Introduction To

Pathology
Dr.Samuel
 Introduction

• Pathology is study of disease/suffering (pathos/logos) and its

causation.
• Disease is any alteration of Health
• WHO Defination of Health: is a complete well being:
Physically, Mentally and Socially.
• Core substances in pathology:
• Etiology
• Pathogenesis
• Morphology and
• Manifestation
 Cont...

• Pathology is the scientific study of disease

• Pathology is the foundation of medical science & practice
• Pathology is a bridging discipline devoted to the study of
the structure & functional changes in cells, tissues & organs
that underlie diseases
 History of Pathology
• Era of Medical Antiquity, the early dominance of animism,
diseases caused by mystification
• Era of Morbid Anatomy
• Autopsies performed scientifically from about 1500A.D,
19th century in Germany by ROKITANSKY & ASCHOFF
 Subdivisions of Pathology

• Histopathology: The investigation & diagnosis of disease from the

examination of tissues architectural organization
• Cytopathology: The investigation & the diagnosis of disease from the
examination of isolated cells
• Haematology: The study of the disorders of the cellular & coagulable
components of blood
• Toxicology: The study of the effects of known or suspected poisons
• Forensic pathology: The application of pathology to legal purposes
(e.g. investigation of death in suspicious circumstances and criminal
asualts)
• Chemical pathology : The study & diagnosis of disease from the
chemical changes in tissues & fluids
 Techniques of pathology

• Light Microscopy- appreciates the structure of tissues & cells in

health & disease
• Histochemistry- is the study of the chemical component and their
distribution in tissues
• Immunohistochemistry- is histologic study employing antibodies and
antigen reaction to visualize substances in tissues sections or cell
preparations
• Electron Microscopy- study of disorders at very high magnification,
1,000,000 times; at organelle level & demonstration of viruses in
tissue samples
• Biochemical assays- Fluid & electrolyte homeostasis, serum enzyme
assays e.g. raised levels of cardiac enzymes in the blood
• Radioisotope techniques (Autoradiography): Scans diseases using
intake of different isotopes eg. Thyroid diseases by iodine isotopes
• Molecular Pathology- Uses advances of new science, molecular
pathology eg. in the study of genetic defects, using DNA technology;
eg. IN SITU HYBRIDISATION in different diseases e.g.Hg molecule,
collagen.
 General & Systematic Pathology

• General Pathology:
• Is teaching of our current understanding of the causation,
mechanisms and characteristics of the major categories
of disease (e.g. congenital, acquired, inflammation,
tumors or degenerations)
• Systematic Pathology:
• Is teaching of our current knowledge of specific diseases
as they affect individual organs or systems
(e.g.appendicitis, lung cancer, atheroma).
What should we learn in pathology?

• A logical & orderly way of thinking about diseases & their

characteristics:
–Incidence and prevalence
–Etiology
–Pathogenesis
–Pathological (morphologic) features
–Clinical features (manifestations)
–Diagnoses
–Complications and sequelae
–Prognosis
 Etiology of diseases

• It is a cause of disease
• General Features of etiology
• Single or multiple causes of a disease
• Single cause a particular disease of different severity
• Some times no disease by the particular etiology
• Important terms related to etiology
• Pathogenesity: the power of inflicting disease of by an
etiology, particularly of infectives.
• Susceptibility: The liability of a person to acquire a
particular disease
• Associated factors: Factors contributing to the severity or
occurrence of a particular disease.
 Classification of etiology

• Genetic : Inherited chromosomal abnormality or mutations

• Aquired: causes disease after birth
• Dietary deficiency: Usually multiple and complex deficiency
of diets.
• Dietary over intake: Obesity, Diabetes , Hypertension and
heart diseases
 cont...

