General pathology II

Level 6 Dr.Anas Salhany

Introduction to general

pathology

Definition of pathology
It is the Scientific study of disease"

"scientific study of the molecular, cellular, tissue, or organ system response to injurious agents."

Pathology serves as a "bridge" or "link" between the

preclinical sciences (anatomy, physiology, etc.) and the courses in clinical medicine.

What is the Disease?

It is the State in which an individual exhibits an

anatomical,

physiological,

or

biochemical

deviation from the normal Disease may be defined as : an abnormal alteration of structure or function in any part of the body.

Learning Pathology:
General Pathology

Common changes in all tissues. e.g.. Inflammation,

cancer, ageing, edema, hemorrhage .etc.

Systemic Pathology

Discussing the pathologic mechanisms in relation to various organ systems e.g. CVS, CNS, GIT..etc.

Pathology focuses on 4 aspects of disease:

ETIOLOGY: Cause of disease. PATHOGENESIS: Mechanisms of development of disease.

MORPHOLOGY:

The structural alterations induced in cell and tissues.

FUNCTIONAL CONSEQUENCES:

Functional results of the morphologic changes, as

observed clinically.

Study of the cause of a disease"

Knowledge of etiology remains the backbone of:

Etiology

Disease diagnosis Understanding the nature of diseases

Treatment of diseases.

 Biopsy:

Removal and examination of tissue obtained from the living body

pathogenesis
The sequence events in the response of the cells or tissues to the etiologic agent,from the time it is initiated to its final conclusion in recovery or death

Clinical Symptoms & Signs

Clinical

symptoms are the patients complain

usually by its own words.

Clinical signs are seen only in the living individual. Functional evidence of disease which can be

determined objectively or by the observer" (fever, tenderness, increased respiratory rate, etc.)

Tumors
based on

of origin * biologic behavior

Benign

* cell

Malignant

Epithelial

Mesenchymal

Epithelial

Mesenchymal

Differences between benign and malignant tumors

Feature
Capsulation Mode of growth Differentiation Anaplasia

Benign
Usually present By expansion Well differentiated Absent

Malignant
Usually absent By infiltration Variable Present

Rate of growth
Metastases Recurrence Fate

Slow
Does not happen Usually do not recur Cured by excision

Rapid
May occur Common Usually fatal

Benign
Histology Cells Nuclei Mitosis
Uniform in size and shape Equal Few or absent ( normal if present) Well formed

Malignant
Pleomorphic Hyperchromatic / N/C ratio Many ( abnormal)

Blood vascularisation

Poorly formed

Differentiation and Anaplasia

Benign tumors Well differentiated Malignant tumors Range from well to poorly differentiated Hallmarks of anaplasia: Cells and nuclei show pleomorphism Cells contain abundant DNA, coarse, clumped chromatin Large NC ratio (1:1) rather than (1:4) Large nucleoli Large of mitosis Dysplasia Precancerous condition in epithelial tissue Anaplastic cells in epithelium Dysplasia does not always progress to cancer

Rate of Growth

Benign tumors

Generally grow slowly over a period of years Grow rapidly at an erratic pace

Malignant tumors

Local Invasion
Benign tumors grow as cohesive, expanding masses that remain localized to site of origin Do not have capacity to metastasize to distant sites Frequently are surrounded by a fibrous cap Malignant tumors Grow with progressive infiltration, invasion and destruction of host tissue Poorly demarcated from surrounding normal tissue

Benign

Malignant

Metastasis

Metastasis
Tumor implants that are discontinuous from the

primary tumors 30% of newly diagnosed patients with solid tumors present with metastases How do cancers spread?

Direct seeding of body cavities or surfaces Lymphatic spread (carcinomas) Hematogenous spread (sarcomas)

Benign tumors
In general, benign tumors are designated by

attaching the suffix -oma to the cell of origin. Tumors of mesenchymal cells generally follow this rule.

fibroblastic cells fibroma, cartilaginous tumor chondroma, tumor of osteoblasts osteoma

Nomenclature of benign epithelial tumors is more

complex. They are variously classified, based on:

their cells of origin microscopic architecture macroscopic patterns.

Thank you