Fundamentals of Pathology. Medical Course and Step 1 Review

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C C S N S P
21 ED T ON
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11 1 1 1 1 1 1 1
Growth Adaptations, Cellular Injury, and Cell Death . . . . . . . . . . . . .1
Inflammation, Inflammatory Disorders, and Wound Healing . . . 11
Principles of Neoplasia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Hemostasis and Related Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Red Blood Cell Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
White Blood Cell Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Vascular Pathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Cardiac Pathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Respira
espirator
oryy Tr
Trac
actt Pathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Gastr
astroin
ointtestinal P
Paathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Exocrine
Ex ocrine Pancr
Pancreas
eas,, Gallbladder
Gallbladder,, and Liver
Liver Pa
Pathol . . . . . . . . . . .115
115
Kidne
idneyy and Urinary
Urinary Trac
actt Pa
Pathology . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Female Genital System and Gestational Pathology. . . . . . . . . . . . 137
Male Genital System Pathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Endocrine Pathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
Breast Pathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
Central Nervous System Pathology . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
Musculoskeletal Pathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195
Skin Pathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
1
Growth
GrowthAdaptations,
Adaptations,Cellular
Cellular
Injury,
Injury,and CellDeath
andCell Death 11
GROWTH ADAPTATIONS
I. BASIC PRINCIPLES
A. An organ is in homeostasis with the physiologic stress placed on it.
B. An increase, decrease, or change in stress on an organ can result in growth
adaptations.
IL HYPERPLASIA AND HYPERTROPHY

A. An increase in stress leads to an increase in organ size.
1. Occurs via an increase in the size (hypertrophy) and/or the number
(hyperplasia) of cells
B. Hypertrophy involves gene activation, protein synthesis, and production of
organelles.
C. Hyperplasia involves the production of new cells from stem cells.
D. Hyperplasia and hypertrophy generally occur together (e.g., uterus during
pregnancy).
1. Permanent tissues (e.g., cardiac muscle, skeletal muscle, and nerve), however,
cannot make new cells and undergo hypertrophy only.
2. For example, cardiac myocytes undergo hypertrophy, not hyperplasia, in
response to systemic hypertension (Fig. 1.1).
E. Pathologic hyperplasia (e.g., endometrial hyperplasia) can progress to dysplasia and,
eventually, cancer.
1. A notable exception is benign prostatic hyperplasia (BPH), which does not
increase the risk for prostate cancer.
III. ATROPHY
A. A decrease in stress (e.g., decreased hormonal stimulation, disuse, or decreased
nutrients/blood supply) leads to a decrease in organ size (atrophy).
1. Occurs via a decrease in the size and number of cells
B. Decrease in cell number occurs via apoptosis.
C. Decrease in cell size occurs via ubiquitin-proteosome degradation of the
cytoskeleton and autophagy of cellular components.
1. In ubiquitin-proteosome degradation, intermediate filaments of the cytoskeleton
are "tagged" with ubiquitin and destroyed by proteosomes.
2. Autophagy of cellular components involves generation of autophagic vacuoles.
These vacuoles fuse with lysosomes whose hydrolytic enzymes breakdown
cellular components.
IV. METAPLASIA
A. A change in stress on an organ leads to a change in cell type (metaplasia).
1. Most commonly involves change of one type of surface epithelium (squamous,
columnar, or urothelial) to another
2. Metaplastic cells are better able to handle the new stress.
B. Barrett esophagus is a classic example.
pathoma.com 1
2 FUNDAMENTALS OF PATHOLOGY
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from earnin Radiolo y.com)
22 Cro n disease. Cobblestone mucosa it stricture. trin si n. ( , Courtesy of 22 ryt ema nodosum.
um at .com. , Publis ed it ermission from earnin Radiolo y.com)
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I I I
23 Colonic di erticula. ross a earance. Microsco ic a earance. 2 ereditary emorr a ic

telan iectasia. (Courtesy of rs. . red and .
an Di , Images of Memorable Cases)
2
I I I
1 1
1
2 denomatous oly . 2 amilial adenomatous oly osis.

