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m  



   

 

 
  

     pathos ± suffering; disease
logos ± study; knowledge
- branch of medicine concerned with determining
the nature & course of diseases by analyzing body
tissues & fluids
- study of diseases
a eneral vs. Systemic/Specialr
Systemic/Specialr
J Ô 

   


    disease mechanisms ± may
be common to several diseases
J —— 

     genetic, cellular,
molecular manifestations of specific diseases
a natomic/Surgical vs. Clinical
J a
— 

     utopsy; Biopsy;
Cytopathology
J x  

     ¦ematology & Blood Banking;
Clinical Chemistry; Clinical Microscopy; Serology;
Microbiology
3 
   

     
 
 
x



   
 a   medical examination of a
dead human body, to determine cause of
death, diagnosis, or disease progression
    bio - µlife¶ ; opsis - µa viewing¶ ± the
removal of a sample of tissue from a living
person for laboratory examination; primarily
for the detection of Cancer
J0xcision biopsy
JIncision biopsy
JFine needle aspiration biopsy (FNB)
JFrozen section biopsy
 ! 
x
     microscopic
examination of cells in body tissues or body
fluids primarily to determine if they are
cancerous; uses the Papanicolaou method
of staining, hence the term µPap¶
µPap¶ smear
x  
 
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 x x 
º 
%    cells that
never leave the cell cycle;
retain their mitotic ability
º 
    cells that
  
leave the cell cycle
permanently; no mitotic
ability
º —
%    cells that have 

temporarily left the cell


cycle; mitotic ability is
retained but quiescent, may
occur when needed
x 
a



" 

 increase in number of cells through
cell division
"    increase in cell size due to
increase in cellular components
a   decrease in cell size due to reduction in
cell components; associated with increased
autophagic vacuoles & lipofuscin pigment



 change from one adult cell type to
another due to chronic irritation; always
pathologic
x 
a


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G     




x 
m *r
*r
Ô 
x 
 
 ›he structural & biochemical elements of the cell are
so closely inter-
inter-related that whatever the precise point
of initial attack, injury at one locus leads to wide-
wide-
ranging secondary effects
 Morphologic changes become apparent only when
some critical biochemical system has been deranged
 Reactions of the cell to injurious stimuli depend on the
type, duration, & severity of injury, as well as on the
type, state, & adaptability of the cell
x
x 
m *
è ¦ POXI
è P¦ SIC  0N›S
è C¦0MIC  0N›S/DRU S
è BIOO IC  0N›S
è IMMUNOO IC R0C›IONS
è 0N0›IC D0RN 0M0N›S
è NU›RI›ION IMBNC0S
x 
x    
 
% m *
º x %
  Selective permeability
º   
 erobic respiration /
Oxidative phosphorylation
º -% -  
 
 Protein synthesis
º  
 
  enetic material /
DN ± control of cellular activities
x  
 
x 
m *

›P depletion & defects in Membrane


permeability
Ĺ intracellular Calcium & loss of
Calcium homeostasis
Ļ Oxygen & production of Oxygen-
Oxygen-
derived free radicals
3-


J definition ± chemical species that have a single
unpaired electron in an outer orbital; extremely
reactive & unstable, can react with organic or
inorganic chemicals, esp. cell membranes & nucleic
acids
J ¦ydroxyl O¦
O¦;; ¦ydrogen peroxide ¦O; Superoxide
O; Nitric oxide NO
J actions ± lipid peroxidation of cell membranes;
denaturation of proteins; DN mutation
J neutralized by nti (vit 0, vit C, sulfhydril
nti--oxidants (vit sulfhydril--
containing compounds Cysteine, lutathione-
lutathione- S¦,
lbumin, Ceruloplasmin, ›ransferrin, Superoxide
dismutase, S¦ peroxidase)
peroxidase)
-% x 
m *
3

 
replacement of
parenchymal cells by lipid
droplets-- most commonly
droplets
seen in the liver
x +  
accumulation of water
within cells - most
commonly seen in renal
tubular cells: ³ground
glass´´ or ³cloudy
glass cloudy´´
histologic appearance
m% x 
m *x 

