- 1. Chapter One Introduction to Pathology Section A What is
pathology?
2. Definition of Disease
- Disease may be defined as an abnormalalteration of structure or
function in any part of the body.
3. Classification of Diseases:
- Developmental genetic, congenital.
- Inflammatory Trauma, infections, immune, etc.
- Neoplastic tumors, cancers
4. Pathology
- Study of what is abnormal or wrong or disease!
- Scientific Study of Disease
5. Study of Disease:
- Morphology -Structural Changes
- Clinical Significance Functional Changes
Pathology 6. Pathology focuses on 4 aspects of disease
- ETIOLOGY:Cause of disease.
- Mechanisms of development of disease.
- MORPHOLOGY:The structural alterations induced in cell and
tissues.
- Functional consequences of the morphologic changes, as observed
clinically.
- Knowledge of etiology remains the backbone:
- Understanding the nature of diseases
7. Etiology:
Multifactorial: 8.
- One etiologic agentone disease.
- Several etiologic agentsone disease.
- One etiologic agentseveral diseases.
9.
- Diseases are caused due to internal or external factors.
-
- No more one cause to one disease
- Genetic factors affect acquired diseases and environment has
profound effect ongenetic diseases.
10. Pathogenesis:
- Sequence of events in the response of cells & tissues to a
stimulus/pathogen starting from the initial stimulus to the
ultimate expression of disease.
- Gross and microscopic Structure, Function, Chemistry &
molecular mechanisms.
11. Pathogenesis
- The sequence events in the response
- of the cells or tissues to the etiologic agent, from the
initial stimulus to the ultimate expression of the disease.
12. Pathogenesis Immunologic, cytogenetic and molecular analyses
oftissues and cells are increasingly becoming guides to render
diagnoses, to assess prognosis, and to suggest therapy. 13.
- W hile much still needs to be uncovered to link abnormal genes
and the expression of disease, gone are the time when the
mechanisms of most diseases wereunknown? or obscure? or
mysterious?
14.
- Characteristic of the disease
- Diagnostic of the etiologic proceess
MORPHOLOGY Morphology remains at the heart of diagnostic
pathology. 15. Morphology:
- Structural and associated functional changes in cells, tissues
and organs that are characteristic of the disease or
condition.
16. Renal Infarction 17. 18. 19. Normal glomerulus 20.
Membranous GN 21. Clinical Significance:
- Functional derangements and its clinical manifestations
resulting from the morphologic changes.
- Signs and symptoms, course and prognosis of disease depend on
the morphology.
22. Pathology Summary:
-
- Carcinogenesis. DNA Damage, Mutation.
-
- Uncontrolled cell division, tumor.
-
- Enlarged lymphnodes, liver, spleen, microscopically lymphoma
cells.
-
- Fever, Wt loss, tumor-Ln, Liver, Spleen.
23. Section B What do pathologists do? 24.
Scopeof Pathology 25.
26.
- The internal examination of the body after death performed
scientifically for medical or legal purposes.
27. 28. 29. 30. 31. 32.
- to clarify the nature of many diseases.
- to determine the cause of death and to collect evidence
- to gather accurate statistics about disease incidence
33.
- to establish a precise diagnosis by the removal and examination
of tissue from the living body.
34. Tissue sections areembedded with paraffin. 35. stony hard
lump or mass on palpation 36. 37. Diagnosis:Carcinoma of the breast
The invasive duct carcinoma usually has an abundant fibrous stroma,
so it is also refered to as scirrhous carcinoma. Dense collagenous
background 38.
- Single cells or clumps of cells exfoliated from their
surrounding tissues.
- Sputum, urine and abdominal fluid
39. Sputum smears ofcytology 40. Pap smear of CIN-III Large
hyperchromatic nuclei, nuclear pleomorphism .There aresome
interspersed neutrophils with lobated nuclei and much smaller size.
41. Diagnosis
-
- The formal name(s) used to describe a patients disease
-
- The process of identifying a disease based on the patients
symptoms, the doctors findings, and the results of investigations
and laboratory tests
- What do you need to make a diagnosis?
-
- A system of classification that supplies the necessary names,
definitions, and criteria
-
- The means to ascertain the defining characteristics of a
disease in the individual patient
42. Sample Case: 43. Clinical Details:
- Neck swelling, 2-3 months,
44. Right neck mass 45. Lymphnode Biopsy
46. Lymphnode Biopsy
47. Histiocytic/Tcell NHL
- Diffuse pattern no follicles.
- Large cells with moderate cytoplasm
- Plenty of mitotic figures, Nuclei are vesicular prominent
nucleoli
- Features suggest T-cell NHL malignant lymphoma.
- Needs further marker studies for typing & management.
48.
In vitro: Tissue culture Organ culture Cell culture In vivo:
Experimental animals Nude mice 49.
- Cell and tissue culture :
- cellular environment can be modified and the responses to it
monitored.
50.
- toobserve the effect of manipulations on the animal model of
disease .
51. 52. Nude mice 53. Section C How do pathologists do? 54.
RESEARCH METHODS
- Microscopic observation (HE)
- Cell Cultures, Medical Microbiology
55.
56.
- Congestive Splenomegaly: the volume of the spleen is increased
and swollen, red-brown. Irregular tan-white fibrous plaques can be
seen over the purple surface.
57. Renal Infarction 58. 59. 60. 61. 62.
- Histopathological and Cytopathological Investigation
- The microscopic examination of tissue and cell samples with LM
on H.E. sections or smears.
- Frozen sections sometimes for a very urgent diagnosis and
histochemistry.
63. Renal Infarction 64. Liver cirrohsis 65. Liver carcinoma
66.
- 3.Electron Microscopic Investigation
- studydisorders at an organelle level and subcellular
details.
- transmission and scanning EM
67. 68. 69.
- 4.Histochemical and Immunohistochemical Investigation
- Histochemistryis the study of the chemistry of tissues after
treated with specific reagents, so that the chemical features of
individual cells can be visualised.
70. Normal glomerulus 71. Membranous GN 72. A masson trichrome
preparation shows complete replacement of virtuallyall glomeruli by
blue-staining collagen. Chronicglomerulonephritis: 73.
- The bound Ab is then visualized, using another Ab and a dye
complex such as diaminobenzidine.
74. 75. 76. 77. 78. Section D about the subject ofPathology, How
to learn pathology? 79. Pathology
- Is the foundation of medical science and practice. Without
pathology, the practice of medicine would be reduced to myths and
folklore
80. Pathology The Status of Pathology in Medicine a bridging
discipline the clinical practice of medicine basic science 81.
Learning Pathology:
-
- Common changes in all tissues.
-
-
- E.g.. Inflammation, cancer, ageing.
-
- Specific changes in organs.
-
-
- E.g.. Goiter, pneumonia, breast cancer.
82.
- General pathology is concerned with the basic reactions of
cells and tissues to abnormal stimuli that underlie all
diseases.
- Systemic pathology examines the specific
- responses ofspecializedorgans and
- tissues to more or less well defined stimuli.
83. Subdivisions of Pathology:
84.
85. Past and Present.!
- In the past, .. people mistook magic for medicine!
- Now people mistake medicine for magic.!