(Courtesy of um at .com)
ne n 3
Streptococcus o is
1
. I I
111
coli
. I I I
I I I
1
1
1 1
I. I I I
II. I I I
1 1
11
1 1
A
cute ancreatitis. (Courtesy of 2 allstones. C olesterol stones. ilirubin stones. ( , Courtesy of .V. antos , MD. ,
um at .com) Courtesy of um at .com)
x ne n e dde nd e
11
1
coli, scaris lum ricoi es, lonorchis sinensis

scaris lum ricoi es
lonorchis sinensis
I I I
I I
coli
↑ ↑
I I I
11
11
1
3 C ronic c olecystitis. Ro itans y- sc off sinus. Porcelain allbladder. ( , Courtesy

of Drs. . red and . an Di , Images ofMemorable Cases)
I I I
I
.
11
.
.
.
I. I
11
↑
11 1
allbladder carcinoma. (Courtesy of .V. aundice. (Courtesy of ames eilman, cute e atitis.
antos , MD) MD, i i edia)
x ne n e dde nd e
I I I I
I I
I
↑
↑
↑ ↓
↑
lonorchis sinensis
↑
↑
2 m ortant eatures of e atitis Viruses
I I I
11
2
3 erolo ic Mar ers of e atitis Virus
I I I
11
1
11
1 11
I I
11
β
C ronic e atitis. Cirr osis. Microsco ic a earance. ross a earance. ( , Courtesy of um at .com)
x ne n e dde nd e 2
I I I
1
11
1 11
111
I I I
I I
atty li er. Microsco ic a earance. ross a earance. ( , Courtesy of erome a y, Mallory bodies, alco olic e atitis.
MD)
22
1 HFE
↑ ↓ ↑ ↑
11 11
11 11
11 11
I I
T
↑ ↓ ↑
III I I I I I
I I I I I
emoc romatosis. ron de osition in e atocytes. Prussian blue stain. i ofuscin in e atocytes for com arison.
x ne n e dde nd e 23
11 1
I I
II I
1
sper illus
III I I
111
2 nion-s in fibrosis, rimary sclerosln 3 Metastatic carcinoma in ol in li er.

c olan ltls. (Courtesy of erome a y, MD)
12
I I
1 1
II I
III I I
I I I I
I I I
I I I
12
2
II I
↓
1
1
III I
1 1
I I
1
2 orses oe idney. (Courtesy 2 2 Potter se uence. (Courtesy of um at . 2 3 Dys lastlc idney. (Courtesy of
of um at ,com) llya com) usain, MD)
dne nd n 2
I I I I I
1
I I I
I I I
I I I
2 Polycystlc idney disease. (Courtesy of 2 cute tubular necrosis. 2 cute nterstitial ne ritis.
amie teinmet , MD)
2
1
1
1
I I I I
1 1 1
I I
2 Minimal c an e disease. ormal lomerulus. ffacement of foot rocesses on M. 2 ocal se mental lomerulosclerosis.
(Courtesy of ony C an , MD)
dne nd n 2
1
1 11
I I I
I I I
1 1
2 Membranous ne ro at y. ic lomerular basement membranes. ranular . ube it elial de osits it s i e and

dome a earance. (Courtesy of ony C an , MD)
2 ubendot elial de osits, 2 immelstiel- ilson nodules, diabetic 2 2 y ercellular, inflamed lomerulus,
membrano roliferati e lomerulone ritis (ty e ne ro at y. ne ritic syndrome.
). (Courtesy of ony C an , MD)
3
II. I I
β
1 1
1 1
III. I I I I
2 lmmunofluorescence indin s in Ra idly Pro ressi e lomerulone ritis
I
I
2 3 ube lt ellal um s, P . (Courtesy 2 Crescent formation, ra idly

of ony C an , MD) ro ressi e lomerulone rltls.
dne nd n 3
1 1
1 1
I I
1
1 1
I I I I
II I I
1 1
1 coli
Staphylococcus saprophyticus
coli
le siella pneumoniae
roteus mira ilis
2 inear , ood asture 2 l ne ro at y. (Courtesy of ony

syndrome. (Courtesy of ony C an , MD) C an , MD)
32
nterococcus aecalis
1
1. hlamy ia trachomatis eisseria onorrhoeae
III I I
1.
coli
nterococcus aecalis
le siella
I I I I
1 1
. I I I
1
1.
. I I I
dne nd n 33
I I I
II I
I I
1 1
roteus ul aris le siella
2 yroidi ation of idney, c ronic 2 mmonium ma nesium os ate

