Evaluation: Difference between revisions

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==Microscopy settings==

[[File:Parts of a light microscope (english) - larger text.png|thumb|300px|Usual parts of a microscope.]]

If only one eye piece has adjustable '''focus''', you generally raise or lower the stage until you are in focus on the non-adjustable eyepiece, and then adjust the other eyepiece. {{Memorization-worthy}} With objectives that are close to the microscope slide, start focusing from what you know is a lower stage level, and slowly raise it from there, to avoid colliding with the objective and potentially damaging the slide.

<noinclude>Low magnification has a greater span of focus compared to high magnification, so it is normal to need to re-focus if you're switching to a higher magnification objective. However, if you find that you need to '''change focus''' even if going from high to low magnification, try the following (if you can adjust the eye piece):

#Use high magnification and focus on a specimen using the main focus knob.

#Switch to low magnification, and focus using the eye piece adjustment.</noinclude>

===Condenser===

Generally the '''condenser''' is placed in its highest position or just slightly lower. At low magnification objectives (mainly 4x and 10x objectives), the opening of the condenser (or iris) diaphragm should be wide open. This corresponds to turning away or "lowering" the condenser on microscopes where the condenser apparatus can be turned to the side (and is shown as "without condenser" in images below). For high-dry (40x) and oil-immersion objectives (100x), the diaphragm should be closed slowly while looking at a sharply focused section until the level of illumination is just slightly reduced, in order to attain optimal contrast and resolution (and corresponds to "with condenser" in images below).<ref>{{cite web|url=https://histologylab.ctl.columbia.edu/HistologyLabManual.pdf|title=Histology Laboratory Manual, Vagelos College of Physicians & Surgeons Columbia University|author=Patrice F Spitalnik|accessdate=2021-09-20}}</ref>

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</gallery>

Low magnification has a greater span of focus compared to high magnification, so it is normal to need to focus if you're increasing magnification.<noinclude> However, if you find that you need to '''change focus''' even if going from high to low magnification, try the following (if you can adjust the eye piece):

~~#Use high magnification and focus on a specimen using the main focus knob.~~

~~#Switch to low magnification, and focus using the eye piece adjustment.</noinclude>~~

If there's a '''constant visual artifact''', even after you've cleaned the eye piece and objective lenses with lens tissue, try raising or lowering the condenser if you can, and the artifact may disappear out of focus.

</noinclude>

==Priority==

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*Try to pick up glass slides '''without touching''' the tissue area, as fingerprints may interfere with the evaluation.

*Look at each microscopy slide by plain '''eye''', to plan the microscopy scanning so as to not miss peripheral fragments.

*Have a '''systematic direction''' of scanning through microscopy slides, such as from top left to bottom right as seen in the microscope. When the microscope makes what you see two-way mirrored, the starting position is with the objective pointing at the bottom right of the glass slide. You may center on findings on interest and evaluate them at higher magnification, and then resume the scanning

*Have a '''systematic direction''' of scanning through microscopy slides, such as from top left to bottom right as seen in the microscope. When the microscope makes what you see two-way mirrored, the starting position is with the objective pointing at the bottom right of the glass slide. You may center on findings on interest and evaluate them at higher magnification, and then resume the scanning.

File:Position of objective (edited).jpg|Example starting position of objective.

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File:Histology of deep zone of articular cartilage.jpg|'''Hyaline''' usually refers to extracellular material that stains homogeneously pink on H&E stain (like the matrix of hyaline cartilage, pictured).

File:Histopathology of hyaline membranes in diffuse alveolar damage.jpg|Example of hyaline material (in alveoli of lungs, indicating diffuse alveolar damage)

File:Glass for pathologist.png|~~Hence, this~~ is what pathologists also refer to as "glassy" (because hyaline cartilage looks like glass grossly).

File:Glass for pathologist.png|This is what pathologists also refer to as "glassy" (because hyaline cartilage looks like glass grossly).

</gallery>

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==Marking slides==

The main indications for marking slides are hard-to-see findings on a slide, and/or to distinguish one slide out of many. Just make a figure rather than a word if you are not sure what it is, as it might be confusing for reviewers if the pathology report ends up being something different.

File:Photograph of marking a microscopy slide.jpg|To mark a microscopy slide, use an objective that gives you enough space underneath. Rest a finger on the stage, while holding the marker pen relatively close to its tip. Move the tip of the marker pen into the field of view but at least a few millimeters from the slide...

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{{further|Cytology}}</noinclude>

==Consideration==

Consider the '''adequacy''' of the specimen. Have a somewhat lower threshold to make a report of "inadequate" or "insufficient" if it is easy to resample from the patient, such as remaining diagnostic tissue at a superficial location.

First, generally suspect the '''common conditions''' for the location at hand. A less common variant of a common condition is often still more likely than a rare condition, so generally call the latter only if it really fits the picture.

