast
3 Breast
EMBRYOLOGY
ADOLESCENCE
THE ADULT FEMALE BREAST
PREGNANCY AND LACTATION
MENOPAUSE
BLOOD SUPPLY
LYMPHATIC DRAINAGE
THE ADULT MALE BREAST
BIOLOGIC MARKERS, IMMUNOPHENOTYPE, AND MOLECULAR BIOLOGY
Estrogen Receptor and Progesterone Receptor
Other Biomarkers and Immunophenotypic Features
Molecular Markers
CONCLUSION
REFERENCES
SECTION III Musculoskeletal System
4 Bone
BONE—THE ORGAN: GROSS AND MICROSCOPIC ANATOMY
Woven and Lamellar Bone
Cortical (Compact) Bone
Cancellous (Trabecular or Spongy) Bone
Periosteum
Vascular Supply and Innervation
Bone Marrow
BONE—THE TISSUE: ORGANIC AND INORGANIC COMPONENTS
Organic Components
Inorganic Components
BONE FORMATION, GROWTH, AND REMODELING
Endochondral Ossification
Intramembranous Ossification
Modeling and Remodeling
BONE—HISTOLOGIC ARTIFACTS
REFERENCES
5 Joints
THE NORMAL JOINT
Diarthrodial Joint
Amphiarthrodial Joint
THE NORMAL JOINT TISSUES
Articular Cartilage
Synovial Membrane
Ligaments and Tendons
THE ARTHRITIC JOINT
Alteration in Shape
TISSUE RESPONSE TO INJURY
Cartilage
Bone
Ligaments and Tendons
Synovial Membrane
Synovial Fluid
REFERENCES
6 Adipose Tissue
TYPES OF FAT CELLS
WHITE FAT
Prenatal Development
Molecular Biology
Postnatal Development
Gender Differences
Functions
Regulation
Gross Aspects
Histology
Ultrastructure
BROWN FAT
Prenatal Development
Postnatal Development
Function
Regulation
Histology
Beige Fat
Stem Cells
HISTOCHEMISTRY
Enzyme Histochemistry
Lipid Histochemistry
IMMUNOHISTOCHEMISTRY
Obesity
ADIPOCYTE LESIONS
Terminology
Degeneration
Atrophy
Cellulite
Ischemia
Metaplasia
LIPODYSTROPHY
ADIPOCYTES IN ORGANS
Fatty Infiltration
FAT BIOPSY FOR AMYLOID
INFLAMMATIONS
Fat Necrosis
Calciphylaxis
Panniculitis
Mesenteritis
Lipogranuloma
TUMORS AND TUMOR-LIKE LESIONS
Brown Fat Lesions
White Fat Lesions
Special Lipoma Types
Lipoblastoma
CYTOGENETICS OF LIPOMAS
SYNDROMES ASSOCIATED WITH FATTY LESIONS (INCLUDING LIPOMATOSIS)
MIMICS OF FAT CELLS
Mature Fat Cells
Lipoblasts
REFERENCES
7 Skeletal Muscle
EMBRYOLOGY
POSTNATAL AND DEVELOPMENTAL CHANGES
ANATOMY
LIGHT MICROSCOPY
ULTRASTRUCTURE
SPECIAL TECHNIQUES
GENDER, TRAINING, AND AGING
ARTIFACTS
DIFFERENTIAL DIAGNOSIS
SPECIMEN HANDLING
REFERENCES
8 Blood Vessels
GROSS AND LIGHT MICROSCOPIC FEATURES
Aorta
Arteries
Arterioles
Capillaries, Sinusoids, Venules, and Lymphatics
Veins
Pulmonary Arteries and Veins
Anastomoses, Angiodysplasias, and Vascular Malformations
Vascular Surgery
ELECTRON MICROSCOPY
Endothelial Cells
Inclusions of Endothelial Cells
Media
Adventitia and Supporting Cells
Lymphatics and Veins
ANTIGEN EXPRESSION OF NORMAL AND NEOPLASTIC VASCULAR TISSUE
Endothelium
Smooth Muscle
Other Useful Antibodies for Diagnostic Vascular Pathology
REFERENCES
SECTION IV Nervous System
9 Central Nervous System
INTRODUCTION
REGIONAL NEUROANATOMY
Organization of the Spinal Cord and Brain Stem
CELLULAR CONSTITUENTS OF THE CENTRAL NERVOUS SYSTEM
Gray Matter and White Matter