• Physical agents: Trauma, Heat and cold, electricity, radiation,

atmospheric pressure
• Chemicals: Drugs, Industrial products (agriculture or home
use)
• Infective microorganisms
• Immunologic
• Psychogenic
 Morphology
• Def.: Structural alterations underlying diseases, progressively or
regressively to give different manifestations.
• The different morphologic alterations can be
• Early as Molecular
• Late as Gross (necked eye) changes
• Intermediates can be seen in microscopy :
• Routinely by Light microscopy or
• Electrone microscopy
 cont..…
• The morphologic changes are appreciated from the different
samples (specimens) that the clinicans send:
• Necropsy: Samples from dead body (postmortem
examination, autopsy)
• Biopsy: Specimens from live patient
• Body fluids: peritoneal, pleural, pericardial, joint spaces, CSF,
Urine, Blood, Cystic spaces fluid, Sputum etc.
• Surface scrapes: mucosal (eg. buccal, conjunctival) and skin
surface lesions sampling
• Aspirations: sampling of solid organs or inaccessible or
small spaces by needle eg. Bone marrow, L. nodes and
endometrial cavity
• Washes: sampling of inaccessible spaces or surface by
rinsing using isotonic fluids.
• Brushing: sampling of small delicate spaces or surfaces
such as bronchial mucosa
PATHOGENESIS

• It isDevelopment of disease altering the structure

progressively or even regressively.
• This is the knowledge it helps us predict the out come of
disease or prognosis.
• The mechanism through which the etiology (cause) operates
to produce the morphological alterations and clinical
manifestations.
 Manifestation

• It is Characteristics representing underlying morphologic

alterations which they alter the Anatomical, Biochemical and
Physiological which the patient may complain or the clinician
appreciates.
 Diagnostic Pathology
• Biopsies are samples of tissue removed from a patient for
diagnostic purposes.
• biopsy methods:
• Needle biopsy
• Endoscopic biopsy
• Incisional biopsy
• Excisional biopsy (resections)
 cont...

• Cytology involves the examination and interpretation of dispersed

cells rather than solid tissues, usually for the diagnosis of cancer &
pre-cancerous lesions.
• These cells can be obtained by a variety of methods according to
the organ being investigated
• Samples for cytology can be obtained by a variety of
methods, according to the organ being investigated
 Exfoliative cytology: collects shaded cells from surfaces:
• Fluid cytology : cells withdrawn with the fluid in which
they are suspended
• Washings: cells flushed out of an organ using an
irrigating fluid
• Brushing/Scraping: accessible or exposed surface
 Fine –needle aspiration cytology: cells are collected by
suctions of a solid tissue using a thin needle attached to a
syringe.
 AUTOPSIES

• It is means examination of a deceased body

• Necropsy: Tissue samples from autopsy
• Autopsies are used for:
–Determining the cause of death
–Audit of the accuracy of clinical diagnosis
–Education of undergraduates & postgraduates
–Research into the causes and mechanisms of disease
–Gathering accurate statistics about disease incidence
 Nomenclature of disease
• Common prefixes
• Primary vs Secondary
• Acute vs chronic: Dynamicity of severity and onset
• Benign vs Malignant
• Hyper, Hypo and meta
Common suffixes

• –itis: denotes Inflammatory eg appendicitis, colitis

• –oma: denotes swelling or mass eg Fibroma, carcinoma,
lymphoma
• –osis: denotes state or condition not necessarily pathological
eg osteoporosis, osteoarthrosis, nephrosis
• –oid: denotes resemblance eg. Rheumatoid disease,
Leukomoid reaction
• –plasia: related to proliferation or growth eg. Hyperplasia,
dysplasia
• –opathy: recognized pathologic abnormality, but not specific
eg Lymphadenopathy, osteorathropathy
• –megaly: denotes enlargement eg. Splenomegaly,
hepatomegaly
• -ithiasis: denotes concretions eg. Urolithiasis, Cholelithiasis
Epynomous names

• It is Disease naming after a person, place or abbreviations

eg.:
• Grave’s disease, Hodgkin disease, Bantu’s disease, COPD
(chronic obsructive lung diseases), GOO (Gastric outle
obstruction)
• Syndromes: Constellation of sign and symptoms
characterizing a particular disease eg. Cushing syndrome,
Nephrotic syndrome
 Principles of disease
• Diagnosis: Giving specific name to a disease to have specific
treatment or any other management which they can be
reproducible and evaluable.
• Differential diagnosis: List of diseases sharing many features
that they need farther work up to get specificity
• Prognosis: Prediction of the out come of a disease.
• Complication: The course of a disease which is unusual and
could be explainable or not.