COURSE INQUIRY PROJECT: ACTIVITY 3

Huriyeh Agha Ali Maghazehi, Regina Mariae Agtarap, John Seth Lewis Andres,
Arriane Mae Antejendra, Rae Ann Elinor Avendaño, And John Orland Bantola
University of Santo Tomas, Sampaloc, Manila

SOME CONFUSION IN THE HISTOLOGY LABORATORY

1 Background of the Case
Alexis, a pre-nursing student, had some confusion during her Anatomy and Physiology
laboratory class. She had difficulty in using the microscope and in identifying tissues. Alexis
placed a slide labeled “simple columnar epithelium” onto the microscope stage and focused the
microscope with the lowest objective. To her dismay, the image shown in her Visual Anatomy and
Physiology module was different from what she saw under the microscope.

2 Questions
A. Explain the discrepancy.
The discrepancy that Alexis went through during her Anatomy and Physiology class was
the lack of knowledge in tissues and in the proper use of microscopes. She did not know that the
light micrograph image of the simple columnar tissue in her module was viewed in a 320-
magnification or high power objective, hence it was detailed in terms of its features. However,
Alexis used low power objective which is why she viewed her specimen differently. The image of
the tissue in her module was closer compared to how she saw the tissue.
B. If you were her lab partner, how would you help her?
If I were her lab partner, I would have the initiative to share my acquired knowledge and
skills regarding tissues and the proper use of microscopes. I would help her adjust the objective to
high power. Similarly, I would ask our professor for further assistance to resolve her problem.

CASE STUDY: BASAL CELL CARCINOMA

1 Background of the Case
A fisherman in his late sixties went to the clinic with what appears to be small and pink
bumps with sunken center. His chief complaint was identified to be small ulcers found on both of
his forearms, as well as on his face and ears (Fig. 1). He mentioned that he has had them for several
years already; however, he never experienced complication until now.

Figure 1. Small ulcers on forearm, face, and ears [1][2][3]

2 Diagnosis
All of the signs examined in the patient could be attributed to Basal Cell Carcinoma (BCC).
BBC is the most common type of skin cancer [4]. It appears as a change in skin, such as bump or
sore. It looks like an open sore, red patch, pink or shiny bumps, with slightly elevated edges and
central indentation. BCC usually arises in sun-exposed areas of the body, such as forearm, face,
and ears [5]. All of the mentioned characteristics of BCC can be seen in the patient.

3 Cause and Contributing Factors

A type of Non-melanoma Skin Cancer called Basal Cell Carcinoma (BCC) happens when
the DNA on the basal cells of the skin mutates, and in the case of the fisherman, mutated on other
sites as well as there is an abundance of it on most parts of his skin. As a background, basal cells
located in the epidermis are responsible for the continuous generation of skin cells that push and
reach upwards until they die and get exfoliated [6]. In this case, the mutated DNA of his skin’s
basal cells prompted the rapid multiplication and growth of cells in the upper strata, forming
cancerous tumors (i.e. the small “ulcers” found on the fisherman’s skin). Principally, the greatest
factor that played a role in his condition is his frequent and constant exposure to the sun as he
fishes. Basal carcinoma is triggered by exposure to Ultraviolet radiation from sunlight [6].
Mayo Clinic added, other factors may include the fisherman’s age. BCC is commonly seen
in older people because 80% of it is caused by cumulative sun exposure, and this is generally since
that this cancer develops in a slow pace. On the face, BCC usually appears as an innocent-looking
papule on sun-exposed areas like the face with rolled borders and fine blood vessels
(telangiectasias) which bleeds easily and doesn’t completely heal. Assuming the fisherman is a
Filipino, the pigmented variant (pigmented BCC) is more common among them, appearing as a
black papule with crust which doesn’t heal over time [7]. Generally not a deadly type of skin cancer,
BCC hardly metastasizes (spreads beyond the original site); however, if not treated either
surgically or under radiation therapy, it may subsequently cause local destruction and deformation
on the skin, connective tissues, or in some cases, on the bones [8].

4 References
[1] Skin Cancer in Irish Air Corps personnel – Basal Cell Carcinoma [Picture] (2017). Retrieved
from http://www.accas.info/?tag=basal-cell-carcinoma
[2] Williams, H., Bath-Hextall, F., Ozolins, M., … Miller, P. (2017). Surgery versus 5%
imiquimod for nodular and superficial basal cell carcinoma: 5-year results of the SINS
randomized controlled trial [Picture] . Journal of Investigative Dermatology, 137(3),
614-619. doi: https://doi.org/10.1016/j.jid.2016.10.019
[3] Kutlubay, Z. (2011). Superficial spreading basal cell carcinoma located on ears [Picture].
Retrieved from https://www.researchgate.net/figure/Superficial-spreading-basal-cell-
carcinoma-located-on-ears_fig2_221921390
[4] Roiger, D. & Bullock, N. (2019). Anatomy, Physiology, and Disease: Foundations for the
Health Professions. New York, NY: McGraw Hill Education.
[5] Karen, J. & Moy, R. (2019). Basal cell carcinoma. Retrieved from
https://www.skincancer.org/skin-cancer-information/basal-cell-carcinoma/#bcc
[6] Mayo Clinic. (2018). Basal cell carcinoma. Retrieved from:
https://www.mayoclinic.org/diseases-conditions/basal-cell-carcinoma/symptoms-
causes/syc-20354187
[7] St. Luke’s Medical Center. (2017). A closer look at skin cancer. Retrieved from:
https://www.stlukes.com.ph/health-library/health-articles/a-closer-look-at-skin-cancer
[8] American Academy of Dermatology. (2016). Basal cell carcinoma: Overview. Retrieved
from: https://www.aad.org/public/diseases/skin-cancer/basal-cell-carcinoma
CONCEPT MAP