Neurons
Astrocytes
Oligodendroglia
Ependyma
Microglia and the Monocyte—Macrophage System
Response to Injury
SPECIALIZED ORGANS OF THE CENTRAL NERVOUS SYSTEM
Pineal Gland
Median Eminence and Infundibulum
Olfactory Bulbs and Tracts
Choroid Plexus
Circumventricular Organs
INTRADURAL ELEMENTS OF THE PERIPHERAL NERVOUS SYSTEM
MENINGES
Dura Mater (Pachymenix)
Pia-arachnoid (Leptomeninges)
Leptomeningeal Melanocytes
Optic Nerve
FETAL BRAIN
ARTIFACTS
SUGGESTED READINGS
10 Pituitary and Sellar Region
EMBRYOLOGY
GROSS ANATOMY
Bony Sella
Meninges
Vasculature
PHYSIOLOGY AND HISTOLOGY
Hypothalamus
Adenohypophysis
Variation in Normal Morphology of the Adenohypophysis
Age-Related Changes of the Adenohypophysis
Neurohypophysis
Variation in Normal Morphology of the Neurohypophysis
DIFFERENTIAL DIAGNOSIS
REFERENCES
11 Peripheral Nervous System
DEVELOPMENT OF THE PERIPHERAL NERVOUS SYSTEM
GROWTH OF AXONS
SCHWANN CELLS AND MYELINATION
ANATOMY OF PERIPHERAL NERVES
HISTOLOGY, IMMUNOCYTOCHEMISTRY, AND ULTRASTRUCTURE OF PERIPHERAL NERVES
Components of the Nerve Sheath
CORRELATION OF NORMAL HISTOLOGY WITH THE PATHOLOGY OF PERIPHERAL NERVES
Handling and Preparation of Peripheral Nerve Biopsy and Autopsy Specimens
ACKNOWLEDGMENTS
REFERENCES
SECTION V Head and Neck
12 Eye and Ocular Adnexa
CORNEA
SCLERA
CORNEOSCLERAL LIMBUS
CONJUNCTIVA, CARUNCLE, AND PLICA SEMILUNARIS
THE UVEAL TRACT
The Iris
The Ciliary Body
Choroid
RETINA
Artifacts of the Retina
THE OPTIC NERVE
THE CRYSTALLINE LENS
INTRAOCULAR COMPARTMENTS
THE EYELIDS
THE ORBIT
LACRIMAL DRAINAGE APPARATUS
ACKNOWLEDGMENTS
REFERENCES
13 The Ear and Temporal Bone
EMBRYOLOGY
EXTERNAL EAR
Embryology
ANATOMY
HISTOLOGY
AUDITORY EPITHELIAL MIGRATION
MIDDLE EAR
Embryology
ANATOMY
MIDDLE EAR OSSICLES AND MUSCLES
EUSTACHIAN (AUDITORY) TUBE
HISTOLOGY
Tympanic Cavity Proper
Eustachian Tube
Mastoid Air Cells
Pneumatization of the Temporal Bone
Middle Ear Ossicles
Middle Ear Joints
Middle Ear Muscles
INNER EAR
Embryology
ANATOMY
Osseous Labyrinth (Otic Capsule)
Membranous Labyrinth
Cochlear Duct
Utricle
Saccule
Semicircular Canals
Endolymphatic Duct and Sac
INNER EAR INNERVATION
HISTOLOGY
Osseous Labyrinth
Membranous Labyrinth
Cochlea
Semicircular Canals, Utricle, and Saccule
Nerves and Paraganglia
Endolymphatic Sac and Duct
COMPOSITION AND CIRCULATION OF THE PERILYMPH AND ENDOLYMPH
CONDUCTION OF SOUND
SELECTED ABNORMALITIES AND PATHOLOGY
External Ear
MIDDLE EAR
Otitis Media
Cholesteatoma (Keratoma)
Pathology
Otosclerosis
INNER EAR
Presbycusis and Other Hearing Loss
Ménière Disease
TEMPORAL BONE DISSECTION
REFERENCES
14 Mouth, Nose, and Paranasal Sinuses
EMBRYOLOGY AND PRENATAL CHANGES
GROSS ANATOMY
Jawbone
Nose
Paranasal Sinuses
Blood Vessels
Nerves
Lymph Nodes
Lymphatics
Tonsils
MICROSCOPY
Mouth
Nose and Paranasal Sinuses
REFERENCES
15 Larynx and Pharynx
LARYNX
Definition and Boundaries
Embryology
Gross and Functional Anatomy
Microscopic Anatomy