yelone ritis. stone. (Courtesy of eb at olo y.com)
3
1 1
1 1
1
1.
1
eletion
11 1
mutations
i . . Renal cell carcinoma. , ross a earance. , Microsco ic a earance. i . . ilms tumor.
ney an r nary ra t Pathology 3
11 1
I I I I
1 1
1
I I
Schistosoma haemato ium
....
...
. .. . . . . . .
22 rot ellal carcinoma. lat. Pa illary.
13
I I I
11 1 1
1 1
11
I I
I I I
1 1
pathoma.com 13
3
I
1
1.
1 1
1
I I I I
II I
1
1. 1
III I
3 Condyloma acuminata. Microsco ic a earance. oilocytic c an e. 32 tramammary Pa et disease of t e

ul a. (Courtesy of eb at olo y.com)
e e en e nd e n 3
I I
. I I I
1 1 1 1
11
3 2 Va inal adenosis. 33 mbryonal r abdomyosarcoma.

(Courtesy of um at .com)
I I I I I
1 1
I I
I I I I
1
1
3 Cer i . Cer ical transformation one, normal. C ll. i - rade dys lasia, Pa smear. (Courtesy of d t man, MD)
e e en e nd e n
11 1 1
11
1 1
I I I
3 ndometrium o erlyin myometrium, 3 ndometrial oly .

normal.
2
I I
I I I
hlamy ia ,
I
1
I I
A
3 ndometriosis. C ocolate cyst of o ary. un o der nodules. ( , Courtesy of ulent 3 ndometrial y er lasia. (Courtesy of
Celasun, MD. , Courtesy of um at .com) d t man, MD)
e e en e nd e n 3
III I I
1
I I I
1
1
I I I
1 1
3 ndometrial carcinoma. ross a earance. ndometrioid ty e. erous ty e. ( , Courtesy of .anatomia atolo ica.com.br)
I
I I I
1 11
1
1 11
I I I
1 1
3 terine leiomyomas. (Courtesy of 3 arian follicle. ormal. Cor us luteum. ( , Courtesy of d t man, MD)
amie teinmet , MD)
e e en e nd e n
I I I I
II I I
1
1 1
3 2 arian cystadenoma.
1
1
1 1
1
1
1 1
1 1
3 3 Cystic teratoma. 3 Dys erminoma. 3 c iller-Du al body. (Courtesy

eb at olo y.com)
e e en e nd e n
1 1 1
I I
1 1
3 arian fibroma. 3 cto ic tubal re nancy. (Courtesy of

um at .com)
1.
1. 1
1.
1 1
I
1 1
2 Common erato ens and ssociated ffects
e e en e nd e n
I
1 1
I I
T eatures of Complete an Partial Moles
1 1
3 Placental abru tion. (Courtesy of 3 Com lete mole. ollen, ra e-li e illi. ydro ic illi. ( , Courtesy of te en
erome a y, MD) Connor, MD)
β
1 1
1
1 β
1
I I
11 1 1
I I
I I
hlamy ia trachomatis eisseria onorrhoeae
scherichia coli seu omonas
I I
oilocytic c an e. 2 emorr a ic infarction of 3 ydrocele.

testicle. (Courtesy of um at .com)
e en e l 3
I I I
1
1
1
β
1
1
1
eminoma. Microsco ic a earance. ross a earance. ( , Courtesy of d t man,

MD)
1
1
β
1
β
mbryonal carcinoma. Microsco ic a earance. ross a earance. (Courtesy of

eb at olo y.com)
c iller-Du al body, yol sac tumor. C oriocarcinoma. ormal testicle, microsco ic

(Courtesy of eb at olo y.com) (Courtesy of eb at olo y.com) a earance.
e en e l
I I I
I I
hlamy ia trachomatis eisseria onorrhoeae
scherichia coli seu omonas
I I I
I I I
1 1
ormal rostate, microsco ic ydrone rosis.

