INTRODUCTION TO

PATHOLOGY

Dr. Laura Romero

Department of Pathology
Pathology has been considered the cornerstone
of medicine.
From an academic point of view, it is a
fundamental part of preparing students for clinical
practice.
It serves as a bridge or link between preclinical
courses (anatomy, physiology, biochemistry) and
medical courses (clinicals).
Pathology is the fundamental knowledge of the
disease.
It follows the morbid process from its beginning to its
end, and investigates the injuries that occur and how
they occur.
Therefore, background and prior knowledge are
necessary for logical reasoning, when trying to solve a
real-life clinical problem.

Pathology
( πάθόσ = abnormal, altered)
• Science that studies disease.
• It studies the causes, development and
morphological and functional changes that occur in
diseased organisms.
 Pathology
It is the science that studies the cause and
development of the functional and structural changes
that occur in diseased organisms.
Pathology is the discipline that bridges the gap
between basic sciences and clinical practice.
Anatomy
cell biology
tissue biology

Biochemistry Pathology Medicine

Physiology
Microbiology
Immunology
 Pathology
That? Study
As?
When? Because

Disease

* Associated injuries
• Mechanisms that cause it
 Pathology
General Systemic
Study
Disease Organ and system
mechanisms diseases
Alterations of basic cellular functions
• Metabolism
• Growth
• Answer's capacity
 Pathology
Immunopathology
Pathophysiology

Ultrastructural pathology

Branches Molecular pathology

Experimental pathology
Cytopathology

Clinical pathology

General Pathology
It involves the study of the mechanisms by
which tissues are damaged and develop
structural changes.

It provides the basic principles that allow

us to understand diseases.
 Systemic
Studies the pathology of specific diseases that
Pathology
affect different devices and systems.
DEFINITIONS
Anatomical Pathology: Studies tissue changes, using
macroscopic pathology (necropsy), or microscopic pathology
(histopathology), to identify the nature of the diseases.
Clinical Pathology: It is applied to the solution of clinical
problems through the use of laboratory methods (hematology,
blood chemistry, urine tests, clinical endocrinology) based on the
physical and chemical study of body fluids.
Cytopathology: It is the microscopic study of groups of cells or
isolated cells, from tissue or body fluids.
Surgical pathology: Specializes in the study of tissues obtained
through surgical biopsies.
Comparative Pathology: It is the study of the pathology of
diseases of domestic and wild animals, and its relationship with
human pathology.

Experimental Pathology: Manipulates, analyzes and reproduces

structural and functional abnormalities, for a better understanding
of the mechanisms associated with a disease. Molecular
Pathology: Involves knowledge of the genetic and molecular
bases of diseases. It is an important area in the practice of
modern Pathology, which has emerged thanks to advances in
biotechnology that allow the analysis of nucleic acids and genetic
material.
Ultrastructural pathology: Studies the alterations of intracellular
organs, which can be visualized only through electron microscopy
techniques. Pathophysiology: Studies the functional
consequences of organic diseases. Pathophysiology observes the
behavior of tissues in response to a stimulus imposed by a
disease.
Immunopathology: The area of pathology that studies tissue
damage associated with disorders of the immune system.
Veterinary pathology: It is the study of diseases that affect
animals.
Homeostasis: It is the ability of the organism to maintain
physiological constants within a narrow range, in the face of
changes and aggressions from the internal or external
environment.
Health: It is the state of harmonious functioning of an individual's
entire organism, controlled by homeostasis and defense
mechanisms.
Disease: It is the functional imbalance of an individual's organism
due to aggression from an external agent or alteration of the
organism itself, which has not been able to be compensated by
homeostasis mechanisms.
Sign: It is the manifestation of disease perceptible by the
doctor through observation and clinical examination. pe
claudication, vomiting, diarrhea, etc.
Symptom: It is the manifestation of disease only perceptible
by the patient.

Syndrome: A set of signs and symptoms common to a

group of diseases but insufficient to establish an etiological
diagnosis.
Lesion: Macroscopic or microscopic morphological
alteration of a tissue.
Pathognomonic Lesion: Specific and exclusive
morphological alteration of a disease.

Negri corpuscles
Necropsy: It is the macroscopic, systematic study of the
organs and tissues of a corpse.
Biopsy: It is the microscopic study of a fragment of
tissue obtained from a living animal.
Cytology: It is the microscopic study of a group of
isolated cells, coming from tissue or body fluids.
Pathogenesis: It is the study of the development of
diseases, from their beginning to their resolution.
Altitude Sickness
2600 m asl i O 2 concentration Tissue
hypoxia

dilation and Tachycardi

Vasoconstriction and
hypertrophy a
pulmonary
of the Polypnea
hypertension
YOU Polycythe

Insufficiency Hemoconcentration
right heart Congestion and
edema
widespread
Decrease of
Hypovolemic Shock
cardiac output
Alteration or disorder:
Death
Change or modification,
with respect to normal. Change in the nature, form or
qualities of a body or substance.

