Introduction His To Pathology
Introduction His To Pathology
word pathology is derived from two Greek words- pathos meaning suffering words- pathos and logos meaning study. logos
Thus,
pathology is the scientific study of diseases i.e. it is the study of abnormal form and function and the relationship between them.
1- Etiology (Its cause). 2- Pathogenesis ( Mechanism of development). 3- Morphologic changes (gross and microscopic pictures). 4- Functional derangement (clinical significance of the disease).
The
study of organs and tissues removed from the dead body for verification of the clinical diagnosis and treatment of the disease . Includes: gross & microscopic examination.
Pathological
study of surgically removed tissues or organs during life for diagnosis & therapy. Includes: gross & microscopic examination.
Types of biopsies
Tissue biopsy
1. Surgical biopsy: a) Incisional biopsy. b) Excisional biopsy. 2. Tru cut (core) needle biopsy. 3. Endoscopic biopsy.
Cytology
Incisional
removed.
Excisional biopsy
Excisional biopsy
This
type of biopsy is performed using an endoscope introduced through a natural body orifice (e.g. rectum) or a small incision (e.g. arthroscopy). A small forceps is used to take a sample from the lesion. Samples are small fragments.
Endoscopic biopsy
Endoscopic biopsy
It
Cytology
Is
the study of cells in smears prepared from exfoliated cells. cells. e.g: pleural effusion urine smear from cervix . as a screening test for cancer in patients who have no clinical evidence of the disease.
Used
FNA
-This involves the aspiration of cells or fluids from masses that occur in palpable sites e.g. breast, thyroid & lymph nodes. nodes.
Thyroid
Breast
-For diagnosis within minutes while surgery is taking place in suspected cases of cancer. -Uses: 1.Determine the nature of the lesion e.g.breast e.g.breast lump. lump. 2.Determine the adequacy of surgical margins e.g . malignant ulcer. ulcer. 3. In sentinel LN procedure, a LN containing tumour tissue prompts further LN dissection while a benign LN will avoid such a procedure.
For
frozen section technique, the tissue is always transported fresh (unfixed). tissue is frozen and then sectioned. sections are ready for staining. staining.
The The
Adequate. Representative:
Piece of tissue submitted must be from the lesion & preferably include an adjoining area of healthy tissue. Labeled. Combined with adequate clinical information.
1. Fixation:
10% formalin (most commonly used). Other fixatives: - 95% alcohol ( in cytologic smears)
2.Dehydration: - By passing the tissue in ascending grades of alcohol 70%,95% & 100%. 70%,95% 100%. 3.Clearing : - by using certain reagents ( e.g. Xylol). 4.Impregnation in paraffin wax (soft paraffin): -Done automatically by an electric apparatus. 5.Blocking out : in hard paraffin wax.
6.Sectioning : - section cutting by microtome. 7.Staining: - H & E stain OR Special stains. 8.Mounting: -Covering the stained section by a colourless medium that preserves the section. -The commonest mounting medium is canada balsam.
Formation of slides
A 48-year-old male comes to the physician because 48-yearof an odd discoloration of his skin. A full work up for this abnormal skin pigmentation shows diabetes mellitus & increased levels of serum ferritin & transferrin saturation. A liver biopsy was done . In addition to H&E ,which of the following is ,which the most appropriate stain to use for this specimen? a)Congo red. b)Periodic acid- Schiff. acidc)Prussian blue. d)Mucicarmine.