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Course: Health and medicine > Unit 10
Lesson 5: Colon diseasesHyperplasia in colon tissue
Dr. Andy Connolly from Stanford Medical School shows Sal what hyperplasia in colon tissue looks like. Created by Sal Khan.
Want to join the conversation?
- What's the difference between hyperplasia and cancer?(1 vote)
- hyperplasia is cell division
cancer is uncontrolled cell division(3 votes)
- Not sure I caught this or not, but hyperplasia related to what? foreign objects? undigestible food? disease?(2 votes)
- different stimuli that would cause cell growth. it could be what you ingest: their texture irritates the intestines more than usual. it could be the chemicals in what you ingest: the cells get irritated by some specific chemical in a certain food.
a previous disease that caused a lot of stress on the tract such as one that caused diarrhea could also make cells divide more to compensate.(1 vote)
- Wait a sec... what is the really dark hole at the colon during the fit screening parts?(2 votes)
- How to read ecg(1 vote)
- Is it possible to misdiagnose cancerous tissue due to a poor cross-sectional field of view?(4 votes)
- What are the three possible diagnosis of the abnormal growth?(1 vote)
- in some cases Cryocauterization- a method in which cells are exposed to extreme cold, is used.
laser therapies are also quite common.(1 vote)
- I'm not sure whether I interpreted this correctly, and it's not directly related, but are there different types of stem cells?(1 vote)
- At3:24,how does sal go from x/2 to x/4?(1 vote)
- how dose hyperplasia grow(1 vote)
- it can be a protective mechanism of the body in response to an irritant - for example, a repeated exposure to a chemical - or repeated trauma - like the skin on your heels is thicker than the skin on the inside of your forearm, or like people who play guitar have calluses on their fingers.
It can also be a pathological process where the mechanisms that would normally control how thick a particular cell layer is become disordered(0 votes)
- what's in the colon and what's makes the cancer????? CAN YOU HELP ME?!(0 votes)
- The colon is the organ that basically is the last stop in the digestive system. It digests and moves the waste along for its last stage! What causes cancer is when damaged cells divide uncontrollably to form lumps or masses of tissue called tumors. Although this is different in the case of Leukemia where cancer prohibits normal blood function by abnormal cell division in the blood stream!(1 vote)
Video transcript
SAL KHAN: This is Sal here. And I'm at Stanford
Medical School with Dr. Andy Connolly,
who's a pathologist here. And this is the
second in our series on looking at some
of these slides. ANDY CONNOLLY: Yeah. So we left off last time,
Sal, looking at this piece here, which is normal colon. We had said this is an
example of what you'd see at the edge of a specimen
released for colon cancer. Now I'm going to click
to the next one, which is a slightly more
worrisome area if you're a pathologist looking
through the colon. And so I'm going to zoom
in just a little bit here to take a look at these. SAL KHAN: Looks very worrisome
compared to the last one. ANDY CONNOLLY: And
so what we don't like about it is
we saw before this is what the normal
gland looks like. It's a test tube
shape and 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 is these aren't just straight test tubes anymore. They divide. They kind of go in
and out like that. SAL KHAN: But they
still are test tubes. 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 the two dimensions. ANDY CONNOLLY: That's right. But although, when you
come from the surface here and you go down, they
normally should never branch. SAL KHAN: I see. ANDY CONNOLLY: And so
these ones are branching, and that's always bad. And then you can
see the way-- when you're putting a
cross-section, there's normally just a little
hole in the middle. And that's where the
mucin-- you can even see it spilling out there. SAL KHAN: Wow. You can. ANDY CONNOLLY: 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. And so it's a little
bit bigger around. And in order for these
cells, 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, hmm, I
wonder if that's cancer. Could it be pre-cancer,