a earance.
1
1 1
1
1 11
1 1 11
1
1
Prostatic adenocarcinoma. ross a earance. Microsco ic a earance. steoblastic metastasis in ol in lumbar s ine.
e en e l
1 11
1
I I
I I I
1 1
I I I
I I I
I I I I
I I I I I
I I I I
nd ne
I I
I I I
1
11
1
ra es disease. Diffuse oiter. Microsco ic a earance. ( , Courtesy of d t man, MD)
2
1 1
1 ↑ ↓
I I
1
I I
1.
nd ne 3
I. I I I I
1
↓ ↑
II. I I I I
III. I I I I I I
I I I I
1
1 1
I
1
2 Multinodular oiter. (Courtesy of amie 3 as imoto t yroiditis. ollicular adenoma.

teinmet , MD)
I I
1
1
1
I I
1
1
I I
1
Pa illary carcinoma. uclear features. Psammoma bodies. ollicular carcinoma. (Courtesy of

ulent Celasun, MD)
nd ne
I I I
I I I
1 1
↑ ↑ ↓
↑ ↑
I I
1
↑
↓
↑
↑ ↓ ↑ ↑
Medullary carcinoma. na lastic carcinoma. e rocalcinosis.
I I I
↓ ↓
1 ↑
I I I
1 11
I I
1.
steitis fibrosa cystica. slets of an er ans. 2 myloid in islets, ty e DM.
nd ne
I I
1 1
1 1
1
1
1
1 1
1 1
I I
1 ↓ ↑ ↑
I I I I
3 Com lications of diabetes. yaline arteriolosclerosis. lomerulosclerosis.
nd ne
1
1 1
1 1 1 1
↓
1
↓ ↓
1
↓
↓
11
↓
11
↓ ↓
↓
drenal y er lasia. i . . drenal adenoma.
1
1 11β 11β
11β
III. I I I
1 1
1
nd ne
T Cushing Syn rome
↑↑
no ular
I I
1
1
11
1
1
2
1 1 11
1
1
1
I I I
1 1
eisseria menin iti is
I I I I
II
1 1
i . . ater ouse- rideric en syndrome. i . . P eoc romocytoma. (Courtesy of

(Courtesy of um at .corn) um at .corn)
nd ne 3
1
ollo e yβ
1 1 1 1 1
1
,
1
1
1 1
I I
Staphylococcus aureus
I I I
III I
I I
I I
I I
erminal duct lobular unit. 2 ibrocystic c an e it a ocrine 3 ibroadenoma.

meta lasia.
e
I
1
I I I I
II I I I I
1.
Phyllodes tumor. 5 Ductal carcinoma in situ, comedo type.
1
1
1
III I I I
1
1
1
1
Pa et disease of t e ni le. Clinical a earance. Microsco ic a earance. ( , Courtesy

of erome a y, MD)
n asi e ductal carcinoma. ubular carcinoma. Mucinous carcinoma.
e
I I I I I
I I I
1
I I I I
important
use ul
B
nflammatory carcinoma. Microsco ic a earance. Clinical a earance. ( , Courtesy of n asi e lobular carcinoma.
erome a y, MD)
1 1
1 11
I
1
1.
1.
stro en rece tor, R neu am lification,

immuno istoc emical stain. immuno istoc emical stain.
1
1 1 1
2
I I I II
I I
1 1
1 1
I I I
I I
I I
1 1
1
nence aly. (Courtesy of um at . 2 Dandy- al er malformation, MR. 3 acterial menin itis, ross a earance.
com) (Courtesy of Robert en , MD)
en e e 3
1 (S )
I I I
I I I I
1
1
Spinal Cord Tracts
I I
1 coli, isteria monocyto enes
menin iti is Streptococcus pneumoniae
in luen a
I I I I
I I
Pale infarct, corte . (Courtesy of Robert acunar infarcts. (Courtesy of Robert

ellmann, MD) ellmann, MD)
en e System Pathology
I I
1
1
1
rain infarct. Red neurons. Cyst formation. (Courtesy of Robert ellmann, MD)
I I
I
1
1
1
I. I
II.
1 1
lntracerebral emorr a e, basal ubarac noid emorr a e. (Courtesy of