Neural, Vascular, and Lymphatic Components
PHARYNX
Definition and Boundaries
Embryology
Gross Anatomy
Microscopic Anatomy
Neural, Vascular, and Lymphatic Components
REFERENCES
16 Major Salivary Glands
EMBRYOLOGIC AND POSTNATAL DEVELOPMENTAL CHANGES
Parotid Gland
Submandibular Gland
Sublingual Gland
LIGHT MICROSCOPY
SECRETORY UNITS
Acini
Ducts
SEBACEOUS GLANDS
MYOEPITHELIAL CELLS
THE ROLE OF MYOEPITHELIAL CELLS IN SALIVARY GLAND TUMORS
LYMPHOID TISSUE
HETEROTOPIC SALIVARY TISSUE AND ITS SIGNIFICANCE
AGING CHANGES
Oncocytes
Fatty Infiltration
REACTIVE CHANGES
Metaplasia
Hyperplasia
Atrophy
Regeneration
Artifacts
CORRELATIVE NORMAL AND NEOPLASTIC HISTOLOGY
IMMUNOHISTOCHEMISTRY
SPECIMEN HANDLING
REFERENCES
SECTION VI Thorax and Serous Membranes
17 Lungs
NORMAL STRUCTURE AND HISTOLOGY
General
Airways
Lobule and Acinus
Vasculature
Lymphatics and Lymphoid Tissue
Pleura
SPECIAL STAINS AND THE EVALUATION OF LUNG HISTOLOGY
PATTERN RECOGNITION BASED ON NORMAL ANATOMIC LANDMARKS
SITE-RELATED CHANGES COMMONLY SEEN IN SURGICAL PATHOLOGY MATERIAL
ARTIFACTS SEEN IN LUNG BIOPSY AND RESECTION MATERIAL
INCIDENTAL FINDINGS IN LUNG BIOPSY AND RESECTION TISSUE
INCIDENTAL FINDINGS IN TRANSBRONCHIAL BIOPSIES
EFFECTS OF AGING
THE BIOPSY THAT LOOKS NORMAL AT FIRST GLANCE
IMMUNOHISTOCHEMISTRY
REFERENCES
18 Thymus
EMBRYOLOGY
DEVELOPMENTAL ABNORMALITIES
APOPTOSIS
ANATOMY
HISTOLOGY
Epithelial Cells
Hassall Corpuscles
Thymic Lymphocytes (Thymocytes)
Other Cell Types
ULTRASTRUCTURE
IMMUNOHISTOCHEMISTRY
Thymic Epithelial Cells
Thymic Lymphocytes
MOLECULAR BIOLOGY
FUNCTION
AGE-RELATED AND OTHER TROPHIC CHANGES
Thymic Involution
Thymic Hyperplasia
ARTIFACTS AND OTHER POTENTIAL PITFALLS IN DIFFERENTIAL DIAGNOSIS
REFERENCES
19 Heart
HEART WEIGHTS
PRENATAL FETAL CIRCULATION
POSTNATAL CIRCULATION
PERICARDIUM
Applied Anatomy
CARDIAC SKELETON
Applied Anatomy
INTERNAL STRUCTURE OF THE HEART WALL
INTERATRIAL SEPTUM
Applied Anatomy
RIGHT ATRIUM
LEFT ATRIUM
RIGHT VENTRICLE
Applied Anatomy
LEFT VENTRICLE
Applied Anatomy
CARDIAC VALVES
Semilunar Valves
Atrioventricular Valves
Chordae Tendineae
Applied Anatomy of Intracardiac Valves
Aging Changes of Intracardiac Valves
PAPILLARY MUSCLES
CONDUCTION SYSTEM
Sinoatrial Node
Atrioventricular Node
Aging Changes in the Human Conduction System
CARDIAC INNERVATION
Autonomic Nerves
LYMPHATICS
SMALL INTRAMURAL CORONARY ARTERIES
VEINS AND VENULES
THE ENDOMYOCARDIAL BIOPSY
Tissue Handling and Processing
Biopsy Limitations and Tissue Artifacts
SUMMARY
REFERENCES
20 Serous Membranes
ANATOMY
FUNCTIONAL ANATOMY
MESOTHELIAL CELLS
Morphology
Histochemistry
Immunohistochemistry
Ultrastructure
SUBMESOTHELIAL LAYER
Histochemistry
Immunohistochemistry
Interactions of Mesothelial and Submesothelial Cells
REACTIVE MESOTHELIUM
Fibrous Pleurisy
Reactive Mesothelium versus Mesothelioma
Reactive Mesothelium versus Carcinoma
Endosalpingiosis and Endometriosis
Multilocular Peritoneal Inclusion Cyst
REFERENCES