@@ Line 6: / Line 6: @@
 ==Microscopy settings==
 [[File:Parts of a light microscope (english) - larger text.png|thumb|300px|Usual parts of a microscope.]]
+If only one eye piece has adjustable '''focus''', you generally raise or lower the stage until you are in focus on the non-adjustable eyepiece, and then adjust the other eyepiece. {{Memorization-worthy}} With objectives that are close to the microscope slide, start focusing from what you know is a lower stage level, and slowly raise it from there, to avoid colliding with the objective and potentially damaging the slide.
+<noinclude>Low magnification has a greater span of focus compared to high magnification, so it is normal to need to re-focus if you're switching to a higher magnification objective. However, if you find that you need to '''change focus''' even if going from high to low magnification, try the following (if you can adjust the eye piece):
+#Use high magnification and focus on a specimen using the main focus knob.
+#Switch to low magnification, and focus using the eye piece adjustment.</noinclude>
+===Condenser===
 Generally the '''condenser''' is placed in its highest position or just slightly lower. At low magnification objectives (mainly 4x and 10x objectives), the opening of the condenser (or iris) diaphragm should be wide open. This corresponds to turning away or "lowering" the condenser on microscopes where the condenser apparatus can be turned to the side (and is shown as "without condenser" in images below). For high-dry (40x) and oil-immersion objectives (100x), the diaphragm should be closed slowly while looking at a sharply focused section until the level of illumination is just slightly reduced, in order to attain optimal contrast and resolution (and corresponds to "with condenser" in images below).<ref>{{cite web|url=https://histologylab.ctl.columbia.edu/HistologyLabManual.pdf|title=Histology Laboratory Manual, Vagelos College of Physicians & Surgeons Columbia University|author=Patrice F Spitalnik|accessdate=2021-09-20}}</ref>
 <gallery mode=packed heights=200>
@@ Line 13: / Line 19: @@
 </gallery>
-Low magnification has a greater span of focus compared to high magnification, so it is normal to need to focus if you're increasing magnification.<noinclude> However, if you find that you need to '''change focus''' even if going from high to low magnification, try the following (if you can adjust the eye piece):
-#Use high magnification and focus on a specimen using the main focus knob.
-#Switch to low magnification, and focus using the eye piece adjustment.</noinclude>
 If there's a '''constant visual artifact''', even after you've cleaned the eye piece and objective lenses with lens tissue, try raising or lowering the condenser if you can, and the artifact may disappear out of focus.
+</noinclude>
 ==Priority==
@@ Line 32: / Line 36: @@
 *Try to pick up glass slides '''without touching''' the tissue area, as fingerprints may interfere with the evaluation.
 *Look at each microscopy slide by plain '''eye''', to plan the microscopy scanning so as to not miss peripheral fragments.
-*Have a '''systematic direction''' of scanning through microscopy slides, such as from top left to bottom right as seen in the microscope. When the microscope makes what you see two-way mirrored, the starting position is with the objective pointing at the bottom right of the glass slide. You may center on findings on interest and evaluate them at higher magnification, and then resume the scanning
+*Have a '''systematic direction''' of scanning through microscopy slides, such as from top left to bottom right as seen in the microscope. When the microscope makes what you see two-way mirrored, the starting position is with the objective pointing at the bottom right of the glass slide. You may center on findings on interest and evaluate them at higher magnification, and then resume the scanning.
 <gallery mode=packed heights=140px>
 File:Position of objective (edited).jpg|Example starting position of objective.
@@ Line 94: / Line 98: @@
 File:Histology of deep zone of articular cartilage.jpg|'''Hyaline''' usually refers to extracellular material that stains homogeneously pink on H&E stain (like the matrix of hyaline cartilage, pictured).
 File:Histopathology of hyaline membranes in diffuse alveolar damage.jpg|Example of hyaline material (in alveoli of lungs, indicating diffuse alveolar damage)
-File:Glass for pathologist.png|Hence, this is what pathologists also refer to as "glassy" (because hyaline cartilage looks like glass grossly).
+File:Glass for pathologist.png|This is what pathologists also refer to as "glassy" (because hyaline cartilage looks like glass grossly).
 </gallery>
@@ Line 105: / Line 109: @@
 ==Marking slides==
+The main indications for marking slides are hard-to-see findings on a slide, and/or to distinguish one slide out of many. Just make a figure rather than a word if you are not sure what it is, as it might be confusing for reviewers if the pathology report ends up being something different.
 <gallery mode=packed heights=140>
 File:Photograph of marking a microscopy slide.jpg|To mark a microscopy slide, use an objective that gives you enough space underneath. Rest a finger on the stage, while holding the marker pen relatively close to its tip. Move the tip of the marker pen into the field of view but at least a few millimeters from the slide...
@@ Line 230: / Line 235: @@
 {{further|Cytology}}</noinclude>
 ==Consideration==
+Consider the '''adequacy''' of the specimen. Have a somewhat lower threshold to make a report of "inadequate" or "insufficient" if it is easy to resample from the patient, such as remaining diagnostic tissue at a superficial location.
 First, generally suspect the '''common conditions''' for the location at hand. A less common variant of a common condition is often still more likely than a rare condition, so generally call the latter only if it really fits the picture.

Evaluation: Difference between revisions

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