Deciphering the Intricacies of Intraductal Papillary Lesions: A Clinical Case Study

Medical mysteries often lead us to explore the depths of human health, unraveling the complexities that lie beneath seemingly ordinary symptoms. In this context, we delve into the intriguing case of a 50-year-old female patient who sought medical attention at a clinic due to a short-term right blood clotting issue. The subsequent investigation and analysis provided fascinating insights into the world of cytology and pathology, shedding light on the diagnostic challenges posed by intraductal papillary lesions.

Upon meticulous cytological study, a multifaceted tapestry emerged. Within a serous background, intricate formations of papillary groups captured the attention of the medical team. These groups exhibited a distinctive round shape, accompanied by a central nucleus, characterized by rough chromatin. The variability in cytoplasm density added another layer of complexity, as occasional peripheral microvacuolization was observed. A subset of these formations showcased a moruliform phenotype, further deepening the intrigue. The culmination of these observations led to the preliminary diagnosis of an intraductal papillary lesion.

Fig 1.- Pap Stains x 400 | Motic Panthera DL

Image Credit: Javier Torres

The journey of diagnosis did not stop at cytology; it extended into the realm of histology through surgical excision. The results of this surgical exploration uncovered a crucial piece of the puzzle – the presence of an intraductal papilloma. The juxtaposition of cytological and histological findings underscored the intricate nature of these lesions, and highlighted the importance of a multidisciplinary approach in unraveling their mysteries.

Fig 2.- Pap Stains x 400 | Motic Panthera DL

Image Credit: Javier Torres

Yet, the path towards a conclusive diagnosis was not straightforward. The diagnostic spectrum encompassed two distinct entities – papilloma and papillary carcinoma. The fine line between these entities blurred the boundaries of differentiation, complicating the diagnostic process. Despite the meticulous cytological examination, the certainty of differentiation remained elusive. This conundrum emphasized the need for a histological diagnosis, which holds true even in the presence of cellular atypia.

Fig 3 - Pap Stains x 400 | Motic Panthera DL

Image Credit: Javier Torres

The case of the 50-year-old female patient with an intraductal papillary lesion exemplifies the enigmatic nature of medical diagnoses. From the initial cytological study, with its intriguing papillary formations and variable cellular characteristics, to the subsequent histological unveiling of an intraductal papilloma, the journey was laden with challenges and discoveries. The diagnostic ambiguity between papilloma and papillary carcinoma served as a reminder of the intricate balance between art and science in the realm of pathology.

© Dr. Torres Gómez, Francisco Javier.

Pathology Service.

Virgen Macarena Hospital. Seville. Spain.

lluminating the Winter: The Vibrant Yellow Fungus

As the winter settles in, few fungi possess the ability to brighten up the season quite like the yellow fungus. When severe frost holds off, these fiery-hued fungi flourish brilliantly upon trees, standing out from afar with their radiant coloration.

In the midst of the dark, winter days, the forest is often deprived of vibrant hues. However, the yellow fungi adorning oaks instantly capture one's attention. Hanging from dead branches like large, wrinkled gum balls, their fruit bodies, reaching up to 10 cm in size, consist of gelatinous lobes. Surprisingly smooth and bouncy to the touch, they remain soft even in the presence of frost, almost as if they possess a natural antifreeze. Some variants deviate from yellow and boast a striking bright orange shade.

Particularly in the dunes, the yellow fungus (Tremella mesenterica) often leans more towards a flaming orange hue rather than yellow, a transformation influenced by age and moisture content. As the fungus ages, it gradually pales in color. During severe frost, it dries up and shrivels into a tough, dark orange piece of skin. Yet, after a frosty spell followed by a rain shower, it has the incredible ability to swell back to its original form, reviving its vibrant color. This resilient fungus truly showcases its tenacity.

