Introduction of

pathology
• By
Dr. amira kamal El-Hawary
Dr. AZZa Abdel-AZiZ A. Ali
You all have studied and understood
the broad contents of following
subjects
– Anatomy
– Histology
– Biochemistry
– Physiology

• Beginning this semester….you need to add

pathology
 Introduction to
pathology

?What is pathology
?Who is a pathologist•
?What is a disease•
?How are diseases diagnosed•
 Introduction
Pathology is the science which •
deals with the study of
.diseases

Pathology (Gr. pathos" disease” •

”(+ logos "word, reason
 The Tree of Medicine
((After G. Diamandopoulos

Pathology is
the study of
the links
between
diseases and
the basic
science
 introduction

Pathologist is a person identifying

diseases based on the examination
of cells and tissues removed from
the body
 ?What is a Disease

A disease is a physical or functional disorder of normal body systems•

that places an individual at increased risk of adverse consequences
Diseases are diagnosed by physicians or other health care providers•
through a combination of tools
When a disease is diagnosed, treatment is given to prevent•
complications and to improve prognosis
 Diagnosis
”(Gr. dia“through” + gnosis“ knowledge)

Diagnoses are made by three general categories of physicians or•

:health care providers
Clinical diagnosticians identify diseases by examination of–
patient’s history and physical examination

Pathologists identify diseases by examining cells and tissues–

removed from the body

Radiologists identify diseases by imaging the intact body–

 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 consequences of the morphologic changes, as observed
.clinically
:Knowledge of etiology remains the backbone
Disease diagnoses
Understanding the nature of diseases
.Treatment of diseases
.I-Etiology: This means the causes of the disease
:includes
:i- Predisposing factors
I.e. factors which help development of the
.disease
:ii-Exciting factors
Is the direct cause of the disease (i.e. cause
(.lesion
 Causes of disease
• Oxygen deprivation ( hypoxia, ischemia)
• Nutritional imbalances
• Physical agents
• Chemical agents and drugs
• Infectious agents
• Immunologic reactions
• Genetic derangements
The core of the science of
pathology — the study the
pathogenesis of the disease.
:II Pathogenesis
The mechanisms by which the causative
agent produce the pathological
, changes in the tissues
III Morphology
structural alterations in cells and
tissues
• – Gross = Changes in the tissue or
organ
• – Microscopy = Changes noted under
a light microscope
 Gross appearance of lungs
Normal & Cut surface
Normal Lung Normal Lung
cut surface
Gross appearance of lung in
diseases

Pneumonia Lung Tumor •

 Gross appearance of
heart in diseases
• Normal heart Hypertrophied heart
 Microscopy
• Histologic and cytologic observation
under a light microscope
• most common and basic formalin fixed
• → HE (hematoxylin and eosin) stained
 Microscopy
Normal Lung Pneumonia
 Pathological investigation
I- Biopsy: Is the study of a specimen from
.the lesion during life
II- Autopsy: Is post-mortem examination of
.the cadaver
The materials obtained are put immediately
in fixative fluid to prevent its autolysis.
.This fluid is commonly 10% formalin
 III Ultrastructural observation
(electron microscope)

• Ultrastructural observation
IV-Immunohistochemistry
Antigen -antibody specific reaction that
use antibodies to various constituents of
human cells and their products which help in
clinical diagnosis and distinguishing
diagnosis of tumor histogenesis
 V-Molecular biology
technique
1. Polymerase chain reaction (PCR)
2. DNA sequencing
 Additional terms
Prognosis: Is the forecast of the course &
.termination of a disease
Complications: Are additional pathological
changes which may occur during or after
the termination of the usual course of the
disease. Thus affecting or modifying the
.prognosis of the disease
 So then, what is the
?importance of Pathology
Every disease has a
pathological base
 INFLAMMATION
Definition:
It is a response of living tissue to injurious agent.
The response consists of a series of vascular, lymphatic
and local tissue changes.

Aim of inflammation: :
1. Destroy, dilute, remove or localize injurious agents.
2. replacement of the damaged tissue by a new healthy
one.
.
 Causes of inflammation
• The injurious agents which cause inflammation are
called irritants, these may be:
(A) Living irritants
Bacteria, viruses, fungi and parasites.
(B) Non living irritants: Include
• i- Physical irritants
• ii- Chemical irritants
• iii- Necrotic tissue
• iv- Immune mechanism (Ag/Ab reaction)
 Types of inflammation
According to the onset, severity and duration of irritation, it is
classified into:
(1) Acute inflammation:
- It is of sudden onset, short duration.
- Caused by strong irritant e.g. abscess caused by staphylococci

(2) Chronic inflammation:

- It is of gradual onset, longer duration.
- Caused by mild persistent irritant e.g. TB
abscess
Morphological changes in acute inflammation

1) Vascular changes.
II) Exudative changes.
III) Local tissue changes.
 I. Vascular changes
A) Changes in the caliber (diameter) of the blood vessels:
-Transient vasoconstriction of the arterioles lasting for few seconds.
-Permanent vasodilatation:

B) Changes in the vascular wall:

Increase vascular permeability

C) Changes in the blood flow:

i-The vasodilatation is accompanied by temporary acceleration of
blood flow.
ii-This is followed later by gradual slowing
 II- Exudative phenomenon
(A) Fluid component (fluid exudate)
Accumulation of extra cellular fluid at the area of
inflammation to dilute the irritant specially chemical
and bacterial toxins. It brings antibodies to the site
of inflammation
(B) Cellular component (cellular exudate)
escape of leucocytes (neutrophils, macrophages) outside
the circulation for destruction of microorganisms and
necrotic debris.
Fluid and cellular
exudate
 III-LOCAL TISSUE
CHANGES
• The irritant is at a maximum concentration in
the center of the inflammatory area where it
produced necrosis ( death of group of cells).
• In the surrounding area, it is of lesser
intensity producing degeneration (sick cell).
• Necrotic cells and degenerated cells release
chemical substances called chemical
mediators which help the vascular changes.
 CHRONIC INFLAMMATION

• Definition:
It is inflammatory process in which lymphocytes,
plasma cells and macrophages predominate and
which is accompanied by fibrosis.

• Causes: chronic inflammation may arise in one of

two ways:
• It may follow acute inflammation.
• Chronic almost from the onset.
 General features of chronic
inflammation
.The irritant is mild and has a prolonged action-
.Onset is gradual and duration is prolonged-
.Initial tissue necrosis may not be marked-
Vascular phenomenon is less marked than in acute-
.inflammation
.Fluid exudate is not marked-
-Cellular exudate consists of:lymphocytes, plasma
cells, macrophages and giant cells forming
granuloma