SECTION VII Alimentary Tract
21 Esophagus
EMBRYOLOGY
Esophageal Atresia
Esophageal Duplication
Lower Esophageal Rings and Webs
TOPOGRAPHY AND RELATIONS
MACROSCOPIC/ENDOSCOPIC FEATURES
Glycogenic Acanthosis
Heterotopias
Esophageal Musculature
Lower Esophageal Sphincter
Gastroesophageal Junction
HISTOLOGY
Mucosa
Submucosa
Muscularis Propria
Serosa
ARTERIAL SUPPLY
VENOUS DRAINAGE
LYMPHATIC DRAINAGE
INNERVATION (NERVES AND INTERSTITIAL CELLS OF CAJAL)
DIAGNOSTIC CONSIDERATIONS
Barrett Esophagus
Gastroesophageal Reflux Disease
Eosinophilic Esophagitis
Lymphocytic Esophagitis
Exfoliative (Sloughing) Esophagitis (Esophagitis Dissecans Superficialis)
Acute Necrotizing Esophagitis
Adenocarcinomas of the Gastroesophageal Region
ACKNOWLEDGMENT
REFERENCES
22 Stomach
EMBRYOLOGY AND POSTNATAL DEVELOPMENT
GROSS MORPHOLOGIC FEATURES
Blood Supply
Nerve Supply
Lymphatics
GENERAL HISTOLOGIC FEATURES
Surface Epithelium
Cardiac and Pyloric Mucosa
Oxyntic Gland Mucosa
Endocrine Cells
Lamina Propria
Submucosa
Muscular Components
ULTRASTRUCTURE
GASTRIC FUNCTION
SPECIAL TECHNIQUES AND PROCEDURES
AGE CHANGES
ARTIFACTS
DIFFERENTIAL DIAGNOSIS
Metaplasia
SPECIMEN HANDLING
REFERENCES
23 Small Intestine
GROSS ANATOMY AND SURGICAL PERSPECTIVE
PHYSIOLOGY
HISTOLOGY
Mucosa
Submucosa
Muscularis Externa
Serosa and Subserosal Region
DISTINCTIVE REGIONAL CHARACTERISTICS OF THE SMALL BOWEL
Duodenum
Jejunum
Ileum
SPECIAL CONSIDERATIONS
Geographic, Age-Related, and Dietary Factors
Metaplastic and Heterotopic Tissues
Lymphoid Proliferations
Morphologic Changes Associated with Ileal Diversion and Continence-Restoring Procedures
MUCOSAL BIOPSY SPECIMEN EVALUATION IN SUSPECTED MALABSORPTION
Specimen Procurement and Processing
Specimen Interpretation and Common Artifacts
ACKNOWLEDGMENT
REFERENCES
24 Colon
EMBRYOLOGY
ANATOMIC CONSIDERATIONS
FUNCTION
LIGHT MICROSCOPY
Mucosa
Submucosa
Muscularis Externa, Subserosal Zone, and Serosa
EFFECTS OF PREPARATION AND ARTIFACTS
Bowel Preparation Effects
Incorrect Tissue Orientation and Tangential Sectioning
Tissue Trauma
ACKNOWLEDGMENTS
REFERENCES
25 Appendix
GROSS ANATOMY/SURGICAL PERSPECTIVE
Development of the Vermiform Appendix and Congenital Anomalies
FUNCTION
NORMAL HISTOLOGY OF THE APPENDIX
Mucosal Architecture and Design
Submucosa
Muscularis Externa, Subserosal Region, and the Serosa
SPECIAL CONSIDERATIONS
Normal Variation of Mucosal Inflammation Versus Acute Appendicitis
Obliteration of the Appendiceal Lumen (Appendiceal Neuromas)
Mucocele of the Appendix
Dissection and Processing Techniques
REFERENCES
26 Anal Canal
DEFINITION AND BOUNDARIES
EMBRYOLOGY
GROSS AND FUNCTIONAL ANATOMY
Musculature
Innervation
Vasculature
LIGHT MICROSCOPY
Mucosa
Submucosa
Muscles
DIAGNOSTIC CONSIDERATIONS
Epithelial Metaplasia and Heterotopia
Inflammatory Conditions
Neoplasia
REFERENCES
27 Liver
EMBRYOLOGY
GROSS MORPHOLOGY
HISTOLOGY
Structural Organization
Hepatocytes
Bile Canaliculi
Sinusoidal Lining Cells