or is this just an area of irritation? And a common response of
the body to irritation is some sort of change. And like we were saying before,
epithelium is the top layer. SAL KHAN: Right, right. The stuff that's facing
the outside world. ANDY CONNOLLY: Facing
the outside world. So if it's irritated, often
the epithelium will change. And in this case, it's changing
by undergoing more growth. SAL KHAN: Is it always--
even if it's non-cancerous, is it going to be a higher
likelihood that it's going to become
cancerous in the future? ANDY CONNOLLY: 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 that are constantly at them. And part of that is because
there's a lot of cell division. SAL KHAN: I see. ANDY CONNOLLY: If you
keep dividing a cell, you might have
errors in the DNA. SAL KHAN: So that's why
skin cells, bowel cells-- ANDY CONNOLLY: That's right. And even things like liver. If you keep damaging
your liver, you might have ongoing
things and liver cancer. So when you're looking
here, 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. SAL KHAN: I see. So even within these
test tubes-- well, they're not really test tubes. But inside of these
vessels, there are also still the
absorptive cells as well. ANDY CONNOLLY: That's right. So here, we would sign
this off as hyperplasia. SAL KHAN: Hyperplasia. So hyper, like too
much of something. ANDY CONNOLLY: Yes. SAL KHAN: And plasia? ANDY CONNOLLY: Growth. SAL KHAN: See. ANDY CONNOLLY: And so
plasia just means growth. And so hyperplasia
means too much growth. But the important thing is if
you took away the irritant, it wouldn't do this. SAL KHAN: I see. ANDY CONNOLLY: So
if you took away whatever the irritant
is for the hyperplasia, it would go back
to being normal. SAL KHAN: I see. I see. And that's just
something we know. ANDY CONNOLLY: That's right. SAL KHAN: There's
some stimulus that was causing these
cells to do that. It might have been diet,
might have been some chemical. It could have been just-- ANDY CONNOLLY: We're
never really sure what, because so
much of it is things that just float on through. So it's really hard to know. But, yeah, this is probably
too much growth in response to an irritant. SAL KHAN: So it's
possible that it just happened to be when this section
of the colon was taken out. If this was done
a day later maybe, then maybe this might
have not been there? ANDY CONNOLLY: Yeah, probably
take longer than that. A couple weeks. SAL KHAN: A couple
weeks, but it's-- ANDY CONNOLLY:
Because what happens is that the cells
come from the bottom, and they work their
way up towards the top. And so eventually the
top would behave-- SAL KHAN: And so the way
the body works here-- and it's kind of like the
skin-- is this as constant. These cells are being
used up, because things are kind of scraping by them. And they get a lot of use. ANDY CONNOLLY: They do. And in fact, there's a lot
known now about stem cells. And the stem cells for the
intestine are these guys. SAL KHAN: Oh, wow. So how do you differentiate
the stem cell versus-- ANDY CONNOLLY: At the very
bottom, the bottom hemisphere, there are going
to be cells there that do not have
the open chromatin and kind of elongated. SAL KHAN: I see. ANDY CONNOLLY: There
may be ones which are endocrine cells, meaning
they release hormones. And so they may have
hormone-releasing cells. But in this bottom
hemisphere, that turns out to be where
the intestine keeps them. And these guys are
probably the stem cells. SAL KHAN: And stem
cells are cells that haven't picked
their jobs yet. ANDY CONNOLLY: They
haven't, and so there's all kinds of stem cells. There's the stem cell that
can make a whole body, being. But then there's
also the kind that can make the rest of the colon. SAL KHAN: I see. ANDY CONNOLLY: And so
this one is probably the stem cell they can make
the rest of the epithelium, but these two different kinds. SAL KHAN: The two
different types, right. ANDY CONNOLLY: So they're
down here at the bottom. That's about where
you'd want them. SAL KHAN: Exactly. Right. ANDY CONNOLLY: So
that makes sense. So down there are your stem
cells, and it grows like that. So this is a hyperplasia. So I'd like to show you
next the next step, which is a pre-cancer legion. Should we do that
in another videos? SAL KHAN: Yeah. Let's do that in another video.