Pathology L1

Pathology is the scientific study of diseases.

Pathology is a elinical knowledge service that is

fundamental to modem medical practice

Importance of Pathology:

It is used in the diagnosis, treatment and.

management ofmany clinical conditions Congenital

The patient is born with

the disease (due to

What is the disease genetic abnormality or an

acquired injury in utero).

It is an abnormal variation of the structure and

function of any organ or tissue of the body

Etiology Classification of Acquired

diseases:
Have no genetic basis.

DEVELOPMENT OF DISEASE Pathogenesis

The study of pathology

General pathology
study of basic reactions of

is divided into: cells and tissues to

abnormal stimuli.

Manifestations

Systematic pathology:
study of specific responses

Study of a disease include the following items: of specialized organs and

tissues to well defined stimuli.

Etiology Pathogenesis Morphologic Clinical Fate Complications Prognosis

changes features
predisposing mechanisms gross and symptoms end results
the bad forecast of the
factors, causes) that lead to microscopic and signs). of the probable
production of changes). effects
disease) of the course or
the disease) outcome of a
disease.

disease).

Cell injury and cell death

Cell injury

The basis of all diseases is injury to the smallest

unit of the body (the cell).

• Normal cell is in a steady state, able to handle

physiologic demand according to its adaptive

capacity.

Causes of cell injury:

Hypoxia Biological agents Chemical agents Physical agents Endogenous Immunologic Nutritional Genetic abnormalities.
imbalances

deprivation of oxygen). bacteria, strong alkalis and excessive heat and

toxins:
uremia, jaundice, reactions and protein calorie
viruses, fungi,
and parasites.
acids, insecticides,
alcohol, narcotics
cold, radiation,
mechanical trauma
& diabetic
ketosis.
autoimmune
diseases
malnutrition, starvation,
obesity, diabetes mellitus,

and air pollutants. and electric injury. and vitamin deficiencies .

، ‫ ﺳﻮء اﻟﺘﻐﺬﯾﺔ‬، ‫اﻟﺒﺮوﺗﯿﻨﺎت‬

‫ ﻧﻘﺺ‬، ‫ اﻟﺴﻜﺮي‬، ‫ اﻟﺴﻤﻨﺔ‬، ‫اﻟﺠﻮع‬

.‫اﻟﻔﯿﺘﺎﻣﯿﻨﺎت‬


Cell injury may be:

Irreversible Reversible

Necrosis
Apoptosis (programmed Hydropic swelling Fatty change
(death of cells). single cell death). (accumulation of fat in

(excess water in the cell)
the cells of some
organs).
Definition: • It is the Apoptosis = falling

morphologic changes that or dropping off.

follow cell death in living

tissue. Referred to as

programmed cell death.

Causes of necrosis: •
The same causes of cell It is an active process

injury. regulated by genes and ‫إﻧﮭﺎ ﻋﻤﻠﯿﺔ ﻧﺸﻄﺔ ﺗﻨﻈﻤﮭﺎ اﻟﺠﯿﻨﺎت و‬

involves RNA and protein ‫ﯾﻨﻄﻮي ﻋﻠﻰ ﺗﺨﻠﯿﻖ اﻟﺤﻤﺾ اﻟﻨﻮوي‬

synthesis. .‫اﻟﺮﯾﺒﻲ واﻟﺒﺮوﺗﯿﻦ‬

Types of necrosis:

1. Coagulative necrosis:

It is the most common type of necrosis occurs

in most organs including heart, kidney and spleen.

2. Liquifactive necrosis:

The necrotic tissue undergoes rapid softening by hydrolytic

enzymes e.g. infarction of the nervous tissue, suppurative

inflammation.

• Gross appearance:
the affected tissue appears as homogeneous structure.

Caseous necrosis:

Characteristic of tuberculosis.
The affected tissue undergoes slow partial liquefaction forming

yellow cheesy material

Grossly, the tissue is soft friable and resembles clumpy cheese.