• Circulatory disorders: hyperemia, congestion, edema.

• Mental disorders: fear, anxiety, panic, phobias, anorexia,

bulimia.

• Gastrointestinal disorders: diarrhea, vomiting, colic.

Resolution: Form of termination of an illness, which

may culminate in total or partial recovery or death.
Prognosis: Prediction of the type of resolution of a
disease.
Sequela: Morbid state following an illness.
Acute process: Presentation of the illness in minutes
or hours: Hyperemia, viral gastroenteritis.
Chronic process: Presentation of a disease that
lasts from days to months or years: Tuberculosis
Diagnosis: Identification of the specific process or
disease.
Clinical: Preliminary identification of an individual's
disease or condition using various tools such as
anamnesis, medical history and physical examination.
Presumptive: constitutes the first conclusion about the
problem, based on signs, symptoms and lesions.
Differential: it is a diagnosis chosen from among several
possible ones, after studying all the information necessary
in the diagnostic process.
Morphological: Macroscopic or histological description
of the tissues affected in the disease.
It is considered: Organ, location, type of injury,
severity, course.
Examples:
• Suppurative bronchopneumonia, cranioventral, severe,
acute.
• Hepatitis, lymphocytic, periportal, moderate, chronic.

Etiological: Conclusion and identification of the agent

that caused the disease.
Final/Comprehensive: Accurate identification of the
disease, integrating all diagnoses with laboratory tests.
What is your morphological diagnosis?
etiological?
Etiological or causal agent: Environmental factor that causes a
functional imbalance in the individual or tissue injury.
Exogenous
Toxins Fac
Poisons
Drugs Medications
tors
GENETIC
ABNORMALITIES
Biological
Etiologica Autosomal
Prions Extrinsic linked to sex
l of Viruses
Dominant
Bacteria
Disease Fungi recessive
Protozoans
Parasites
Chemicals

Extrinsic

Metabolites
Free
radicals
Endogenous
Intrinsic predisposing factors

Rinderpest
PRRS

Mellitus diabetes
Hip Dysplasia

Melanoma
 Parvovirus

Osteoporosis
Feline Respiratory Complex

Endocardiosis
 Carcinoma
epidermoid

Melanoma
 Breast carcinoma

Prostatic hyperplasia
Environmental predisposing factors (extrinsic)
 Triggers

Factors that, when combined with predisposing factors,

contribute to the appearance of injuries and disease.
Examples:
• Wet floors + Fusobacterium necrophorus = pododermatitis
• Cold + distemper virus (Morbilivirus) = Canine distemper
(Distemper).
• Distemper virus + Bordetella bronchiseptica = Suppurative
bronchopneumonia.
• Osteoporosis + trauma = fracture
 Bacterial
viral pododermatitis
pneumonia
 Physical - Traumatic
Trauma
• Application of a sudden violent force, which
produces crushing or separation of tissues
 Pressu
• Physical force that is milder than trauma, but acts for a
re
longer time, causing compression of blood vessels and
hypoxia. pe Prolonged prostration.
 Obstruction
• It is the partial or total closure of the lumen of a
hollow organ.
Uroliths, foreign bodies, parasites, etc.
 Contusion
• Result of trauma in which there is no loss of
continuity in the skin, but in the underlying
tissues the capillaries are broken and blood
escapes. pe Hematoma.
 Abrasion
• Injury similar to the previous one, in which the
integument is torn.
 Drilling
• Wound in which the entry point is narrow and
deep.
peInjury from a nail or bullet.
 Volvulus
• Rotation of the intestine around its mesenteric
insertion.
 Torsion
• It is the rotation of an organ on itself or around
its major axis.
Torsion of abomasum, of the intestine.
 Prolapse
• It is the exit of an organ through a natural opening.
Prolapse of the uterus and rectum.
 Eventration
• It is the exit of an organ through a tear in the
abdominal wall.
 Hernia
• Exit of an organ through a natural or artificial
orifice, being covered by its serosa.
 Sprain
• Injury to a joint in the anatomical relationship of
the bones is maintained, but there is stretching
and tearing of the ligaments.

Dislocation
o Injury to a joint in which the anatomical
relationship of the bone structures is lost.
 Fracture
• Alteration in the continuity of hard tissues (bones,
cartilage, teeth).
 Breaking off
• Injury in which the tissues are excessively
distended, causing separation of their fibers.
Stomach rupture, liver capsule rupture.
 Incision
• It is a long, narrow wound caused by a sharp
object.
Surgical incision.

