Discuss the role of the teaching medical museum in undergraduateand postgraduate education.

Making the Link – Macro specimens and Histopathology (Group Work)
Learning outcomes
At the end of this session you will be able to
1. Discuss the role of the teaching medical museum in undergraduateand
postgraduate education.
2. Outline the history behind, and application of, the Human Tissue Act
(2004).
3. Use simple examples of the language of pathology.
4. Explain the relationship between your knowledge of histopathology and the
cognate lesions or structural changes observed in museum specimens.
Introduction
As part of this module, we have organised sessions to be held in the Gordon Museum
of Pathology, hosted by the Curator, Mr Bill Edwards.
This is very much a student-centred exercise where we provide you with a learning
environment. Here you will be able to explore selected specimens in the museum’s
collection.
Typically, the majority of histological specimens seen by pathologists and biomedical
scientists will arrive in specimen reception in pots full of fixative. Therefore, the
description of these specimens will be of them in their fixed, rather than fresh, state.
The specimens in the museum have also been fixed, so you will be seeing them in a
similar state to that seen at the cut-up bench.
In the Histopathology department, the specimens must be “described” before they
are prepared for processing to sections on glass slides. These descriptions are
dictated by the pathologist and tend to be precise and concise so that information on
the appearance of the specimens can be reviewed and understood by any
pathologist interpreting the slides in the reporting tray.
Here is an example:
SPECIMEN(S) RECEIVED
Right breast excision
CLINICAL DATA
20mm right breast microcalcification B3 on biopsy
MACROSCOPIC DESCRIPTION
Pot labelled [patient’s name]. Right breast excision biopsy wide local: A fibrofatty tissue
fragment measuring superior to interior 23mm medial tolateral 22mm and anterior to posterior
25mm. The wire is passing near the short stitch attached superiorly. Specimen is sliced into
four slices, slice 1 being lateral most guide wire is passing through slice 2.
Block 1: Slice 1 lateral resection margin cruciates.
Block 2: Slice 2.
Block 3: Slice 3.
Block 4: Medial resection margin cruciate. No tissue remains.
SP3: 09 February 2018
Biomedical scientists mostly assist the pathologist at cut-up and will therefore need to
have some understanding of the descriptive language used. Some biomedical
scientists progress their careers by undertaking additional formal training in dissection
so that they can take on the role of the pathologist at cut-up for simple specimens.
In your groups, you should use your knowledge and understanding of anatomy,
histology and pathology to help you recognise and explain the presentations of the
various diseases on display. Every display specimen (or “pot”) has a code number
that links to a short description to be found in the relevant folder on the gallery sills.
You should also have copies of your histology and histopathology text books within
your groups.
Once you begin to study these pots, you will be faced with the challenge of describing
what you can see. Why is this? How many different words can your group use to
describe the specimens? Is your vocabulary up to the task?
Assignment for your group’s ePortfolio
By now, you will be beginning to appreciate how important the language of pathology
is for describing macroscopic and microscopic specimens. We do not expect you to
be experts at anatomical description as this takes many hours of practical experience.
Nonetheless, by the end of the session you should be able to provide basic
descriptions at a macroscopic level, with the aid of drawings (photography is
prohibited in the museum), of either one neoplastic or one non-neoplastic
disease of your choice. Where possible, support your descriptions with a description
of the underlying histology at the microscopic level. These descriptions should be
uploaded to your group’s ePortfolio as a short one-page document and accompanied
by labelled histological slide images (derived from images available through WSB,
your SP1/SP2 sessions or other relevant sources) describing the underlying
histopathology. You may also consider sunstituting the written work with a two minute
Explain Everything video, not filmed in the Museum.
Programme
15:20 Leave the University for the Gordon Museum (please request leaving
earlier if there are mobility issues)
15:50 Meet in the foyer of the Hodgkin Building. Please assemble quietly and
respect other users of the building
