HISTOPATHOLOGY

Introduction to Pathology
DEFINITION OF TERMS:

 Pathology
 From Greek, Pathos = pain & Logos = word
 Also called Pathobiology
 Bridging discipline of basic science and clinical practice
 Study of structural and functional changes in cells, tissues, and organs that underlie disease.
 Aspects of disease forming core of pathology:
 Etiology/Cause
 Pathogenesis/Mech. of development
 Morphologic changes/structural alterations
 Clinical significance/functional consequences
 Microscope
 Important in detecting tissue changes, esp.in the examination of small sections of tissue removed for
diagnosis
 Pathogenesis
 The development of a disease or morbid condition
 Pathologist
 A physician who interprets & diagnoses the changes cause by disease in the body
 A specialist physician expert in the origin & progress of disease & the microscopic analysis of body
tissues
 A physician who studies all aspects of disease with an emphasis on the nature, causes, & the
development of abnormal conditions, as well as the structural & functional changes that result from
disease processes
 The laboratory expert behind the front line clinical team.
 Medical Technologist
 An allied health profession who performs diagnostic analysis on:
 Human blood
 Urine
 Body fluids:
 Cerebrospinal fluid  Pericardial fluid
 Peritoneal fluid  Synovial fluid
 Other specimens:
 Stool
 Sputum
 Autopsy
 In greek: A seeing for oneself , Auto-, auto + opsis , sight
 AKA necropsy, post-mortem examination.
 Systematic examination of a cadaver for study or for determining the cause of death
 Uses of any methodical procedures to determine the etiology & pathogenesis of diseases, for
epidemiologic purposes for establishment or genetic causes, for family counsel, and for
improvement of safety standards for the living
 Biopsy
 Examination of cells or tissues from a living organisms
 Excised material may be studied in order to diagnose disease or to confirm findings of
normality
 Incisions may be made and total or partial lesions removed in form of wedges or
cylindrical pieces or scrapings of the surface membranes of internal organs may be
collected.
 Tumors are routinely biopsied in order to determine whether they are malignant or
benign.

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DIVISIONS OF PATHOLOGY
GENERAL PATHOLOGY SYSTEMIC PATHOLOGY
Description Basis reaction of cells and tissues to abnormal Specific responses of specialized organs and
stimuli that underlie all diseases tissues

 Gross pathology
 Anatomic pathology
 Clinical pathology

DECRIPTIONS OF DIVISIONS OF PATHOLOGY

 Gross pathology & microscopic pathology

 Gross pathology:
 Recognition of disease based on macroscopic exam of specimens from surgery or autopsy
 Microscopic pathology:
 Recognition of disease based on microscopic exam of specimens from surgery or autopsy

 Anatomic pathology
 Study of changes in the function, structure, or appearance of organs or tissues, including post
mortem examination and the study of biopsy specimens
 Division of Anatomic Pathologys:
 Surgical pathology
 The pathology of disease processes that are surgically accessible for diagnosis or
treatment
 The study of gross appearance and histology of tissues removed during surgery
 Autopsy pathology
 Involves external and internal examination of a human body after death
 The study of gross appearance and histology of tissues removed ff. death
o Most important task: Identify cause of death
 Exfoliative cytology
 Branch of general cytology which deals with the microscopic study of cells that
have been desquamated from the epithelial surfaces

 Clinical pathology
 Focused on diagnosing & monitoring of diseases through the examination of blood, body fluids,
secretions, & tissue biopsy specimens for chemical, morphological, microbiological &
immunological abnormalities.
 Identifies & interprets changes that characterize diff. diseases or disease states in cells, tissues, &
fluids of the body
 Monitor metabolic status of patients under medical therapy
 Decipher specific markers that characterize individual patients for purposes such as transfusions
or transplantations
 ! Subdivided into:
 Clinical chemistry including toxicology
 Hematology
 Blood banking including transfusion medicine
 Microbiology including immunology
 Clinical Immunology & Serology

