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Lecture 1

This document provides an introduction to pathology for dental students. It defines pathology and disease, and outlines the key aspects studied in pathology including definition, etiology, pathogenesis, morphological examination, prognosis, and complications of diseases. It describes the importance of surgical pathology in medical practice and different methods of pathological examination, including gross examination, light microscopy, electron microscopy, immunohistochemistry, frozen sections, and cytology. Learning outcomes include understanding important pathology terms, the role of surgical pathology, and different examination methods and techniques.

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16 views

Lecture 1

This document provides an introduction to pathology for dental students. It defines pathology and disease, and outlines the key aspects studied in pathology including definition, etiology, pathogenesis, morphological examination, prognosis, and complications of diseases. It describes the importance of surgical pathology in medical practice and different methods of pathological examination, including gross examination, light microscopy, electron microscopy, immunohistochemistry, frozen sections, and cytology. Learning outcomes include understanding important pathology terms, the role of surgical pathology, and different examination methods and techniques.

Uploaded by

ahmedfawakh0
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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BMS 252

General Pathology for dental students


By
Dr. Mona Younis Youssef
A member of pathology team
pathology lecture 1;
Introduction to Pathology
Learning Outcomes
By the end of the lecture, you will be able to:
1. Understand the important terms in pathology.
2. Recognize the importance of surgical pathology in medical practice.
3. Identify different methods of pathological examination.
4. Recognize the different pathological techniques.
Pathology
Pathology is:
It is the science which deals with the study of diseases.

What is “Disease”??
It is “A State in which an individual exhibits an anatomical,
physiological, or biochemical deviation from the normal”
This study includes the following points:
1. Definition & Nature of the disease.
2. Etiology.
3. Pathogenesis.
4. Pathological examination of the lesions.
5. Fate & Prognosis.
6. Complications.
7. Pathological investigations.
The important terms in
pathology
I-Definition & Nature of the disease:
i- Congenital & Hereditary diseases.

ii- Acquired diseases:


Inflammation
Degeneration
Circulatory disturbance
Infectious, nutritional and genetic diseases
Tumors
II-Etiology:
means the causes of the disease.
i- Predisposing factors: ii. Exciting factors:
factors which help development of Is the direct cause of the disease
the disease.
as bacterium, virus, trauma, etc

In other words “the Risk factors


which make an individual more
susceptible to a disease than
others”

as obesity, poor ventilation, etc..


The structural changes occurring in the tissue
as the results of the disease are called

“lesions”.
III- Pathogenesis:
The mechanisms by which the causative agent produce the
lesion in the tissues,

i.e.
mechanism of lesion formation.
IV- Morphology
(Pathological examination of the lesions):
it is the structural changes in the diseased tissues which includes:
i- Gross picture (macroscopic picture): A naked eye description of the
pathological changes.

ii- Microscopic picture (histological picture): These are the changes in


the tissues of organs detected on microscopic examination by:
Light microscope
Electron microscope
Immunofluorescence microscope.
V- Fate & Prognosis:
Is the forecast of the course & termination of a
disease.
VI- Complications:
Are additional pathological changes which may occur during
the course or after the termination of the usual course of the
disease.

Thus affecting or modifying the prognosis of the disease.


VII - Pathological investigations:
a- Biopsy: Is the study of a specimen from the
lesion during life.

b- Autopsy: Is the study of a specimen from


the lesion after death.
The importance of surgical
pathology in medical practice
The practice of surgical pathology is mandatory for:
1. Diagnosis; identify the disease.

2. Determination of treatment; [medical, surgical, radiotherapy,


chemotherapy].

3. Follow up to determine the treatment success and effectiveness of


therapy
Surgical Pathology Specimens
1.Excision biopsy: surgical resection of the entire lesion.

2.Incision biopsy: Surgical resection of part of the lesion.

3.Tru-cut biopsy: Core of tissue obtained by large needles.

4.Fine needle aspiration: fluid aspiration from the lesion by a fine


needle for cytologic smear preparation.
Tru-cut biopsy (Core biopsy)
23
Fine-needle aspiration cytology
(FNAC)
24
Fixation
Immediate specimen fixation is mandatory.
The widely used fixative is 10% formaldehyde (Formalin)
buffered to a neutral pH.

Importance:
Preserve the morphology.
Prevent autolysis.
Minimize microbial growth.
The methods of pathological
examination
Pathological examination of the lesions
A. Gross picture (Macroscopic picture= Naked eye; N/E): A naked eye
description of the pathological changes.
We should comment on: (4s, 4c):
•Site
•Size
•Shape
•Surface (smooth, irregular)
•Capsule
•Color
•Consistency (firm, soft, hard)
•Cut surface [presence of necrosis (paler areas) or haemorrhage]
B. Microscopic picture:

These are the changes in the tissues of organs detected on microscopic


examination by:
Light microscope
Electron microscope
Immunofluorescence microscope.

28
1. Light microscope
- Routine hematoxylin
and eosin stain (H&E)
1. Light microscope
- Special stains

Sudan III, Fat, liver


30
1. Light microscope
- Immunohistochemical (IHC) stain

Keratin IHC, Buccal mucosa


31
2. Electron microscope (EM)
Gives black and white images
Tooth enamel (EM)

32
3. Fluorescent microscope (FM)

Tooth (FM)
Kidney (FM)

33
The different pathological
techniques
Pathological Techniques
[A] Paraffin technique:
1.Samples are cut grossly from the specimen.

2.Samples are processed and embedded in paraffin.

3.Samples are sectioned on glass slides (unstained).

4.Sections should be stained by Hematoxylin and Eosin (H&E) for microscopic


examination. Other special stains, IHC stain could be used.

5.Stained slides are examined on microscope. 35


36
4
1
3
6

2
5

Microtome

37
[B] Frozen technique used for

“Intraoperative Consultation"
Rapid microscopic examination of fresh tissue is
done for intraoperative consultation which is
needed for important decisions during operation by
preparation of histologic slides using the frozen
section technique.
38
Staining and
Rapid Freezing Cutting on examination
Cryostat

39
[C] Cytological examination.
Stained smears prepared from fluid samples.

40
Now,
can you answer the following?
Prognosis means:
1. Cause of the disease
2. Mechanism of formation of the lesion
3. Morphology of structural changes
4. Added difficulties to the course of a disease
5. The forecast of the course of a disease
Frozen section technique is applied for:
1. Postoperative diagnosis
2. Postmortem diagnosis
3. Fixation of pathology specimen
4. Electron microscopy
5. Intraoperative consultation.
Complications means:
1. Cause of the disease
2. Mechanism of formation of the lesion
3. Morphology of structural changes
4. Added difficulties to the course of a disease
5. The outcome of the disease
References & recommended readings

1. https://medicine.nus.edu.sg/pathweb/pathology-
demystified/approach-to-gross-pathology/where-to-start/

2. https://www.microscope.com/students-guide-light-microscope/

3. Pathmax: http://www.pathmax.com/

4. Webpath:http://library.med.utah.edu/webpath/inflhtml/inflidx.html
Welcome to Pathology

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