Importance of learning of
Pathology
• Pathology literally translates as the study of
suffering (Greek: pathos = suffering, logos = study)
• As applied to modern medicine, it is the study of
disease
• Pathology is the study of the causes and effects of
disease or injury
• It is the bridge between science and
medicine.
• Pathology is important in, every aspect of
patient care, from diagnostic testing and
treatment advice to using cutting-edge
genetic technologies and preventing disease.
• Pathologists play a critical role in research, advancing medicine
and devising new treatments to fight viruses, infections and
diseases like cancer.
Pathology addresses four components of
disease:
• Cause (etiology),
• mechanisms of development (pathogenesis),
• structural alterations of cells (morphologic changes –
gross and microscopic), and
• the consequences of changes (clinical manifestations)
1. Cause (etiology)
A. Genetic
B. Acquired (Environmental factors)
- Physical
- Chemical
- Nutrition
- Infections
- Immunological
- Psychological
2. Pathogenesis
• Sequence and patterns of cellular injury that lead to
disease
• The term can also describe the origin and
development of the disease, and whether it
is acute, chronic, or recurrent
3. Morphologic changes – gross and
microscopic
• Gross Examination:
• Determining what organ you are looking at
• Determining what’s wrong (the pathology)
• Useful Gross features: Size, Shape, Consistency, Color
• Microscopic examination – Under microscope
4. Consequences of changes (clinical
manifestations)
• Sign and symptoms
• Disease course
• Prognosis
The modern practice of pathology is divided into a
number of subdisciplines:
• Histopathology
• Cytopathology
• Clinical pathology
• Hematopathology
• Blood Banking and Transfusion medicine
• Molecular pathology
Histopathology
• Microscopic examination of various forms of human
tissue
• Specifically, in medicine, histopathology refers to the
examination of a biopsy or surgical specimen by a
pathologist, after the specimen has been processed and
histological sections have been placed onto glass slides
• This contrasts with the methods of cytopathology, which
uses free cells or tissue fragments
• Histopathological examination of tissues starts with
surgery, biopsy, or autopsy.
• The tissue is removed from the body/ organ and then
placed in a fixative that stabilizes the tissues to
prevent decay. The most common fixative is formalin
• To see the tissue under a microscope, the sections are
stained with one or more pigments (eg hematoxylin and
eosin).
• Histochemistry refers to the science of using chemical
reactions between laboratory chemicals and components
within tissue to stain the slides.
• The histological slides are then interpreted
diagnostically and the resulting pathology report
describes the histological findings and the opinion of the
pathologist.
A biopsy is a sample of tissue taken from the body in order to
examine it more closely
• Needle biopsy: Large bore needle is used to access the suspicious
tissue.
• CT-guided biopsy: CT-scanner help doctors determine the exact
position of the needle in the targeted tissue.
• Ultrasound-guided biopsy: An ultrasound scanner helps a doctor
direct the needle into the lesion.
• Bone biopsy. A bone biopsy is used to look for cancer of the bones.
• Bone marrow biopsy: A large needle is used to enter the pelvis
bone to collect bone marrow. This detects blood diseases such as
leukemia or lymphoma.
• Liver biopsy: A needle is iserted into the liver through the skin on the belly,
capturing liver tissue.
• Kidney biopsy. Similar to a liver biopsy, a needle is inserted through the
skin on the back, into the kidney.
• Aspiration biopsy. A needle withdraws material out of a mass. This simple
procedure is also called fine-needle aspiration
• Prostate biopsy. Multiple needle biopsies are taken from the prostate
gland.
• Skin biopsy. A punch biopsy is the main biopsy method. It uses a circular
blade to get a cylindrical sample of skin tissue.
• Surgical biopsy. Either open or laparoscopic surgery may be necessary to
obtain a biopsy of hard-to-reach tissue. Either a piece of tissue or the whole
lump of tissue may be removed.
Branches of histopathology
• Dermatopathology
• Neuropathology
• Pulmonary pathology
• Renal pathology
• GI Pathology
• Forensic pathology/ autopsy
Cytopathology
• Branch of pathology that studies and diagnose diseases on the
cellular level.
• Usually aids in the diagnosis of cancer, but also certain infectious
diseases and inflammatory conditions and diseases involving sterile
body cavities (peritoneal, pleural, and cerebrospinal)
• Cytopathology is generally used on samples of free cells or tissue
fragments (in contrast to histopathology, which studies whole tissues)
• Cytopathologic tests are called smear tests because the samples
are smeared on a glass slide for staining and microscopic
examination.
• However, cytology samples may be prepared in other ways,
including cytocentrifugation.
Chemical pathology, also called clinical chemistry
• Concerned with the diagnosis of disease based
on the laboratory analysis of bodily fluids, such
as blood, urine, and tissue homogenates or
extracts using the tools of chemistry, microbiology,
hematology, and molecular pathology.
There are following secondary specialties of
clinical pathology:
• Chemical pathology, also called clinical chemistry
• Hematopathology
• Blood banking - Transfusion medicine
• Cytogenetics
• Molecular genetics pathology
• Reproductive biology including Assisted reproductive
technology, Sperm bank and Semen analysis
• Immunopathology
Types of specimens used in clinical pathology
• Blood - Blood is used in many tests as
- As a "whole“
- As the fluid left when red and white blood cells are removed (plasma)
- As a clear fluid that separates from blood when it clots (serum)
• Urine - Urine is also used for many tests. Urine samples can be
collected by:
- Random method. Early morning specimen
- 24 Hr Urine Sample
- Clean catch specimen. The outer genital area has been cleaned
before urinating in a cup.
- Sterile urine. - catheterization. A tube is put into the urethra and
goes to the bladder to get urine.
• Sputum (also called phlegm) - Sputum can be coughed into a
clean container.
• Stool (also called feces) - Stool is often collected by the person
in a clean cardboard or plastic container.
• Other body fluids - Other body fluids collected for testing may
include:
- Spinal fluid
- Pleural fluid. (pleural cavity).
- Cerebrospinal fluid
- Ascitic fluid
- Joint fluids
- Bone marrow aspirate
Types of Microscopes
• Simple microscope
• Compound Light Microscope
• Digital Microscope
• Electron microscope
• Polarizing Microscope
• Inverted microscope