Portal Tracts
Blood Supply and Drainage
Lymphatics
Bile Ducts
Nerve Supply and Innervation
EXTRACELLULAR MATRIX
AGING CHANGES
METHODOLOGY
Liver Biopsy
Specimen Handling
Special Stains
Immunohistologic Studies
Electron Microscopy
Molecular Studies
FREQUENT HISTOLOGIC CHANGES OF LITTLE SIGNIFICANCE
The Liver at Autopsy
Surgical Liver Biopsy Specimens
MINOR BUT SIGNIFICANT HEPATIC ALTERATIONS
Nonspecific Reactive Hepatitis
Mild Acute Hepatitis and Residual Hepatitis
Sinusoidal Dilatation
Nodular Regenerative Hyperplasia
Hepatoportal Sclerosis
Vicinity of Space-Occupying Lesions
BROWN PIGMENTS
Lipofuscin
Dubin–Johnson Pigment
Hemosiderin
Copper-Associated Protein
Bile
ACKNOWLEDGMENTS
REFERENCES
28 Gallbladder and Extrahepatic Biliary System
GALLBLADDER
Gross Anatomy
Physiology
Blood Supply and Lymphatic Drainage
Nerve Supply
Histology
Ultrastructure
CYSTIC DUCT
RIGHT AND LEFT HEPATIC DUCTS, COMMON HEPATIC DUCT, AND COMMON BILE DUCT
Gross Anatomy
Arterial Supply, Venous Drainage, and Relationship to Bile Ducts
Lymphatic Drainage
Nerve Supply
Histology
VATERIAN SYSTEM AND MINOR PAPILLA
Gross Anatomy
Vascular and Nerve Supply and Lymphatic Drainage
Histology
BILIARY INTRAEPITHELIAL NEOPLASIA
REFERENCES
29 Pancreas
ANATOMIC CONSIDERATIONS
Location and Relationship to Other Structures
Gross Anatomy
DEVELOPMENT
Organogenesis
Cytogenesis
Developmental Anomalies and Heterotopia
MICROSCOPIC FEATURES
Acini
Ducts
Islets of Langerhans
Extrainsular Neuroendocrine Cells
Connective Tissues
Cytologic Features
MINOR ALTERATIONS
Acinar Cells
Ductal Cells
Islet Cells
CHRONIC PANCREATITIS, ATROPHY, AND FIBROSIS
REFERENCES
SECTION VIII Hematopoietic System
30 Lymph Nodes
EMBRYOLOGY/DEVELOPMENTAL CHANGES
GROSS FEATURES
ANATOMY
Blood Supply
Lymphatics
LIGHT MICROSCOPY: THE DIFFERENT COMPARTMENTS, HISTOLOGY, AND FUNCTION
The Follicle
Follicular Dendritic Cells
Lymphoid Cells
Tingible Body Macrophages
The Medullary Cords
Lymphoid Cells
Macrophages
Other Cell Types
The Paracortex
Epitheloid (or Postcapillary or High Endothelial) Venules
Interdigitating Dendritic Cells
Lymphoid Cells
Other Cell Types
The Sinuses
Function
CHANGES IN COMPARTMENTS: BENIGN VERSUS MALIGNANT
Follicular Changes
Changes in the Medullary Cords
Changes in the Paracortex
Sinusoidal Changes
Combined Patterns
ARTIFACTS
Technical Artifacts
Intrinsic Artifacts
HANDLING OF LYMPH NODE SPECIMENS
SPECIAL TECHNIQUES AND PROCEDURES
REFERENCES
31 Spleen
INTRODUCTION
PRENATAL AND DEVELOPMENTAL CHANGES
APOPTOSIS
GROSS FEATURES/ORGAN WEIGHT
ANATOMY
Blood Supply
Nerves
Lymphatics
LIGHT MICROSCOPY
Vascular Tree
Red Pulp
White Pulp
Perifollicular Zone
FLOW CYTOMETRY
ULTRASTRUCTURE
FUNCTION
Filter Function
Immunologic Function
Hematopoiesis
Reservoir Function
AGING DIFFERENCES
DIFFERENTIAL DIAGNOSIS
SPECIMEN HANDLING
HISTOLOGIC TECHNIQUE
SPECIAL PROCEDURES
CONCLUSION
REFERENCES
32 Bone Marrow
TECHNIQUES FOR STUDYING THE MARROW