Concussion
o Loss of consciousness and reflex activity
by a sudden and violent blow to the head.
 Laceration
• Wound caused by an object in which there is
tearing and detachment of tissues.
Wire wounds.
 Intussusception or
• Invagination
When a portion of the intestine penetrates
into the immediate posterior portion.
DIAGNOSTIC TECHNIQUES
IN PATHOLOGY
 CYTOLOGY
• Mucosal scraping (smear)
• Imprint
• Fine needle cytological
aspiration (CADA)
 Sampling
ACAD
■ Superficial lesions or nodules (cutaneous,
subcutaneous, soft tissue, mucous
membranes and lymph nodes)
■ Internal lesions (serous cavities or
parenchymal organs) I guided by ultrasound
 Liquid Cytology
Peritoneal, pleural, articular, urine, BAL
 Cytopathology
Advantages: { Low cost
Disadvantages:
• Quick
• Scarce material
{ Low
invasiveness • Low sensitivity
{ Does not require
anesthesia
• Probability of error
if HP is not available
{ Little material
 Biopsy
■ With punch, trucut
or
punch.

■ Surgical

* Fixation in formaldehyde
10% V/V = 1/10
Macroscopic

Microscopic or
histopathological
Hematoxylin and
eosin
Phosphotungstic acid-hematoxylin
(PTAH)
Periodic Acid Schiff (PAS)-Blue
Alcian
Congo red
Ziehl-Neelsen
Von Kossa
Gomori metamine silver
Toluidine blue
DIAGNOSTIC TECHNIQUES
AUXILIARIES
Immunofluorescence and
immunohistochemistry
Uses antibodies to
identify tissue
components of
interest (cells or
extracellular matrix)
Visualized with
fluorescence or
immunostaining
> Fixation in 10%
formalin for no more
than 48 hours
 Immunofluorescence and
immunohistochemistry

Simian herpesvirus
 Electron microscopy

• Of transmission
(1000 to 4000x magnification)

Molecular biology
They detect the presence of
a gene sequence (DNA) or its

Mitochondria
expression in a cell (mRNA, proteins).
• In situ hybridization : detects mRNA, which
indicates expression of a gene and • • synthesis of
a certain protein.
• PCR = polymerase chain reaction. They are
based on the base pairing capacity of a segment of
nucleic acid (DNA or RNA).
• Western Blot : Detects the presence of a
specific protein, based on its molecular weight.
In situ hybridization
Analyzes the expression of a gene in a histological
specimen.
It consists of marking a probe -primer- (base
sequence) that will detect the molecule of interest,
pairing with its complementary chain, in the cells that
have been permeated.
The paired probe can be visualized by
immunofluorescence (FISH) or using an appropriate
detector.
The probe is incubated with the sample to bind
to an analogous sequence of RNA or DNA, and
subsequently be visualized in the
microscope

Polymerase chain reaction

• Detects specific sequences of nucleic acids.
• Obtains copies of a particular DNA fragment.
• It is used to copy and amplify a DNA fragment
and be able to identify with a high probability
viruses or bacteria , people or corpses,
hormones, genetic diseases or carry out
research on the amplified DNA.
• High sensitivity and specificity and less time to
obtain results.
PCR

1. Separation of the two strands of DNA that you

want to amplify.
 When the hydrogen bonds are broken, each
chain acts as a template to make its
complementary one.

2. The temperature is decreased so that the

probes (primers) that correspond to the ends
of the DNA fragment to be amplified,
“recognize” their complementary sequences in
the DNA strands and join them.
 Extension with Taq polymerase
3. The temperature is raised so that the taq
polymerase adds the different complementary
nucleotides, following the order of the chain that
serves as a template.
PCR
 4. Once the DNA molecule is amplified, it is run
on a gel (applying 100 mV current x 30 to 40
min.) Depending on the size of the DNA
molecule, the distance it travels on the gel will
be; It is stained with ethidium bromide to
visualize it (with UV light) in the form of bands.

The bands are Agarose gel PCR

compared with a
molecular weight
marker to verify if they
correspond to the
fragment being sought,
or can be run at the
same time as a known
control.
Western Blot PCR Fragment Marker
esomdecular 3
 Determine the presence of a specific protein,
with a known molecular weight, and
measure the relative amount in a sample
2 Secondary Antibody
Anti-mouse HRP
HRP + Luminol ECL
1' Primary Antibody
Non-specific Mouse \
Proteins

(Detected by
Film)
Non-specific
Proteins
Antigen
Protein of
interest Nitrocellulose
Membrane
Copyright2006 Molecular
Station
 Protein Blot on SDS Polyacrylamide
Nitrocellulose Electrophoresis Gel

W
e
st Label with Specific

e
Detect Antibody

r
n
Reveals Protein
of interest
Western Blot

215K

Tubulin

Actin
120K

84K

60K

39K
28K
I25k& • SOUTHERN
History of Pathology
 Egyptians (4000 BC)