16:00 Short introduction to the museum by the museum’s curator, Mr Bill
Edwards. This will be followed by your pursuit of the activities
outlined below.
17:00 “Medical Museums” by Mr Bill Edwards
This lecture explores the purpose, history and development of Human
Specimen Collections and Museums. Looking at the philosophical and legal
changes and the societal and educative implications of such collections,
moving from pre-history to the “lawlessness” of the 18th and 19th centuries.
Also looking at the move from the old Anatomy Act and Human Tissue Act
to the Modern Human Tissue Bill.
There will be examples of different specimen collections from around the
world, many created during the last four hundred years, and compares and
contrasts the various approaches to the preservation and use of Human
Material. Finally trying to divine the future, if any, of such collections.
18:00 End of scheduled session
SP3: 09 February 2018
Student-Centred Activity in the Gordon Museum
We have decided to run this session in the Gordon Museum as it presents us with a
fantastic and rare opportunity to show you a huge range of macroscopic pathology
with histopathological correlation in the context of the module. It will make such a
difference to your understanding and appreciation of the pathologies that we cover in
the module. The guidance below suggests a focused route through the collection.
This will also ensure that you are not all crowding around one area. If you cannot get
to your target area, then explore what else is available to you, following your own
curiosity and interest.
If you are unable to attend the session, then please use Westminster Slide Box to
explore the histological slides available to you on the day and discuss the learning
outcomes with the other members of your group when you next meet them.
Exam Pots
1. Liver
HB68 – chronic active hepatitis
HB94 – micronodular cirrhosis
ACTION FOCUS: Compare and contrast HB94 and HB68
2. Lung
R75 – Healed post-primary TB
R124 – Emphysema
R201
ACTION FOCUS: Explain the gross appearance of the TB-affected lung
based on your understanding of its histopathology.
3. Breast
B1, B2 – Fibrocystic disease of the breast
Q: What is apocrine metaplasisa?
Case note: “A conservative removal was effected and recovery
followed.”
Q: What is meant by the term ‘conservative’ mean and why itis
important?
B17 – Tuberculous mastitis
Case Note: ‘Mastectomy’
Q: Is this the the normal procedure for breast lumps? (Note the year,
1937.)
B18
B28 – Fibroadenoma
B37 – Multiple Fibroadenomata
B53 – Fibrotic reaction to implant (fibrosis)
B58 – Male mammary carcinoma
SP3: 09 February 2018
B69 – Carcinoma
B71- Demonstrating peau d’orange
B75 – Fungating (exophytic) carcinoma
B78 – Advanced stage breast carcinoma
ACTION FOCUS: Compare and contrast the appearance of B2 and B78
4. Prostate
U485, U486, U486B – examples of an enlarged prostate and the
consequences to the bladder of an obstructed urethra.
ACTION FOCUS: Discuss how hyperplasia of one organ (prostate) can have
indirect compensatory effects on another (bladder).
5. Gut
A436 – appendicitis
A685 – ulcerative colitis
A670 – Crohn’s disease
ACTION FOCUS: Choose one of these and relate the macroscopic
appearance to the underlying histopathology.
A518 – Familial adenomatous polyposis
A543 – colonic adenocarcinoma
ACTION FOCUS: Choose one of these and relate the macroscopic
appearance to the underlying histopathology.
6. Kidney
Look at the models demonstrating the organisation of the blood vessels in the
kidney. It is worth also looking at the congenital disorders of the kidney.
U156 – acute pyelonephritis – note the pale tan streaks, what are they?
U254 – transitional cell carcinoma of the renal pelvis. Look at thecommentary
and clinical history and review your level 5 Applied Pathophysiology case
study.
ACTION FOCUS: Relate the macroscopic appearance of U156 to the
underlying histopathology.
7. Cervix
CG97 – squamous cell carcinoma of the cervix (do not mistake the fibroid
(high and left) for the tumour.
There are another of other similar examples on display of tumours affecting
the vagina, cervix, uterus and ovaries. We will only be looking at thecytology
of potentially malignant lesions in the module, so it is worth looking at the
endpoint of cervical cancer in particular.
ACTION FOCUS: Describe the macroscopic appearance of a named cervical
cancer specimen.
SP3: 09 February 2018
8. Lymphoreticular System
LR96 – Non-Hodgkin lymphoma
LR108 – Hodgkin lymphoma
ACTION FOCUS: These tumours look very similar macroscopically. How can
they be differentiated microscopically?

 

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