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  Description per subdivisions of Clinical pathology
 Clinical Chemistry including Toxicology
 Biochemical analysis performed on human samples (Blood, Fluids & Tissues)
 Substances which could be assayed:
o Sugars o Hormone
o Lipids o Vitamins
o Proteins o Metals
o Ab o Electrolytes
o Enzymes
 Employed methods
o Spectrophotometry o Flame photometry
o Fluorometry o Ion selective eletrodes
o Enzyme kinetics o HPC
o Enzyme o Gas chromatography
immunoassay o Mass spectrometry
(EIA) o Atomic absorption spectrometry
o Electrophoresis

Most instruments are almost completely automated

In the toxicology subsection:
o Specimen are analysed for presence of drugs & substance abuse.
 An important application of toxicology testing:
o measure the blood levels of therapeutic drugs to assure that conc. are:
 Adequate to treat the disease
 But not so high as to cause toxic side effects
 Hematology
 assessment of the cellular elements (RBC, WBC, and platelets) in blood samples
 Blood cells may be enumerated, either by manual cell counting techniques or
automated particle sensing and sizing instruments.
 Microscopic examination of stained PBS is limited to assessing the morphology in
atypical cells as they may appear in cases of dysplastic syndromes and overt
leukemias.
 Hematopathologists examine bone marrow and lymph node biopsies, expert in
the field of anemia, leukemia, and lymphomas.
o In complicated cases, the diagnosis of a hematological disorder cannot be
made by study of the PBS, a bone marrow exam is done
 Blood banking including transfusion medicine
 Also called immunohematology
 Deals with collection, storage, compatibility and safety of blood with its various
components for the purpose of human transfusion
 Specific tasks include:
o Blood collection after donor screening
o Chemical and serological tests to exclude transmission of infective diseases
o Component preparation & proper storage
o Blood typing, screening for antibodies against red cells and compatibility
testing
o Immunophenotyping of blood cells
o Investigation into transfusion reaction
o Apheresis & plasmapheresis
 Procedure where plasma or platelets can be separated from the
withdraw blood and the formed elements (red cells and
platelets)
 Microbiology including immunology
 Involved in isolation, culture and identification of microorganisms in biological
samples
 In addition to conventional microscopic and biochemical methods for
identification, DNA/RNA based assays including PCR and Immunoassays are being
used.

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 Subdivisions include:
o Bacteriology
o Parasitology
o Mycology
o Virology
 Presumptive identification of microbes can be made by microscopically examining
direct mounts of an appropriate portion of the specimen or thin smears that have
been stained with a variety of dyes
 Rapid presumptive diagnoses can also be made by directly testing specimens with
a variety of immunological rgts.
 Specimens are applied to the surface of a variety of agar culture media for the
purpose of recovering in pure culture any bacterial species that may be clinically
significant.
 Gram stains may determine the cellular morphology and staining characteristics of
the bacteria and a variety of rapid, direct tests can be performed to provide an
early identification
 The lab id of fugi and the diagnosis of fungal infections is similar to bacteria
 Specimens are inoculated on special fungal media, incubated for as long as 4
weeks, growth of mold or yeast is identified morphologically and biochemically.
 Nucleic acid pprobes are available to quickly confirm any fungus colony suspected
of being one of the dangerous pathogens
 The lab id of parasites involve microscopically detecting the typical forms in
bodyfluids and secretions
 Viruses can live only in viable cells and for most part, can survive briefly outside
human or animal hosts
 Culture techniques must use:
o embryonated eggs
o cell culture suspensions
o thin cell sheets called monolayers
 viruses are identified by observing their ability to produce certain cytopathic
effects in the cells where they are growing or to cause recognizable diseases in lab
animals
 Clinical immunology and serology
 Diagnoses infectious diseases by detecting antibodies in serum and other body
fluids
 Immunologic and serologic techniques are used to diagnose an infectious disease
when the agent may be too difficult to recover in culture

THE MEDICAL TECHNOLOGIST’S ROLE IN THE HEALTHCARE PROCESS

 to provide accurate results in a timely manner
 results will ultimately be used to help make a diagnosis or monitor treatment
 observe details of cells, ova and cysts of parasitic infections
 test whether the blood donor is compatible with the patient-recepient
 utilize special stains to identify microorganisms
 measure substances in blood and other body substance
 rgt preparation
 Collect specimen for study
 Preparation of specimen
 Quality control

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