an lia. (Courtesy of Robert ollmann, MD) erome a y, MD)
en e System Pathology
I I
I I I I
II I
erry aneurysm. (Courtesy of erome ubdural ematoma. (Courtesy of ray la ue, multi le sclerosis.
a y,MD) Robert ellmann, MD) (Courtesy of Peter Pytel, MD)
I I
1 11
1.
I I I
1.
I I
1.
I I I
1.
I I I
en e e
I I
1 1
1
1 1
β
1 1
β
1
β
1 1
2 l eimer disease. Cerebral atro y. euritic la ue. eurofibrillary tan le. ( , Courtesy of erome a y, MD. and C, Courtesy of
Peter Pytel, MD)
I I
I I
1 1
1.
1.
I I
1 1
1
3 Par inson disease. oss of i mented neurons in substantia ni ra. ormal substantia ni ra for com arison. e y body. ( and ,
Courtesy of Robert ollmann, MD)
en e e
III I
1
1 1
I I I I
untin ton disease. De eneration of caudate nucleus. ormal caudate nucleus on iform ence alo at y. (Courtesy
for com arison. (Courtesy of Peter Pytel, MD) of Peter Pytel, MD)
2
I I
1 1
1 1
I I
1 1
I I
1 1
I I
1 1
lioblastoma multiforme. utterfly lesion. Pseudo alisadin . (Courtesy of Peter

Pytel, MD)
en e e 3
1 1
I I I
Menin ioma. li odendro lioma. (Courtesy of Peter

Pytel, MD)
Pilocytic astrocytoma. Cystic lesion it mural nodule. Rosent al fibers. ( , Courtesy 2 endymoma.
of Peter Pytel, MD)
1
1.
2.
1.
I I
1.
2.
3.
1 1
i.
,
pathoma.com 1
I I I
1
1
↓ ↓ ↑
↑
steo etrosis. (Publis ed it 2 Pa et disease of bone.

ermission from earnin Radiolo y.com)
ee
1
1
I I
III I I
3 steoc ondroma. (Courtesy of steosarcoma. -ray. Microsco ic a earance. ( , Courtesy of ulent Celasun, MD)
um at .com)
ee
V. I
VI. I
1
1
11
VII.
VIII.
IX. I
1.
I. I I I
1.
in sarcoma. C ondroma. (Publis ed it

ermission from earnin Radiolo y.com)
I I I I I
1 1
I I I
De enerati e oint disease. R eumatoid art ritis. (Courtesy of

ames eilman, MD, i i edia)
ee 2
I I I
hlamy ia trachomatis
I I I I
onorrhoeae
S aureus
2 2 FUNDAMENTALS OF PATHOLOGY
I I I
1 1
II I I
III I
1 1
I I
ee 2 3
1.
out. o i. e ati e birefrin ence. ( , Courtesy of d t man, MD) Dermatomyositis. (Courtesy of Peter
Pytel, MD)
1
I I
1 1
1.
2.
3.
4.
I I I I
II I I
1.
2.
3.
III I
ropioni acterium acnes
I I I
2
1
1
I
1
I I I
in istolo y, normal. 2 Psoriasis. Clinical a earance. Microsco ic a earance. ( , Courtesy of Vesna

Petronlc-Rosic, MD)
3 ic en lanus. Clinical a earance. Microsco ic a earance. ( , Courtesy of Vesna

Petronic-Rosic, MD)
n 2
1
1
I I
1 1
I I I I
Pem i us ul aris. Clinical a earance. Microsco ic a earance. ( , Courtesy of

Vesna Petronic-Rosic, MD)
ullous em i oid. Clinical a earance. Microsco ic a earance. ( , Courtesy of

Vesna Petronic-Rosic, MD)
2
I I
1
I I
1
1
1
I I I
1
Dermatitis er etiformis. (Courtesy ryt ema multiforme. (Courtesy of

of Vesna Petronic-Rosic, MD) ames eilman, MD, i i edia)
eborr eic eratosis. Clinical a earance. Microsco ic a earance. i n of eser- r lat. ( and C, Courtesy of Vesna Petronic-Rosic, MD)
n 2
1 1
1
1 1
I I I
cant osis ni ricans. (Courtesy of Vesna asal cell carcinoma. Clinical a earance. Microsco ic a earance. ( ,
Courtesy of Petronic-Rosic, MD) Vesna Petronic-Rosic, MD)
2
I I I
1 11
I I
1 1
1 1
Vitili o. (Courtesy of 2 Con enital ne us. (Courtesy 3 Melanoma. (Courtesy

ames eilman, MD, i i edia) of Vesna Petronic-Rosic, MD) of Vesna Petronic-Rosic, MD)
n 2
I I
I I
aureus pyo enes
Verruca. (Courtesy of Vesna Petronic- Molluscum bodies.