GENERAL FEATURES OF HEMATOPOIESIS
REGULATION OF HEMATOPOIESIS
HEMATOPOIESIS IN THE EMBRYO AND FETUS: DEVELOPMENT OF THE BONE MARROW
POSTNATAL CHANGES IN THE DISTRIBUTION OF RED MARROW AND IN THE TYPE OF HEMOGLOBIN
STRUCTURAL ORGANIZATION OF HEMATOPOIETIC MARROW
Blood Supply
Nerve Supply
Extracellular Matrix (Connective Tissue)
Stromal Cells
HEMATOPOIETIC CELLS
Neutrophil Precursors
Eosinophil and Basophil Precursors
Monocyte Precursors
Red Cell Precursors
Megakaryocytes
Lymphocytes and Plasma Cells
CELLULARITY OF THE MARROW
MARROW DIFFERENTIAL COUNT
REFERENCES
SECTION IX Genitourinary Tract
33 Kidney
INTRODUCTION
PEDIATRIC KIDNEY
KIDNEY DEVELOPMENT
EMBRYONIC KIDNEYS
Pronephros
Mesonephros
METANEPHROS
Overview
Formation of the Renal Pelvis and Calyces
Formation of the Collecting System
Nephron Formation
MOLECULAR REGULATION OF KIDNEY DEVELOPMENT
INTERMEDIATE MESODERM SPECIFICATION
NEPHRIC DUCT
URETERIC BUD FORMATION
URETERAL BRANCHING
Gdnf/Ret Signaling
Other Signaling Pathways
URETERIC BRANCH GROWTH
COLLECTING SYSTEM DIFFERENTIATION
Ureteral Tip and Trunk
Cell Types
METANEPHRIC MESENCHYME
Specification
Nephron Progenitor Population
PATTERNING OF THE NEPHRON
Early Events: Pretubular Aggregate and Renal Vesicle
Later Events: Proximal and Distal Tubules
INTERSTITIUM
GLOMERULOGENESIS
VASCULATURE
DEVELOPMENT OF THE JUXTAGLOMERULAR APPARATUS
GROSS ANATOMY
Kidney Position and Blood Supply
Kidney Weight and Configuration
Fetal Lobations
HISTOLOGY
CORTICAL ARCHITECTURE
NEPHRON NUMBER
GLOMERULAR MATURATION AND GROWTH
Early Juxtamedullary Glomeruli
Glomerulosclerosis in Infants
Ectopic Glomeruli
TUBULAR MATURATION AND GROWTH
ADULT KIDNEY
GROSS ANATOMY
NEPHRON
ARCHITECTURE
PARENCHYMA
GLOMERULUS
Overview
Endothelial Cells
Mesangial Cells
Glomerular Basement Membrane
Podocytes
Glomerular Filtration Barrier
Parietal Epithelial Cells
JUXTAGLOMERULAR APPARATUS
PROXIMAL TUBULE
THIN LIMBS OF HENLE LOOP
DISTAL TUBULE
Thick Ascending Limb
Distal Convoluted Tubule
CONNECTING TUBULE
COLLECTING DUCT
Cortical Collecting Duct
Outer Medullary Collecting Duct
Inner Medullary Collecting Duct
PAPILLARY SURFACE EPITHELIUM
INTERSTITIUM
VASCULATURE
LYMPHATICS
NERVES
ACKNOWLEDGMENTS
REFERENCES
34 Urinary Bladder, Ureter, and Renal Pelvis
EMBRYOLOGY
ANATOMICAL CONSIDERATIONS
Bladder
Ureters
Renal Pelvis
Microscopic Anatomy
Urothelium
Urothelial Variants and Benign Urothelial Proliferations
Lamina Propria
Muscularis Propria
REFERENCES
35 Prostate
EMBRYOLOGY AND DEVELOPMENT OF THE PROSTATE
GENERAL TOPOGRAPHIC RELATIONSHIPS: McNEAL’S ZONAL ANATOMY
SECTIONING OF RADICAL PROSTATECTOMY SPECIMENS
ANATOMY OF THE PROSTATE GLAND IN SURGICAL PATHOLOGY SPECIMENS
Gross Anatomy
Histologic Variation by Anatomic Region
Nonglandular Components of Prostatic and Extraprostatic Tissues
ARCHITECTURAL AND CYTOLOGIC FEATURES OF THE GLANDULAR PROSTATE
Architectural Patterns
Cytologic Features
DEVIATIONS FROM NORMAL HISTOLOGY
