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Color Atlas and Text of HISTOLOGY SEVENTH EDITION Color Atlas and Text of HISTOLOGY SEVENTH EDITION Leslie P. Gartner, PhD Professor of Anatomy (Retired) Department of Biomedical Sciences Baltimore College of Dental Surgery Dental School University of Maryland Baltimore, Maryland Acquisitions Editor: Crystal Taylor Development Editors: Andrea Vosburgh and Kelly Horvath Editorial Coordinator: Annette Ferran Editorial Assistant: Brooks Phelps Marketing Manager: Mike McMahon Production Project Manager: Bridgett Dougherty Design Coordinator: Holly McLaughlin Manufacturing Coordinator: Margie Orzech Prepress Vendor: SPi Global 7th edition Copyright © 2018 Wolters Kluwer Copyright © 2014, 2009, 2006, 2000, 1994, 1990 Lippincott Williams & Wilkins, a Wolters Kluwer business. All rights reserved. This book is protected by copyright. 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To request permission, please contact Wolters Kluwer at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at [email protected], or via our website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Printed in China Translations: Chinese (Taiwan): Ho-Chi Book Publishing Company Chinese (Mainland China): Liaoning Education Press/CITIC Chinese (Simplified Chinese): CITIC/Chemical Industry Press French: Wolters Kluwer France Greek: Parissianos Indonesian: Binarupa Publisher Italian: Masson Italia; EdiSES Japanese: Igaku-Shoin; Medical Sciences International (MEDSI) Korean: E*Public, Co., Ltd Portuguese: Editora Guanabara Koogan Russian: Logosphera Spanish: Editorial Medica Panamericana; Gestora de Derechos Autorales; Libermed Verlag Turkish: Gunes Bookshops Vietnamese: Hanoi Medical University Library of Congress Cataloging-in-Publication Data Names: Gartner, Leslie P., 1943- author. Title: Color atlas and text of histology / Leslie P. Gartner. Description: Seventh edition. | Philadelphia : Wolters Kluwer, [2018] | Includes index. Identifiers: LCCN 2016058316 | ISBN 9781496346735 Subjects: | MESH: Histology | Atlases Classification: LCC QM557 | NLM QS 517 | DDC 611/.0180222—dc23 LC record available at https://lccn.loc.gov/2016058316 This work is provided “as is,” and the publisher disclaims any and all warranties, express or implied, including any warranties as to accuracy, comprehensiveness, or currency of the content of this work. This work is no substitute for individual patient assessment based upon healthcare professionals’ examination of each patient and consideration of, among other things, age, weight, gender, current or prior medical conditions, medication history, laboratory data and other factors unique to the patient. The publisher does not provide medical advice or guidance and this work is merely a reference tool. Healthcare professionals, and not the publisher, are solely responsible for the use of this work including all medical judgments and for any resulting diagnosis and treatments. Given continuous, rapid advances in medical science and health information, independent professional verification of medical diagnoses, indications, appropriate pharmaceutical selections and dosages, and treatment options should be made and healthcare professionals should consult a variety of sources. When prescribing medication, healthcare professionals are advised to consult the product information sheet (the manufacturer's package insert) accompanying each drug to verify, among other things, conditions of use, warnings and side effects and identify any changes in dosage schedule or contraindications, particularly if the medication to be administered is new, infrequently used or has a narrow therapeutic range. To the maximum extent permitted under applicable law, no responsibility is assumed by the publisher for any injury and/or damage to persons or property, as a matter of products liability, negligence law or otherwise, or from any reference to or use by any person of this work. LWW.com To my wife Roseann, my daughter Jennifer, and my mother Mary. LPG REVIEWERS Rocky Behniwal Student Ross University School of Medicine Dominica, West Indies Amber Hale, PhD Assistant Professor Department of Biology McNeese State University Lake Charles, Louisiana Wanda Lai Student Oakland University William Beaumont School of Medicine Rochester, Michigan Lisa M. J. Lee, PhD Associate Professor Department of Cell and Developmental Biology University of Colorado School of Medicine Aurora, Colorado Jamie Qualls Student Michigan State University College of Osteopathic Medicine East Lansing, Michigan Zak Richey Student Rosalind University of Medicine and Science Chicago, Illinois Dilisha Rodrigopulle Student Touro College of Osteopathic Medicine Middletown, New York Guy Sovak, PEng, BSc, MSc, PhD Assistant Professor Division of Anatomy and Histology Canadian Memorial Chiropractic College Toronto, Ontario, Canada PREFACE TO THE