 x-.—m—  a . .—m— 
changes that occur in ³falling off
off´´-
the irreversibly chromatin
injured cell - condensation &
subsequent
denaturation of fragmentation of the
proteins & dead cell into
subsequent enzymatic ³apoptotic bodies
bodies´;
´;
digestion;; always
digestion physiologic or
pathologic; involves a pathologic; may
group of cells; occur in a single cell;
accompanied by no inflammation
inflammation

  
x

x

 ± cell shape is
preserved; denaturation of cellular proteins;
³tombstone cells´
cells´
/
/
 ± amorphous necrotic
debris due to hydrolytic enzymatic dissolution;
typical of brain injury; abscess
x
x

 ± coagulation, then incomplete
dissolution; typical of ›B

 Ô
  ± coagulation + bacterial
contamination (varying degrees of liquefaction):
+ or  - diabetic wounds
3
 : 

 ± breast; subcutaneous
fat; 
 ± pancreatitis
x

/

x

 
Ô
 


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3

a  
  ::
   
J programmed destruction of cells during embryogenesis &
organogenesis; ³developmental involution´; ³programmed
cell death´
J in adults, hormone-
hormone-dependent involution e.g. menopause,
post--partum, thymic involution
post
J cell deletion in proliferating cell populations e.g. epithelial
renewal

    :
 cell death in tumors; cell death in viral injury
 death of immune cells; cytotoxic ›-›-cell action
 pathologic atrophy of hormone-
hormone-dependent tissues
 in parenchymal organs due to duct obstruction
a  

Councilman bodies in ¦epatitis



   x

 r  x


0

 3 #  


  
  
  




  

% 
 
  +   
x
    
%   



+


% 
x

%  + 
 x

atheromas 
% 
aging/damaged heart usually in interstitial tissues
valves of blood vessels, kidneys,
myocardial infarcts lungs, gastric mucosa
tuberculomas hyperCa: hyperparathyroidism
hyperthyroidism, systemic
psammoma bodies
sarcoidosis, vit D intoxication
ddison¶s dse, metastatic
tumors, bone tumors, MM

   x


 
r
r +  
    
 
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deposition of Calcium
in dead or dying
tissues





 
deposition of Calcium
in viable tissues - due
to hypercalcemia
m 
 
a
 
  
 


 
 
  
% 
%

    !  
% 
%

 
%
   1   !  2
 
%
  


 
%  

/

% #! %
m 
 
a
 
  


  +  
  

 
Fatty iver of lcoholism, Kwashiorkor, DM, Obesity, noxia
& ›oxins
may also occur in the ¦eart, Muscles, Kidneys
  
 

     
 


¦yaline droplets in kidneys(PC›) in dses with proteinuria
Russell bodies ± excess Igs in plasma cells
 x
% 

lycogen storage disorders
   
ipofuscin, ¦ematin, Melanin, homogentisic acid,


 
¦eterophagy ± ingestion of outside material by endocytosis
utophagy ± intracellular material (e.g. senescent
organelles) is sequestered into autophagic vacuoles
Residual bodies ± lysosomes with undigested debris
ipofuscin ± yellow
yellow--brown pigment granules that represent
undigested material from intracellular lipid peroxidation
 —  -  1"  2
2 !
 
Barbiturates, Steroids,
Carcinogenic hydrocarbons, insecticides, lcohol, CCl4


   
r

  
 %
Megamitochondria ± very large due to increased metabolic
demands e.g. in alcoholic hepatitis, nutritional deficiencies
Mitochondrial myopathies - in number, + abnormal cristae &
crystalloids seen in skeletal muscle disorders
increase in size & number ± in Oncocytomas of the salivary
glands, thyroids, parathyroids, kidneys
 x$  r
defects in cell locomotion & intracellular organelle
Chediak-¦egashi syndrome; immotile cilia
movements e.g. Chediak-
syndrome
accumulation of microtubules & intermediate filaments
e.g. neurofibrillary tangles in lzheimer¶s disease

$
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