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Current time:0:00Total duration:5:27

Video transcript

this is Sal here and I'm at Stanford Medical School with dr. Andy Connolly was a pathologist year and this is the second in our series on looking at some of these slides yeah so we left off last time so I'm looking at this piece here which is normal colon we had said this is an example of what you'd see it at the edge of a specimen Richard rollin cancer now I'm going to click to the next one which is slightly more worrisome areas yes your pathologists looking through the colon and so I'm going to zoom in just a little bit here to take a look at these looks very worrisome compared to the last one and so what we don't like about it is we saw before this is what the normal gland right right it's a test tube shape and goes down and it has these cells which are normal now all of a sudden it looks a little thicker here and what catches our eye also these aren't just straight test tubes and right right they divide they kind of go in and out like that right so but they still are test tubes I did following up what we said in the last video is that they just look like circles as opposed to test tubes because we're taking a cross-section because they're kind of popping out of that out of the two dimension that's right but although when you come from the surface here and you go down or either they normally should never branch I see so these ones are branches and that's always bad right and then you can see the way when your cross putting a cross section there's normally just a little hole in the middle right and that's where the mucin you can see even see it spilling out Wow Wow so you can see it just kind of coming right out of there this one here looks different and what it is it's piled up right and so it's a little bit bigger around and in order for these cells there's you know more cells they're going to be all piled up and going like this and they even branch and so what this is is that we look a little more closely at this piece and we say hmmm I wonder if that's cancer could it be pre cancer or just just an area of irritation and a common response of the body right to irritation is some sort of change right and like we were saying before epithelium right is the top layer right right and so if it's missing the outside world basically outside world so it's irritated often the epithelium will change in this case it's changing by under growing more growth is it always even if it's not cancer like it's going to be a higher likelihood that's going to become cancerous in the future a lot of cancers it appears in the body come from parts of the body that are either irritated or have some sort of environmental challenges like constantly at them and part of that is because there's a lot of cell division I say if you keep dividing a cell you might have error either so that's why skin cells bowel cells that's right and even things like liver if you keep damaging your liver you might have on doing things in liver cancer right so when you're looking here we would the pathologist would look at this area and say well it's a dividing gland that's kind of thrown up in these areas but largely they're still making mucin or they're this type here which looks like it's tall and probably absorbing water I see so even within these test tubes there are these well not really test tubes but inside of these vessels there are also the still the absorbs the absorptive cells as well that's right so so here this is we would sign this off as hyperplasia hyperplasia so hyper like too much of something yep and then pleasure growth growth I see and so pleasure just means growth and so hyper pleasure means too much growth but the important thing is if you took away the irritant or I wouldn't do this I see so if you took away whatever the irritant is for the hyperplasia it would go back to being normal I see I see and this is something we know that that's right and there's some stimulus that was causing this this these cells to do that it might even die it might have been some chemical that could have been yeah we're never really sure what and because so much of it is things that just float on through I come through so it's really hard to to know but yeah this is probably too much growth eye response too so it's possible that you know it just happened to be when this dissection of the cold was taken out if this was done a day later maybe then maybe this might have not been there yeah probably take a longer than a couple couple weeks a couple of weeks but what happens is that the cells come from the bottom and they worked their way up towards the top ice eventually the top with ice it behaved and so the way the body works here it's kind of like the skin is use this as constant these cells are being used up because things have been kind of scraping by them and and they had a lot of kind of use they do in fact a constant stream there's a lot known out about stem cells and the stem cells for the intestine are these guys oh wow so you had a different sheet this there's there's a at the very bottom the bottom hemisphere there are going to be cells there that do not have the open chromatin I kind of elongated there may be ones which are endocrine cells right meaning they release hormones right and so they may have hormone releasing cells but in this bottom hemisphere right that turns out to be where the intestine keeps them and these guys are probably these just as a stem cells are under front cells that haven't kind of picked their jobs yet they haven't and so there's all kinds of stem cells there's the stem cell that can make a whole body being exactly but then there's also the kind that can make the rest of the cult I see right so this one is probably the stem cell that can make the rest of the epithelium right there are two different kinds or two different types right yeah so they're down here at the bottom that's about where you'd want it exactly sorry right right so so that makes sense so down there are your stem cells and it grows like that so this is a hyperplasia Wow so I'd like to show you next the next step which is the pre cancer lesion okay do that in another video this is in another video okay