Rosie, MD)
2 2
I
1 1
1 1
11
1 1
β 1 1
1 1 1 1
1 1 1 1
11 1 1 1
1 11 11 1 1
11
1 1 1
1
1 1
1
1 1
1 1 1 1 1 1
1 1 1 1 1
1 1 1 1
11 1 1 1
1 1 1
1 1 11
1
1
1 11 111
11 1
1 1 1
1 1
1
11 1
11 1
11
1 11
1 11 1
1
1
11 1 1 11
11
1 1
1 1
1 1
1 1 11
α 1
11 α 1 1
α1 1 1
1 α1 1
1 1 α1 1
α 1
α 1
11 1
1 β2 11
1
1 1
1
1 1
1
1
1
1 1 1 1
1 1 1
1
1 1
11
11 11
pathoma.com 213
2
1
1 1 1
1 1 11
11 1 1
1 1 R 1 1 1
1
1 1
1 1 1
1
1 1 1
1
1
1
1
1 1
1 1
1
1 1 1
1
1
1
1 1
1 1 1
11 1 1 1
1 1
1
1
1
1 1 1
1 1
1 1
1 1 1
1 1 1
1 1
1 1
11
1 1 1
β β
11 β 1 1 1 1
11 β 1
β2
1
1 β
11
1
1
11
1 1
11
11
1
11
11 1
11 1 1
11 1
11
1 1 1
11 1 1 1
1
1 11
1
1
1 1 1
1 1 1
1 1
1 1 1 11
1 1
11 1
1
1 1
1 1 1
1
Index 2
1 1
1
11 11 1
11 1 1 1
1 1
1 1 1 1
1 1
1
11 1 1 1
1 11 1 1 1 1 11
1 11
1
1 1 1 1
11 1 1
11
1 11
1 11 11 1 11 1
1 1 1
1 1 1 1 1
1 1 1
1 1 11 1
1
1
1 1 11 1
1 1
11
1 1 1 11
1 1 1
1 1 1
1 1
1 1
1 1 11
1 1
1 1 1
1
1 1
1 11 11
1 11 11
11
1 1 11 1 1 1
1
11 11 1 1
11 1
11 1 1
11 11 11 1 1 11
11 1 1 1
1 1 1
1 1 1 1
1 1 11 1
1 1
1 1 1
11 1 1
1
1 1 1
1
11 1 1
1 1 1
1 1
1 1
11 1 1 11 11 1 1 1 1
1
1 1 1 1
1 1 1 1
1 1
1
2
1 11
1 1
1 11
1
1 1
1
1 1 1 1
1 1
1 1 1
1
1 1
1 1
1
11 11
111 1
111 1
1 1
1 1
1 1 1 1
1 1 1
1 1
1
1 1
1
1 1
1 11 1
1 1
1 11
1 1 1
1 1 1
1 1
1 1 1 1
1
1 1 11
1
1 1
11 1 1 1
1
11 1
1 1
11 1 1 1 1
1 11 1
1 1 11
1 11 11
1 1 11
1 11
1
1 1
1 1
1 1
11 11 1 1
11 11 1
1 11 1
1 11 1
11 1
1
1
11
1
1 1
1
11
1 1 11
1
11 11
1
1
1 1
1 1
Index 2
1
11 1
1 1
1
1 1 1
1 1 1 1 1
1
1 1 1
1 1 1
1 1 1
1 111 1
1 1 1 1
1
1 1
1 11
1
1 11 1
1 1 1
1
1 1
1 1 1 1
1 11
1 1 1 1
1 1 1 1
1
1 1
1 1
1 1 1 1 1
1
1 1 1
1 1 1
11 1
1
1 1
1
1
11 1 1
1 1
1 1
1 1
1
1 1 1
1 1 1 1
1 1 1
11 1 1
1 1
1
11 1 1 1
1 1 11 11 1 1
1 1
1 1 1
1 11
neu 1 1
1 11 neu
1 1
1 1
1 1 1 11
1 111 1
11
11 1
1
1 11 1
1 1
1 1
1 1 1
1 1 1
1 1
2
11
1 1
1 1 1
1 1
1 1 1