Despite its inviting appearance, the yellow fungus is, in fact, a parasite. It draws its nourishment not from the dead wood it clings to, but from the mycelium of the oak bark fungus—an entirely different fungus that thrives on deceased oak trees. The yellow fungus consumes such a significant amount of nutrients from its host that the latter struggles to bear fruit.

While not considered an edible fungus in Europe, the yellow fungus is a sought-after delicacy in the Far East, where it is known as the "Yunnan golden fungus." In various Asian countries, it is also utilized for medicinal purposes, particularly to address lung ailments. Within its structure, the fungus harbors polysaccharides that possess properties such as cough suppression, anti-asthmatic effects, blood sugar regulation, anti-inflammatory traits, and inhibition of tumor growth.

Throughout the year, the yellow fungus can be found adorning branches of deciduous trees and shrubs, with its prevalence peaking in spring and late autumn/early winter. This captivating species is common in Belgium and the Netherlands.

Nature never ceases to surprise us with its vibrant wonders, and the yellow fungus stands as a testament to the intricacies and secrets that thrive in the heart of the forest.

Fig 1.- Tremella Mesenterica, Yellow Trembler

Image Credit: Willem Cramer

Oats (Avena sativa)

Oats have been cultivated for thousands of years. Traditionally the staple food in Northern Europe, it is a warm and sweet-tasting nutritious food, ideal for cold climates. For medicinal purposes, the whole plant is usually used, which is collected when the grains are ripe.

Traditionally, naturopaths have prescribed oats and oats straw tea as a tonic for nervous weakness, fatigue, and insomnia from arousal.

Oats are a separate group within the grass family. That also explains why oats are different and have specific nutritional properties that are not present in the three gluten-containing grains wheat, barley, and rye, and also differ from rice, for example.

Oats are a plant with many beneficial health properties:

Dietary fiber

Oats are best known for the beta-glucans it contains. Beta-glucans are unique soluble dietary fibers that lower cholesterol levels with a consumption of at least 3 grams per day in combination with other (healthy) foods that are low in saturated fat.

Oil

Oats are the only cereal that accumulates oil in the seed. Certain varieties can contain up to

10-15% oil. This oil consists of 80% unsaturated fatty acids, which means that oats contribute to lowering the risk of cardiovascular disease.

Protein

The oats protein is highly digestible and contains all essential amino acids, most of which are in large quantities. This allows oats to serve as a meat substitute. Because these proteins have a different amino acid composition than the gluten in wheat, barley and rye, they do not pose any problems for people who cannot tolerate gluten.

Starch

Oats starch digests slowly and completely. Oats therefore provide a gradual release of glucose into the blood (low glycemic index) Because of this, oats have the potential to help stabilize blood sugar in diabetes. In obese people, oats starch in combination with oats fiber can provide a long-lasting feeling of satiety, making weight management easier. Because of these properties, new health claims for oats are under development.

Vitamins, minerals and antioxidants

Oats are rich in vitamins and minerals. Of the phenolic compounds in oats, the avenanthramides in particular have an anti-oxidant activity and atherosclerosis and anti-inflammatory action.

Fig 1. - Avena sativa, oats straw c.s. | Motic BA410E PlanApo 40X | 

Moticam ProS5 Lite | Image credit: Willem Cramer

Fig 2. - Avena sativa, oats straw c.s. | Motic BA410E PlanApo 10X | 

Moticam ProS5 Lite | Image credit: Willem Cramer

Ref.: Wageningen University & Research (WUR) The Netherlands

© willemsmicroscope.com

The changing life in the water droplets of lake Sanabria

Green bubbles and crystal stars float on the waters of Lake Sanabria, zigzagging walkways and little suns with thread-like arms, announcing spring, which should be clean and blue like the clearest sky. But man has changed everything and our little ones will inherit what we did not want for ourselves.

The microscope allows us to travel inside a drop of water and to recognise the shapes and life of many beings that surprise us with their colours, their contours or their way of life, making each drop a unique landscape and our observation a magical journey.