CONSIDERATIONS IN TRANSURETHRAL RESECTION AND NEEDLE BIOPSY SPECIMENS
ACKNOWLEDGMENT
REFERENCES
36 Testis and Excretory Duct System
SUPPORTING STRUCTURES
SEMINIFEROUS TUBULES
SERTOLI CELLS
GERM CELLS
INTERSTITIUM
LEYDIG CELLS
VASCULAR SUPPLY
FETAL AND PREPUBERTAL TESTIS
AGING TESTIS
RETE TESTIS
DUCTULI EFFERENTES
EPIDIDYMIS
DUCTUS (VAS) DEFERENS
SEMINAL VESICLES
EJACULATORY DUCTS
MESONEPHRIC AND MÜLLERIAN REMNANTS
GUBERNACULUM
REFERENCES
37 Penis and Distal Urethra
DISTAL PENIS
Glans
Coronal Sulcus
Foreskin
PROXIMAL PENIS (OR SHAFT)
DISTAL URETHRA
ARTERIES
VEINS
LYMPHATICS
NERVES
REFERENCES
SECTION X Female Genital System
38 Vulva
CLINICAL PERSPECTIVE
SPECIAL TECHNIQUES IN CLINICAL EVALUATION
ANATOMY
Vulvar Biopsy
Vulvar Vestibule
Urethral Orifice (Meatus Urinarius)
Hymen
Clitoris
Labia Minora
Labia Majora
Mons Pubis (Mons Veneris)
Lymphatic Drainage
Arterial Supply
Venous Supply
Nerve Supply
REFERENCES
39 Vagina
EMBRYOLOGIC DEVELOPMENT
GROSS FEATURES
ANATOMY
Ligaments
Blood Supply
Nerves
Lymphatic Drainage
LIGHT MICROSCOPY
Epithelium
Epithelial Responses and Functions
Vaginal Wall and Adventitia
ULTRASTRUCTURE
DIFFERENTIAL DIAGNOSIS AND SPECIAL ANATOMY
Wolffian Ducts
Paraurethral Glands (Skene Glands)
G-spot (Gräfenberg Spot)
Remnants of Mullerian Duct Epithelium (Adenosis)
ACKNOWLEDGMENTS
REFERENCES
40 Normal Histology of the Uterus and Fallopian Tubes
EMBRYOLOGY
THE INDIFFERENT STAGE
Female Differentiation
GROSS ANATOMY
Premenarchal Uterus and Fallopian Tubes
Adult Uterus and Fallopian Tubes
Gross Anatomic Features of the Uterus
Gross Anatomic Features of the Fallopian Tubes
Uterine and Tubal Vasculature
Uterine and Tubal Lymphatics
UTERINE CERVIX
Epithelium of the Exocervix
Epithelium of the Endocervix
Epithelium of the Transformation Zone
Cervical Stroma
Cervix During Pregnancy
ENDOMETRIUM
Tissue Sampling and Associated Problems
Histology of the Normal Endometrium
Relevance of Endometrial Dating to Diagnostic Surgical Pathologists
Endometrial–Myometrial Junction
Apoptosis and the Endometrium
MYOMETRIUM
Pregnancy-Related Changes
THE FALLOPIAN TUBE
Histology of the Fallopian Tube
Fallopian Tube in Pregnancy
Paraovarian and Paratubal Structures
REFERENCES
41 Ovary
EMBRYOLOGY
GROSS ANATOMY
Prepubertal Ovaries
Adult Ovaries
Postmenopausal Ovaries
BLOOD SUPPLY
LYMPHATICS
NERVE SUPPLY
SURFACE EPITHELIUM
Histology
Ultrastructure
STROMA
Histology
Ultrastructure
Hormonal Aspects
PRIMORDIAL FOLLICLES
Histology
Ultrastructure
MATURING FOLLICLES
Histology and Ultrastructure
Hormonal Aspects
CORPUS LUTEUM OF MENSTRUATION
Histology
Ultrastructure
Hormonal Aspects
CORPUS LUTEUM OF PREGNANCY
Gross Appearance
Histology
Ultrastructure
Hormonal Aspects
CORPUS ALBICANS
ATRETIC FOLLICLES
Histology
Hormonal Aspects
HILUS CELLS
Histology
Ultrastructure
Hormonal Aspects
RETE OVARII
REFERENCES
42 Placenta
ROUTINE STORAGE, EXAMINATION, AND PROCESSING
UMBILICAL CORD
Embryology
Gross Morphology
Histology