.‫اﻷﻧﺴﺠﺔ ﻟﯿﻨﺔ ﻗﺎﺑﻠﺔ ﻟﻠﺘﻔﺘﯿﺖ وﺗﺸﺒﮫ اﻟﺠﺒﻦ اﻟﻤﺘﻜﺘﻞ‬

3. Gangrenous necrosis:

It is a term used to describe necrosis &putrifaction

‫ وھﻮ ﻣﺼﻄﻠﺢ ﯾﺴﺘﺨﺪم ﻟﻮﺻﻒ ﺗﻌﻔﻦ اﻟﻨﺨﺮ‬:‫ اﻟﻨﺨﺮ اﻟﻐﻀﺮي‬.3

Common sites:
lower limbs, gall bladder, GIT,and testes. ‫اﻷطﺮاف اﻟﺴﻔﻠﯿﺔ واﻟﻤﺮارة واﻟﺠﮭﺎز اﻟﮭﻀﻤﻲ‬

Dry gangrene: .‫واﻟﺨﺼﯿﺘﯿﻦ‬

:‫اﻟﻐﺮﻏﺮﯾﻨﺎ اﻟﺠﺎﻓﺔ‬

Wet gangrene: :‫اﻟﻐﺮﻏﺮﯾﻨﺎ اﻟﺮطﺒﺔ‬

Fate of necrosis

Local General

In small areas, repair by Release of enzymes due to tissue

fibrous tissue occurs. destruction

In large areas, cyst will form. into the blood e.g. CK, LDH,

and transaminases.

‫إطﻼق اﻹﻧﺰﯾﻤﺎت ﺑﺴﺒﺐ ﺗﺪﻣﯿﺮ اﻷﻧﺴﺠﺔ‬

‫ و‬LDH ‫ و‬CK ‫ﻓﻲ اﻟﺪم ﻋﻠﻰ ﺳﺒﯿﻞ اﻟﻤﺜﺎل‬

.transaminases

Pathology Cellular adaptation

DEFINITIONS :
Cellular adaptations are those in which new physiologic & morphologic ‫اﻟﺘﻜﯿﻔﺎت اﻟﺨﻠﻮﯾﺔ ھﻲ ﺗﻠﻚ اﻟﺘﻲ ﺗﺤﺪث ﻓﯿﮭﺎ ﺗﻐﯿﺮات‬

changes occur in response to excessive physiologic or pathologic stimuli, but ‫ﻓﺴﯿﻮﻟﻮﺟﯿﺔ وﻣﻮرﻓﻮﻟﻮﺟﯿﺔ ﺟﺪﯾﺪة اﺳﺘﺠﺎﺑﺔً ﻟﻠﻤﺤﻔﺰات‬

‫ ﻣﻊ اﻟﺤﻔﺎظ ﻋﻠﻰ‬، ‫اﻟﻔﺴﯿﻮﻟﻮﺟﯿﺔ أو اﻟﻤﺮﺿﯿﺔ اﻟﻤﻔﺮطﺔ‬

preserving the cell viability and modulating its functions. .‫ﻗﺎﺑﻠﯿﺔ اﻟﺨﻠﯿﺔ ﻟﻠﺤﯿﺎة وﺗﻌﺪﯾﻞ وظﺎﺋﻔﮭﺎ‬

The adaptive changes in the cells include:

Hyperplasia Hypertrophy Atrophy Metaplasia Dysplasia

‫ اﺳﺘﺒﺪال ﻗﺎﺑﻞ ﻟﻠﻌﻜﺲ‬:‫اﻟﺘﻌﺮﯾﻒ‬
‫إﻧﮭﺎ زﯾﺎدة ﻓﻲ ﺣﺠﻢ اﻟﺨﻠﯿﺔ ووظﯿﻔﺘﮭﺎ‬ ، ‫ﻧﻮع ﺧﻠﯿﺔ ﻣﺘﻤﺎﯾﺰة إﻟﻰ ﻧﻮع آﺧﺮ‬ ‫ إﻧﮫ ﺗﻨﻈﯿﻢ ﻏﯿﺮ‬:‫اﻟﺘﻌﺮﯾﻒ‬
‫إﻧﮭﺎ زﯾﺎدة ﻓﻲ ﻋﺪد اﻟﺨﻼﯾﺎ ﻓﻲ اﻷﻧﺴﺠﺔ او اﻻﻋﻀﺎء‬ .‫اﻟﻨﺸﺎط ﺑﺴﺒﺐ زﯾﺎدة ﺗﺨﻠﯿﻖ اﻟﻤﻜﻮﻧﺎت داﺧﻞ اﻟﺨﻼﯾﺎ‬ ‫ﻋﺎدة اﺳﺘﺠﺎﺑﺔ ﻟﺘﮭﯿﺞ ﻣﺰﻣﻦ‬
.‫طﺒﯿﻌﻲ ﻟﻠﺨﻼﯾﺎ اﻟﻔﺮدﯾﺔ‬
It is an increase in the
number of cells in tissue or Definition: Definition: Definition: a Definition:
organ It is an increase in cell size decrease in cell size reversible It is an abnormal
and function and functional replacement of one organization of
Some cell types are unable activity due to increased ability. differentiated cell individual cells.
to exhibit hyperplasia (e.g. synthesis of intracellular type to another, ‫ﯾﻤﻜﻦ ﻋﻜﺲ اﻟﺪرﺟﺎت اﻟﺨﻔﯿﻔﺔ‬
nerve, cardiac, & skeletal components. usually in response to .‫واﻟﻤﺘﻮﺳﻄﺔ ﻣﻦ ﺧﻠﻞ اﻟﺘﻨﺴﺞ‬
muscle cells). chronic irritation. Mild and
‫ﺑﻌﺾ أﻧﻮاع اﻟﺨﻼﯾﺎ ﻏﯿﺮ ﻗﺎدرة ﻋﻠﻰ إظﮭﺎر ﺗﻀﺨﻢ )ﻋﻠﻰ ﺳﺒﯿﻞ‬
In some cases it occurs moderate degrees
.(‫اﻟﻤﺜﺎل اﻟﺨﻼﯾﺎ اﻟﻌﺼﺒﯿﺔ واﻟﻘﻠﺐ واﻟﻌﻀﻼت اﻟﮭﯿﻜﻠﯿﺔ‬ with hyperplasia, as in of dysplasia are
pregnancy, the uterine Causes of atrophy reversible.
enlargement is caused by The aim of this
Causes of hyperplasia hypertrophy and Decreased work load replacement is for
hyperplasia of the smooth (disuse atrophy) better Severe degree is
muscle fibers. toleration of the premalignant
environmental (intraepithelial
Physiologic Pathologic Ischemia (due to stress. neoplasia “IEN” or
Causes of hypertrophy: atherosclerosis). ‫اﻟﮭﺪف ﻣﻦ ھﺬا اﻻﺳﺘﺒﺪال ھﻮ‬ carcinoma in situ
.‫ﺗﺤﺴﯿﻦ ﺗﺤﻤﻞ اﻹﺟﮭﺎد اﻟﺒﯿﺌﻲ‬ “CIS”).
Compensatory, Prostatic Malnutrition
e.g. after partial hyperplasi Increased Increased ‫اﻟﺪرﺟﺔ اﻟﺸﺪﯾﺪة ھﻲ ﻗﺒﻞ ﺳﺮطﺎﻧﯿﺔ‬
hepatectomy. a of aging. mechanical endocrine Aging ‫" أو‬IEN" ‫)اﻟﻮرم داﺧﻞ اﻟﻈﮭﺎرة‬
stimulation: .("CIS" ‫ﺳﺮطﺎن ﻓﻲ اﻟﻤﻮﻗﻊ‬
demand:
Examples:
Hormonal
Physiologic: Puberty:
Morphology of atrophy:

stimulation, Gravid
e.g. breast
striated
muscles in
growth
hormone,
uterus:
estrogen.
Gross:
Small size of the organ.
Dysplasia of cervical
epithelium in
development
at puberty.
athletes. androgens
and estrogen. Microscopic:
chronic

Small shrunken cells. cervicitis.

Hyperplasia is mediated by:

Hypertrophy is mediated by: Atrophy may be

‫ﺧﻠﻞ اﻟﺘﻨﺴﺞ ﻣﻦ ظﮭﺎرة ﻋﻨﻖ‬
physiologic or pathologic:
Growth factors, cytokines. Growth factors.
‫اﻟﺮﺣﻢ ﻓﻲ اﻟﺘﮭﺎب ﻋﻨﻖ اﻟﺮﺣﻢ‬
.‫اﻟﻤﺰﻣﻦ‬
Cytokines.
Hormones.

Increased DNA synthesis Physiologic Pathologic

and cell division. Increased expression of

genes.
Increased protein

synthesis. Post menopausal

atrophy of breasts,
Disuse atrophy e.g.
muscles after prolonged

uterus and ovaries. immobilization.

Aging: atrophy of
heart, brain, and

skin.

Postpartum

involution of uterus.