Thanks to the collaboration agreement we have established with Motic España, the International Biological Station has added to its scientific equipment a Motic Panthera Microscope, equipped with a fluorescence FLED module and several lighting systems that allow us to observe microorganisms from different perspectives, giving us complementary views and the possibility of contemplating very beautiful images using dark field, phase contrast, polarisation, epifluorescence or even bright field observation techniques.

Water, when it is only water, hardly allows its transparency to be blurred by the contours of intruding beings, but a pinch of dissolved dust is enough for life to germinate magically and delicately, but when that pinch is handfuls of our waste, of grey ashes, of corrupted waters, a liquid veil of dense green smoke eclipses its transparency in the tumult of life that bubbles uncontrollably, brimming with strength. 

The transparency in the waters of Lake Sanabria barely allows the Secchi disc to be seen below 3m when a few years ago it was easily seen up to 10m below the surface. Infinite beautiful and tiny bodies of diatoms, green algae, golden algae and sun amoebae now sow the drops of this aquatic treasure that is gradually losing its shine, dying in neglect.

Microscopic observation in vivo, using the phase contrast technique, allows us to see the defined contours of all these almost invisible beings that our eyes cannot see. Epifluorescence techniques allow us to see her soul radiant with energy in red colors and cut volumes.

Thanks to the transfer that Motic Europe has made to the International Biological Station, it has been possible to observe and photograph at 400 magnification, with phase contrast and epifluorescence techniques, with a Motic Panthera microscope, some water samples collected on April 18, 2023 in Lake Sanabria (Zamora, Spain) by Ibone Martínez Zufiria, Alberto Ávila Pérez from the Helios Cousteau, the first solar wind catamaran built in the world and investigating the waters of this beautiful lake.

Fig 1.- Asterionella formosa x 400 Phase contrast

Image Credit: Antonio Guillén

The sharpness of the images obtained with this microscopic equipment, with the 40 and 20 magnification objectives using the previously mentioned techniques, allows us to appreciate delicate details that are very difficult to see with other equipment.

Fig 2.- Spondylosium planum above and Sphaerozosma granulata, below x 400 Phase contrast
Image Credit: Anotnio Guillén

Fig 3.- Synura uvella x 400 Phase contrast
Image Credit: Anotnio Guillén

In red, photographs taken at 400x magnification with the epifluorescence technique, with the FLED module and the Motic 40X / 0.65 / PH2 (WD 0.6mm) dry objective. The images taken live are shown in gray tones, with the same objective but with the phase contrast technique designed for this equipment and which works excellently.

Fig 4.- Tabellaria fenestrata x 400 epifluorescence
Image Credit: Antonio Guillén

Fig 5.- Synura uvella x 400 epifluorescence
Image Credit: Antonio Guillén

© Antonio Guillén Oterino

What’s in a rat?

The role of rodents in biomedical research is invaluable. Rodents, such as mice and rats, are the most commonly used mammals in biomedical research because of their anatomical, physiological and genetic similarities to humans. 

Scientists are able to genetically adapt mice to study a disease, for example by removing certain genes or by inserting (human) genes that are at the basis of certain disorders. For example, breast cancer can be simulated in mice to study the mechanisms of cancer and to test treatments. Mice and rats are also often used in behavioral studies to test, for example, treatments for memory loss in dementia.

Rodents are used in countless research areas, from cancer to immune diseases, heart disease, hypertension, metabolic and hormonal disorders, diabetes, obesity, osteoporosis, glaucoma, blindness, deafness, psychiatric disorders such as depression and schizophrenia, and neurodegenerative disorders such as Alzheimer's disease, Parkinson's and ALS.

The images taken with the new Moticam S6 camera show a cross-section with details through the upper body of the rat, just above the splice of the trachea into the two bronchi. The beautiful coup shows the various body parts in this cross section, some of which are indicated below.

With thanks to Cees Koopman, veterinarian.