Histopathology
RAMIFICATION OF CHORIONIC VASCULATURE
PATHOLOGIC ALTERATIONS OF THE CHORIONIC VASCULATURE
MEMBRANES
Embryology
Amnion and Chorion
MULTIPLE GESTATION
VILLI
Embryology
Gross Morphology
Gross Morphologic Alterations
Histology
Histopathology
DECIDUA
Histology
Histopathology
GESTATIONAL TROPHOBLASTIC DISEASE
REFERENCES
SECTION XI Endocrine
43 Thyroid
EMBRYOLOGY
GROSS ANATOMY
MICROSCOPIC ANATOMY
FOLLICULAR CELLS
Immunohistochemistry
Physiology
Microscopic Variations
C CELLS
Histochemistry and Immunohistochemistry
Physiology
STROMA
Lymphocytes
Fibrous Tissue
Adipose Tissue and Skeletal Muscle
Calcifications
BRANCHIAL POUCH–DERIVED AND OTHER RELATED ECTOPIC TISSUES
Parathyroid Tissue
Thymic Tissue
Salivary Gland–type Tissue
Ectopic Cartilage
BENIGN THYROID TISSUE IN ABNORMAL LOCATIONS
Midline Structures
Pericapsular Soft Tissues and Skeletal Muscle
Lateral Neck
Thyroid Inclusions in Cervical Lymph Nodes
Other Sites
REFERENCES
44 Parathyroids
HISTORY AND NOMENCLATURE
DISTRIBUTION OF PARATHYROID GLANDS
EMBRYOLOGY
ANATOMY—GROSS FEATURES
HISTOLOGY AND ULTRASTRUCTURE
VARIATIONS WITH GENDER AND AGE
PHYSIOLOGY AND PATHOPHYSIOLOGY
SPECIAL PROCEDURES
ACKNOWLEDGMENTS
REFERENCES
45 Adrenal
ANATOMY
EVOLUTION
DEVELOPMENT
Cortex
Medulla
GLAND WEIGHT AND CORTICAL THICKNESS
ADRENAL GLANDS FOR HISTOLOGIC STUDY
Ideal Adrenal Glands
Adrenal Glands Studied
HISTOLOGY
Capsule
Cortex
Zona Glomerulosa
Zona Fasciculata
Zona Reticularis
Medulla
IMMUNOHISTOCHEMISTRY
Cortex
Medulla
ULTRASTRUCTURE
Cortex
Medulla
OTHER ANATOMICAL STRUCTURES
Blood Vessels
Arteries
Intraglandular Vasculature
Veins
Nerves and Ganglia
Lymphatics
Accessory (Heterotopic) Adrenal Cortex
Adrenocortical Nodules
REFERENCES
46 Neuroendocrine
HISTORICAL PERSPECTIVES AND NOMENCLATURE
EMBRYOLOGY
MOLECULAR ASPECTS OF NEUROENDOCRINE CELL DEVELOPMENT
LIGHT MICROSCOPY AND HISTOCHEMISTRY
ULTRASTRUCTURE
APOPTOSIS
FUNCTION OF NEUROENDOCRINE CELLS
MARKERS OF NEUROENDOCRINE CELLS
Cytosolic Constituents
Secretory Granule Constituents
Synaptic Vesicle and Vesicle Fusion/Release Constituents
Transcription Factors
Somatostatin Receptors
DISTRIBUTION OF NEUROENDOCRINE CELLS
Bronchopulmonary and Upper Respiratory System
Thyroid and Thymus
Skin
Breast
Gastrointestinal System
Urogenital System
AGING CHANGES
SPECIAL PROCEDURES
ARTIFACTS
DIFFERENTIAL DIAGNOSIS
SPECIMEN HANDLING
REFERENCES
47 Paraganglia
HISTORY AND NOMENCLATURE
SYMPATHETIC VERSUS PARASYMPATHETIC PARAGANGLIA: A CLINICOPATHOLOGIC PERSPECTIVE
DISTRIBUTION OF PARAGANGLIA
EMBRYOLOGY
POSTNATAL AND DEVELOPMENTAL CHANGES
PHENOTYPIC PLASTICITY
GROSS FEATURES AND ORGAN WEIGHTS
ANATOMY
LIGHT MICROSCOPY
Cell Types
Lobular Architecture of the Carotid Body
ULTRASTRUCTURE
FUNCTION
Physiologic Roles
Secretory Products
GENDER DIFFERENCES
AGING CHANGES
SPECIAL PROCEDURES
Immunohistochemistry
Immunohistochemical Artifacts
Other Special Procedures
DIFFERENTIAL DIAGNOSIS
ACKNOWLEDGMENTS
REFERENCES
Index