1 1 1 11
1 1 1
1 11 1
I 1
111
1 1 1 1
1 1 1 111 1
11
1 11
1
11
1
1
1
1
1 1 1 1
1 1
1 11 1
1 1 11
1 11 11 11 11
1 1 1 1 11
1 1 1 11
1 1
1 11 1
1
1
1
1 1 1
1
1
1
1
11 1
1
1
1
1 11
11
1 1
11 1
1
11 11
1
1
1 1
1 11 1
1
1
1
11 1
1
1 1
1 11
1 1
1
1 11
ras 11
11
1 1
1
1
1 1 1 1
1
1
1 1 1
β 1 1 1
γ γ 1 1
1
1
1
1 1 1
1 1
1 1
1
11
Index 2
1
11
1
1 1
1
1
1 1
1
1
1 1
1
11 1
1
1
1
1 11
1
1 1 1
1
11 1
11 1 1
1 1
1 1
1 11
1
1 1 1 1 1 1 1
1 11 1
1 1 1 1
11
1 1
1
1 1
1 1
1
1 1
1
1 1 1
1 1
1
1 1
1
1 1 1 1
1 1
1
1 1 1 1 1
1 1 11 1 1
11
1 11
1 1 11
1 1 1
1 1
1 1 1
1 1
1 1 11
1 1
1 1 1 1
11 1
11 1 1 κ 11
1 1 11
1 1 1
1 1
11
22
1 1
11 1
11 1
1 1 1 1 1
11 1 1 1
11 1
1 1 1
1 1 1 1
1 1
1 1 1 1
1 1 1 1 1
1 1
1
1
1 1
1 1 1
1 1
1
1 1 1 1
1 1 1
1 1
1 11 1
1 1
1
1 1 1 1
1 1 1
1
1
1 1 1 1
1
1 1 11
1 1
1
1 11 1
1 1
1 1 1
1 11 1
1 11
1 1 1
1 1
1 1
1 1
1 11
1
1 1 1 1
1 1
1 1
1
1 1 1 1
1 1 1
11 11
1 1 1 1 1
1 1
1
1 1 ,1 11
1 1 1 1
1 1
1 1 1
1 1 1
1 1 1
1
1 1 1
11 11
1 1
11 , 11
1 ,
Index 22
1 1 1
1 1 1
1
1
1 1 1 11
1 1 11
RET 1 1
1 1
11 1
1 11
1 1 1 1
11 1 11
11 1 1
1 1
1
1 1 1
1 1 1 1
1 1 1
1
1 1 1
1
1
1 1 1
1 1
1 1 1
11
1 1 1
1 1
1
1 1
1 11
1 11 11 1
1 1
11 1
1
Salmonella paratyphi
Salmonella typhi 1
1
1 1 1 1
1
1
1 1
1 11
11
1
1 1 1 1 1
1 1
as
1 1 1
1 1 1
1 11
1
1
1
1 1
1
1
1
1 1
1 1
1
1
1 1 1
1 1 11
1 1
1 1 1
1 1
1
1 11
1
1 Staphylococcus aureus, 1 1 1 1
1
1 1 11
1
222
1
11 1 1
11 11 1 1
1 11 1
1 11
1 1 1 1 11
1 1
α 1
β β 1
β 1 1
1 1
1
1 1 1
11 1 1
1 1 1 11 1
1
1 1 1
1
1 1 1
1 1
1 1
1 1 1 1 1
1 1 1 1 1
1 1 11
1 1 1 11
1 1
1 1
β β 1 1
1 1 11
11 1
1 1 1 1 1
+ 1 1
+ 1 1
1 1 11
1 1 1
1 1 1
1 1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1
1
11
11 1 1 1
1
1
11 1 1
1 1
1
1 1 1
1 1
1
1
1
1 1
1 1
1
1
1
1
1
11
1
1
1
1
1
1 1 1
1
1
Index 223
1
1
1 1
1
1
1
1
1 1
1
1
11
1
1 1
1
1
1
1
1
1 1
1
1
11
1
1
1 1
11