© willemsmicroscope.com

Some micro-organisms of the southern peatlands, Quillaipé peatlands (Chile)

Peat bogs are quilted wetlands in which spongy masses of mosses such as sphagnum mosses are soaked with water and generate an acidic environment that is very limiting for the development of many micro-organisms, but which is paradoxically extraordinarily rich in biodiversity.

It is estimated that 3% of the emerged territories correspond to these wetlands, which fix in the substrate up to 30% of all the CO2 incorporated by living beings into the biogeochemical carbon cycle.

The peatlands of the southern hemisphere, such as those in the southernmost lands of the American continent in Chile and Argentina, have very marked singularities that differentiate them from others scattered around our planet and those found in Iberian territory. In addition to their considerable extension, their acidity is very pronounced, and this fact seems to limit the growth of algae such as desmids and diatoms. 

Despite these extreme conditions, these ecosystems are an ideal refuge for many species of thecate amoebae (shelled amoebae) which find their paradise here, with hundreds of forms and species - many of them still to be discovered - and which play an important role in the renewal and balance of the peatlands.

Recently, thanks to the invitation of the University of La Frontera in Chile to give the first international course on peatland microscopy in South America in the laboratories of the Faculty of Agricultural Sciences and Environment of this University in the city of Temuco, we were able to test an equipment provided by Motic Europe: a Motic Panthera C2 trinocular microscope equipped with an epifluorescence module and with condenser and objectives to be able to carry out observations also with phase contrast, darkfield and polarised light techniques.

Within this framework of collaboration between Motic Europe, the Duero-Douro International Biological Station and the University of Temucco, we are carrying out research work on the samples collected in the Quillaipe peat bogs by Professor Rubén Carrillo, Head of the Department of Agronomic Sciences and Natural Resources and his team, trying to identify and study the microorganisms that inhabit these enclaves.

For this, a fundamental work is the live microscopic observation of the material collected using different lighting techniques, and the photographic record of the organisms that we find.

As a small initial sample of this work, we show here some microphotographs of the leaves of some of the most common sphagnums, in this case Sphagnum magellanicum together with several shots taken of some of the pleasant thecadas that live among these mosses: Nebela and Euglypha.

The Nebela species shown here, photographed with three different techniques: phase contrast, darkfield, and epifluorescence, is very similar to Nebela tincta, but also bears many similarities to all of this recently studied group. mainly by Kosyakan, Lara and other authors, who are trying to find the relationship between morphological and genetic diversity within the Nebela tincta-collaris-bohemica species complex, and other taxa such as Nebela gimlii.

Nebela gimlii. 400X. Phase contrast.

Nebela gimlii. 400X. Darkfield.

Nebela gimlii. 400X. Epifluorescence and Darkfield.

Almost all of them, studied and found in the northern hemisphere, are very similar morphologically, and apparently also have a very close relationship with the one found in the Quillaipe bogs that we show here and that could be a species very close to Nebela gimlii not yet described.

On the other hand, the species of Euglypha that we have photographed with the phase contrast technique, probably Euglypha ciliata whose contours resemble those of a light bulb, has its theca flattened and is covered with oval silica flakes that when superimposed seem to form a hexagonal mesh and as a particular feature it has fine siliceous spines on some of its plates.

Both amoebae, which are very voracious, live protected inside this shell-like structure, in which they live as if it were their home.

Euglypha ciliata. 400X. Phase contrast

Euglypha ciliata. 400X. Phase contrast

The cell walls of the sphagnum cells have a great hygroscopic capacity and can retain water between the empty spaces forming this closed reticular lattice that can be seen in the images and which is shown photographed at different magnifications with darkfield, phase contrast and polarised light techniques using the Motic Panthera C2 trinocular microscope at x100, x200 and x400 using different illumination techniques: Brightfield, darkfield, phase contrast and epifluorescence, using the FLED module and Motic dry objectives x10//PH1, x20/0. 45/PH1 and x40 /0. 65/PH2 (WD 0.6mm). 

Leaf tissue of the moss (Sphagnum). 400X. Darkfield.