SEVENTH EDITION I am very pleased to be able to present the seventh edition of Color Atlas and Text of Histology, an atlas that has been in continuous use since its first publication as a black and white atlas in 1987. The success of that atlas prompted us to revise it considerably, retake all of the images in full color, change its name, and publish it in 1990 under the title Color Atlas of Histology. In the past 27 years, the atlas has undergone many changes. We added color paintings, published a corresponding set of Kodachrome slides, and added more material to the text. The advent of high-resolution digital photography allowed us to reshoot all of the photomicrographs for the fourth edition. Major changes are introduced in the seventh edition. The most exciting change is that I have completely rewritten, reorganized, and enhanced the textual material and added new tables to such an extent that it can be used not only as an atlas but also as review book to study for course examinations as well as for the USMLE Step 1. Because clinical content is essential to success both in navigating the integrated medical curriculum and in future practice, this atlas continues to feature numerous Clinical Consideration boxes that describe and illustrate relevant pathology. I have also included a new feature in the form of a new appendix, “Tissues that Resemble Each Other,” that compares and contrasts 40 light micrographs of tissues that may easily be mistaken for the other. Probably the second most exciting change that was introduced into this edition is the addition of 124 new light micrographs and 4 new electron micrographs that assist the student in reviewing the histologic images in every chapter but the first. Moreover, the new chapter on Histologic Techniques (Chapter 20) was created from and expands on the sixth-edition appendix. As in the previous editions, most of the photomicrographs of this atlas are of tissues stained with hematoxylin and eosin. All indicated magnifications in light and electron micrographs are original magnifications. Many of the sections were prepared from plastic-embedded specimens, as noted. Most of the exquisite electron micrographs included in this atlas were kindly provided by my colleagues throughout the world as identified in the legends. For examination preparation purposes, the online Student Resources for the atlas include over 300 additional photomicrographs with more than 700 interactive questions organized in a fashion to facilitate the student's learning and 1 review for practical exams. Additionally, I have included approximately 100 USMLE Step 1 format multiple-choice questions, based on photomicrographs created specifically for the questions. The most dramatic change to the seventh edition, at least to me, is that my coauthor, Dr. James L. Hiatt, decided not to be associated with the writing of this edition of our Atlas. Jim retired from active teaching 20 years ago and decided to make his retirement complete and devote himself to other endeavors. Over the years, Jim and I wrote 24 research articles, 47 abstracts, and, counting new editions, 22 textbooks together. It was a very pleasant and fruitful association, and I sorely miss this long-term professional partnership. Needless to say, our personal friendship remains as strong as ever. I am grateful to the many faculty members throughout the world who have assigned this atlas to their students, whether in its original English or in one of its translated forms that now counts 12 languages. I have received many compliments and constructive suggestions not only from faculty members but also from students, and I tried to incorporate those ideas into this new edition. One suggestion that I have resisted, however, was to change the order of the chapters. Several faculty members have suggested a number of varied sequences and they all made sense to me. However, I feel partial to and very comfortable with the classical sequence that we adopted so many years ago; it is just as valid and logical an arrangement as all the others that were suggested, and, in the final analysis, I believe that instructors and students may use the chapters of the atlas in a different sequence without harming the coherence of the material. As with all of my textbooks, the Color Atlas and Text of Histology has been written with the student in mind; thus, the material is complete but not esoteric. I wish to help the student learn and enjoy histology, not be overwhelmed by it. Furthermore, this book is designed not only for use in the laboratory but also as preparation for both didactic and practical examinations. Although I have attempted to be accurate and complete, I know that errors and omissions may have escaped my attention. Therefore, I welcome criticisms, suggestions, and comments that could help improve this atlas; please address them to [email protected] Leslie P. Gartner 2