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Inflammation, Inflammatory Disorders, and Wound Healing . . . 11

Hemostasis and Related Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

Red Blood Cell Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

White Blood Cell Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

Female Genital System and Gestational Pathology. . . . . . . . . . . . 137

Male Genital System Pathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151

Endocrine Pathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159

Breast Pathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175

Central Nervous System Pathology . . . . . . . . . . . . . . . . . . . . . . . . . . . 181

Musculoskeletal Pathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195

Skin Pathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205

IL HYPERPLASIA AND HYPERTROPHY

eft entricular y ertro y. (Courtesy of 2 arrett eso a us.

3 eratomalacia. (Courtesy of Myositis ssificans. (Re rinted it

at necrosis of eri- ancreatic adi ose ibrinoid necrosis of essel. o tosis.

2 nflammation. cute inflammation it neutro ils. C ronic inflammation

iar ia lam lia

. ranuloma. oncaseatin . Caseatin . . n ioedema. (Courtesy of ames

2 Malar butterfly ras , . 2 Discoid ras , .

2 ym ocytic sialadenitis, ren 2 clerodactyly, scleroderma. 2 ntestinal cry ts.

2 asal layer of s in. 2 Myocardial scarrin . (Courtesy of 2 ranulation tissue.

2 y ertro ic scar. (Re rinted it 2 eloid.

3 2 m ortant Carcino ens and ssociated Cancers

3 3 m ortant nco enes and ssociated umors

3 Retinoblastoma. (Courtesy of erome 3 2 Carcinoma in ol in lym node. 3 3 eedin of t e omentum by carcinoma.

3 Common lmmuno istoc emical tains and ar et Cell y es

coli menin iti is

i . . addle embolus in ol in ulmonary

Microcytic, y oc romic R Cs of iron 2 Rin ed sideroblasts (Prussian blue stain).

aboratory indin s in Microcytic nemia

3 ar et cells. Cre cut a earance. (Re roduced it y erse mented neutro il in

ra ment of nuclear remnant ic le cell disease. emo lobin C crystal.

ite cell. 2 ein bodies ( ein re aration). . c istocyte.

ryt rocytes infected it fal ar m lastic anemia.

2 ty ical lym ocyte, 3 lenic ru ture. (Courtesy of

lasts of acute leu emia. cute lym oblastic leu emia

all trans retinoic

C ronic myelo enous leu emia. 2 ssential t rombocyt emia.

3 Myelofibrosis. ear-dro R C. ormal lym node.

ur itt lym oma. n ol ement of a . tarry-s y a earance. ( , Courtesy

e ener ranulomatosis. , ecroti in ranuloma. , iant cells at ed e of ranuloma. t erosclerosis.

t erosclerotic embolus. (Courtesy of yaline arteriolosclerosis. rteriolone rosclerosis. (Courtesy of

eman ioma. a osi sarcoma.

Coarctation of t e aorta. ross s ecimen. otc in of ribs on -ray. ( , Courtesy of

Streptococcus iri ans

Mural t rombus in ol in left ar e e etations in ol in tricus id ane ay lesions.

aemophilus, ctino acillus, ar io acterium, i enella,

linter emorr a es. Rot s ots. Dilated cardiomyo at y. (Courtesy

Myocarditis. 2 Myofiber disarray, y ertro ic 2 ndocardial fibroelastosis. Courtesy

ronc o neumonia. -ray a earance. ross a earance. ( , Courtesy of

nterstitial neumonia. -ray a earance. nflammatory infiltrate in ol in interstitium.

2 Causes of ronc o neumonia

3 Causes of nterstitial ( ty ical) Pneumonia

yco acterium tu erculosis

C ronic bronc itis. m ysema. ross a earance. Microsco ic a earance. ( , Courtesy of

2 ronc iectasis. (Courtesy of ale Rosen, 3 nterstitial fibrosis, idio at ic

ranularity of lun , neonatal res iratory mall cell carcinoma.

2 ontaneous neumot ora . (Courtesy 2 Mesot elioma. (Courtesy of amie

ird-bea si n, ac alasia. (Courtesy of arrett eso a us.

astric carcinoma, diffuse ty e. initis lastica. i net-rin cells. ( , Courtesy of d

Celiac disease. lattened illi. ormal illi for com arison.

i le disease. Macro a es it in lamina ro ria of small bo el illi. el 2 Carcinoid tumor.

23 Colonic di erticula. ross a earance. Microsco ic a earance. 2 ereditary emorr a ic