General Pathology
General Pathology
General Pathology
Patho – suffering
Logos – study
• It is devoted to the study of the structural &
functional changes in cells, tissues, & organs
underlying diseases.
1
Definition of pathology…
2
Ctd…
• Pathology is divided in to :
1. General pathology – deals with basic
reactions of cells & tissues to abnormal stimuli
that underlie all disease.
2. Systemic pathology – specific responses of
specialized organs & tissues to more or less
well defined stimuli.
3
The core of pathology
• Pathology gives explanation of a disease by
studying the four aspects of the disease
1. Etiology
2. Pathogenesis
3. Morphological changes
4. Functional derangement & clinical significance
4
Ctd…
1. Etiology
• Cause of the disease
• If the cause of the disease is known it is called
primary etiology
• If the cause of the disease is unknown it is called
idiopathic
• Knowledge or discovery of the primary cause
remains the back bone on which a diagnosis can be
made, a disease understood & a treatment
developed
5
Ctd…
• Two factors:-
Intrinsic or genetic
Acquired ( infectious, nutritional, chemical,
physical…)
6
Etiology
• c
Disease Disease
Disease
Disease
Disease
7
Ctd…
2. Pathogenesis
• Mechanisms of disease development
• It refers to the sequence of events in the response of the cells
or tissues to the etiologic agent, from the initial stimulus to
the ultimate expression of the disease
• It means the mechanism through which the cause operates to
produce the pathological & clinical manifestations
• The pathogenic mechanism could take place in the latent or
the incubation period
• It will lead to morphological changes
8
Ctd…
3. Morphological changes
• Structural alterations induced in the cells &
organs of the body
• Characteristic to the disease or diagnostic to
the etiologic process
• Seen with naked eye or under the microscope
9
Ctd…
• Both the gross & the microscopic morphologic
changes may only be seen in that disease, i.e.
they may be specific to that disease
(pathognomonic).
– Therefore, such morphologic changes can be used
by the pathologist to diagnose the disease
• In addition, the morphologic changes will lead
to functional alteration & to the clinical signs
& symptoms of the disease
10
Ctd…
4. Functional derangement & Clinical
significance
• Functional consequence of the morphologic
change
• The morphologic changes influence the
normal function → determine the clinical
feature
• Also the course & prognosis of the disease
11
Diagnostic modalities
• Most are based on morphologic changes
• Diagnostic techniques:
1. Histopathology
2. Cytopathology
3. Hematopathology
4. Immunohistochemistry
5. Microbiological examination
6. Biochemical examination
7. Cytogenetics
8. Molecular techniques
9. Autopsy
12
Histopathology
• Studies the tissue under the microscope
• Tissues are obtained by biopsy
Biopsy – tissue sample from living person
• Biopsy – Incisional
- Excisional
• Tissue examined grossly (macroscopically) &
microscopically
• It is usually the gold standard for pathologic
diagnosis
13
Ctd…
• Once the tissue is removed from the pt, it has
to be immediately fixed by putting it into
adequate amount of 10% formalin before
sending it to the pathologist
• Once the tissue arrives at the pathology
department, the pathologist will examine
macroscopically
14
Ctd…
• Then the tissue is processed to make it ready for
microscopic examination. The whole purpose of the
tissue processing is to prepare a very thin tissue
which can be clearly seen under the microscope
• The tissue is processed by putting it into different
chemicals. It is then impregnated (embedded) in
paraffin, sectioned (cut) into thin slices, & is finally
stained.
• The stains can be Hematoxylin/Eosin stain or special
stains such as PAS, immunohistochemistry, etc…
15
Ctd…
• The Hematoxylin/Eosin stain is usually
abbreviated as H & E stain. It is routinely used.
• It gives the nucleus a blue color, the
cytoplasm & the extracellular matrix a pinkish
color
16
Ctd…
• Then the pathologist will look for abnormal
structures in the tissue & based on this
abnormal morphology s/he will make the
diagnosis
17
Cytopathology
• Study the cells
• Used in:
Screening for early detection of cancer
Diagnosis of symptomatic cancer
Diagnosis of inflammatory condition,
infectious
Surveillance of pts treated with cancer
18
Ctd…
• Its advantage:
• Cheap
• Takes less time
• Needs no anesthesia
Cytopathological methods:
1. FNAC
2. Exfoliative cytology
3. Abrasive cytology
19
Ctd…
1. FNAC
• Easy in superficial organs
• May need guidance in deep seated mass
2. Exfoliative cytology
• From cells that are shed from spontaneously into
body fluids or secretion
3. Abrasive cytology
• Cells are dislodged from skin or mucous membrane
by various tools
20
Hematological examination
21
Immunohistochemistry
22
Microbiological examination
23
Biochemical examination
24
Clinical genetics (cytogenetics)
• This is a method in which inherited
chromosomal abnormalities in the germ cells
or acquired chromosomal abnormalities in
somatic cells are investigated using the
techniques of molecular biology
25
Molecular techniques
• Different molecular techniques such as
fluorescent in situ hybridization, southern
blot, etc… can be used to detect genetic
diseases
26
Autopsy
27
Diseases
• Disease is defined as an abnormal variation in
structure or function of any part of the body
Causes of disease
Environmental
Genetic or
Both
28
Environmental factors
Are many & are classified into:-
1. Physical agents
2. Chemicals
3. Nutritional deficiencies & excesses
4. Infections & infestations
5. Immunological factors
6. Psychogenic factors
29
Genetic factors
• These are hereditary factors that are inherited
genetically from parents
30
General pathology
• Cellular adaptation, cell injury & cell death
• Acute & chronic inflammation
• Tissue renewal & repair: regeneration, healing &
fibrosis
• Hemodynamic disorders, thromboembolic disease, &
shock
• Diseases of immunity
• Neoplasia
• Infectious disease
31
Disease of organ system
• Blood vessels
• The heart
• Red blood cells & bleeding disorders
• Diseases of white blood cells, lymph nodes & spleen
• The lung
• The gastrointestinal tract
• Liver & biliary tract
• The pancreas
• The kidney
• The lower urinary tract & male genital system
• The female genital tract
• The breast
• Bone, joint & soft tissue tumors
• The CNS
32