Leaf tissue of the moss (Sphagnum). 200X. Darkfield and Polarization.

🔬 Motic Panthera C2 trinocular + FLED Fluorescence

© Antonio Guillén Oterino

30-year-old female patient. Cervicovaginal cytology.

Cohesive and discohesive groups of superficial and intermediate cells are observed. The presence of mottled cytoplasms many of them with geographic inclusions that acquire a brownish-golden hue is striking. 

© Image by: Dr. Torres Gómez, Francisco Javier

© Image by: Dr. Torres Gómez, Francisco Javier

In such cases, before thinking of infrequent entities with which to explain the morphological and staining phenomenon, the simplest option should be considered. These are glycogen accumulations, more frequent in intermediate cells and in the second half of the cycle.

Generally, large numbers of lactobacilli are found around such clusters waiting for "lunch time" (cytolysis).

📸 Images: Pap stains. 400x / 🔬 Motic Panthera DL

© Dr. Torres Gómez, Francisco Javier
Pathology Service. Virgen Macarena Hospital. Seville. Spain.

Don't keep wakame in the fridge for too long

Wakame has an olive green to brown color. It is a rubbery, long, smooth, single leaf with wavy edges, growing to almost two meters in length. Just above the root of wakame is a germ (mekabu) that is particularly mineral-rich and also suitable for consumption.

After nori and kombu, wakame is the most commonly used seaweed in Japanese cuisine. One of the richest sources of calcium. Rich in vitamin B and vitamins A, C and K. High concentrations of protein, iron, magnesium, iodine, sodium, chromium, zinc, phosphorus and potassium.

The wakame in the video has been in the fridge for too long. It was intended to make a tuna dish on a bed of this type of algae. Unfortunately there is now mold on it... Something for under the stereo microscope.

On the high magnification of the last images you can notice that in 2 places clearly conidiophores and the formed conidiospores develop on the upright hyphae:

• Approximately in the middle of the image at the transition of the white mycelium
• Top rightmost 

It is though that we are dealing here with a Penicillium species (simpler conidiophore and single short rows of globular conidiospores) than an Aspergillus species (more globular branching at the end of a conidiophore).

With thanks to Dora De Cremer PhD

© willemsmicroscope.com

Scientific discovery with Antonio Guillén and Motic Europe

We start an adventure of scientific discovery with Antonio Guillén and the Estación Biológica Internacional, whose mission is to focus on the conservation and improvement of diverse natural spaces, especially aquatic ecosystems, by applying technological innovation, environmental education and the study of biodiversity. 

To safeguard its independence and ethical principles, the EBI's habitat and species research and conservation work is financed from its own ecotourism projects in cooperation with international volunteer actions.

Following the adherence of the EBI to the principles and philosophy of the European Charter for Sustainable Tourism, with total economic-political independence and thanks to the technical specialization of its collaborators, it has developed and financed various projects for the conservation of habitats and species in the four protected.

Image 1. Duero-Douro International Biological Station (EBI) and its 

representatives in Spain (Europarques Hispano-Lusos SRL) and Portugal 

(Centro de Turismo Ambiental Luso-Espanhol Lda. https://www.europarques.com/en

Dr. Antonio Guillén, biologist and scientific director of the EBI, will open the door to his research under the extraordinary microscopic eye. Guillén altruistically coordinates a multidisciplinary team of volunteers, collaborators and scientific researchers of different nationalities. Specializing in aquatic ecosystems, he directs the field work on board the EBI Hydrographic Vessels in Arribes del Duero, Douro Internacional and Lago de Sanabria, the Microscopic World of Virtual Biodiversity gallery and the Water Project with more than 10 million followers worldwide.

Image 2. S.O.S. LAGO DE SANABRIA, BRAZADAS DE DAPHNIA. 

Cristina, Genis & Javier, April 2016. (CC BY-NC-SA 2.0) ://flic.kr/p/HJ7iA1

Very soon you will be able to see some of the most fascinating samples.

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