• Medical and surgical

practice (trepanations)
• Embalming
(mummifications)
 Greeks
Hippocrates
(460-375 BC)
• father of medicine
• Disease descriptions
• Hippocratic oath: serves
to ethically guide the
practice of medicine
 Greeks
Aristotle (384-323 BC) or
Father of anatomy and
physiology
o Dissected animals for
study
o He studied the
development and growth
of animal life
 Romans
Cornelius Celsus
(30 BC –38 AD)
• Roman nobleman
interested in medicine
• He wrote 8 volumes on
medical observations
• Cardinal signs of
inflammation (heat, tumor,
redness and pain)
 Romans
Claudius Galen
(131-206 AD)
• Added the fifth cardinal sign of
inflammation (laesa
functio = loss of
function)
• Concepts of
antemortem and
postmortem inspection
of animals before
consumption
 European
Giovanni Battista
Renaissance
Morgagni
(1682-1771)
• He published the book “The
seats and causes of illness” (
De sedibus et causis
morborum per anatomem
indagatis )
• Record of 700 complete
autopsies
• Relationship between clinical
manifestation and injuries
• Founder of pathological
anatomy
 European
Marie-Francois Bichat
Renaissance
(1771-1802)
• He showed that the body is
made up of various tissues
• Descriptions of tissue
structures
 Pathology in
Carl Rokitansky
Europe
(1804-1878)
• Major descriptive pathologist
(70,000 autopsies)
• He established the
technique of necropsy and
the examination of each
organ, which is still used
today
 Pathology in
Johannes Mueller
Germany
(1801-1858)
• Examination of tissues
under a microscope
• Tissue structural
changes
• He published: “The
shape and fine structure
of morbid tumors”
• He had Rudolph Virchow
as a student
 Pathology in
Rudolph Virchow
Germany
(1821-1902)
o The organism is made up of cells
o The cell is the seat of tissue alterations in
diseases
o In 1848 he published: “Cellular Pathology”
which established the formal bases of human
and veterinary pathology.
o He instituted terms such as: thrombosis,
embolism, degeneration.
o Emphasized the need for postmortem
examination of animals
o He was unaware of the contributions
 Pathology in
Louis Pasteur's microbiology
Germany
 Pathology in
Germany
Julius Conenheim
(1839-1884)
• Creator of modern
experimental pathology
• Experiments of vascular and
cellular changes in the
mesentery of the frog when
applying acetic acid
• Vasodilation, accumulation of
leukocytes
• Foundation of the School of
 Pathology in
Germany
Veterinary Medicine August 17, 1853.

• MC. Agustín Zepeda, medical pathologist, taught

until 1877.

• MC. Mucio Maycot (1893) taught: General

Pathology, Legal Medicine and Pathological
Anatomy.

• MV. Eutimio López Vallejo (1914) taught and published

 Pathology in
Germany
his book: “Elements of Veterinary Pathology”
• MC. Isaac Ochoterena (1918) taught the
• MV. José Felipe Rulfo (1923-1926) taught the
• MV. Daniel Mercado García (1927) continued with the
professorship

Manuel H Sarvide
• Full professor in 1934 of histology and pathological
anatomy.
 Pathology in
• Germany
Definitively promoted veterinary pathology in
Mexico
• Published “Cancerous Cytology”, description of
veterinary neoplasms
• Initial description of diseases in Mexico
• Student Aline Schunemann
Veterinary Pathology in
Mexico
Aline Schunemann o Professor emeritus at UNAM o
Consolidated veterinary pathology in Mexico
o Teacher training abroad
o Postgraduate in veterinary pathology
o Case archive (tissues and images)
o Improvement of country trails
o Humane treatment of animals
Everyone who deals with the
phenomenon of Pathology soon
realizes that nature often speaks of its secrets in a tenuous
and discreet way; Of all that accumulation of events that
Veterinary Pathology in
Mexico
occurred, whoever manages to listen and understand
should not have intellectual pride and pre-established
conceptions, they should only listen carefully and ask
themselves what they heard.

Peyton Rous
All the morphologist can be sure of is what he sees on
macroscopic examination or in a histological preparation.
The histological preparation represents a single moment
in a long series of events; what occurred in the intervals
before and after is unknown and must be filled with
Veterinary Pathology in
Mexico
conjecture, since even the direction of motion is
sometimes uncertain. Most pathologists will agree on what
they see; However, when filling in the gaps of what is
missing, they do not always agree.
Thelma B. Dunn
Doctors who either performed many autopsies, or who
regularly observed postmortem examinations, learned to at
least have doubts. However, those who are not in touch with
the frequent and depressive findings of autopsy material
find themselves floating on the clouds of uncontrolled
optimism.
Veterinary Pathology in
Mexico Morgani de Sedibus, 1791