Introduction to

Pathology
 Definition of Pathology
It is that branch of medicine which
deals with study of nature of a disease.
This incorporates investigation of
structural and functional changes
produced in tissues and organs of the
body as a result of the disease process.
For clinical purposes, it provides the
requisite knowledge and investigative
techniques that are essential for
practice of modern medicine (Pathos:
suffering; logos: study)
 Simpler definition
Pathology is the study of structural and
functional abnormalities that manifest as
diseases of organs or organ systems.

H/O modern Pathology is said to have

begun when Rudolf Virchow proposed that
injury to cells is the basis of all diseases.
(Earlier, disease was attributed to effect produced by
imbalanced body humors or due to supernatural causes).
 History of Pathology
• Celsus (1st century BC) investigated diseases by
naked eye observation of unhealthy organs.
• Morgagni (18th century AD) was an influential
proponent of this method – a particular disease is
linked to a specific organ.
• Bichet proposed the role of tissue as the site of
any disease.
• Virchow suggested that all diseases arise at the
level of cells.
• Peters is responsible for the view that disease
occurs because of biochemical abnormalities
within cells.
• Molecular Pathology is correlating disease with
structure of proteins and genes.
 Some Definitions
• Disease: A deviation from or interruption
of normal structure or function of any
part, organ or system of the body that is
manifested by a characteristic set of
symptoms and signs and whose
etiology, pathology and prognosis may
be known or unknown.

• Etiology: It is the study of factors that

cause disease and the method of its
introduction into the host
• Prognosis: It is the forecast
about the probable outcome of a
disease or the prospect of
recovery from that disease.

• Complications (syn: sequelae): It

is the secondary or remote
consequences that are produced
due to a particular disease.
• Lesion: It is the structural or functional abnormality
in any disease that is responsible for the ill health.

• Pathogenesis: It is the study of various cellular

events, reactions and other pathologic activities that
occur during development of a particular disease.

• Morphology: It is the form and structure of a

particular organism, organ or a part. Generally, in
disease states, alterations of morphology are
produced.

• Clinical manifestations: It is the functional

consequences that are produced because of
morphologic alterations seen in a disease.
• Pathognomonic abnormality: When a
certain feature is restricted to a single
disease or a disease category, it is said
to be pathognomonic of that disease.

• Syndrome: A symptom complex or a

combination of abnormalities seen in
certain diseases.

• Mortality: It is the probability that death

would be the end result of a disease.
• Morbidity: It is the sum of ill effects of a disease to
the patient.
• Acute: A disease having short and a relatively
severe course.
• Chronic: A disease having an insidious onset and
a prolonged course
• Remission: Interval period of quiescence in a
chronic disease, in which symptoms abate or
improve.
• Relapse: In a chronic disease when signs and
symptoms reappear.
• Primary: it refers to an idiopathic
disorder
• Secondary: when some clinical
manifestations are due to another
underlying disorder.
• Multifactorial: When a disease is due to
a combination of causes.
• Idiopathic: When cause of a disease in
unknown
 Techniques used in Pathology
Commonly used techniques in clinical
practice:
1. Light Microscopy
2. Histochemistry
3. Immunohistochemistry
4. Chemical and Physical analysis of
substances of biological interest
1. Biochemical analysis
2. Radio immunoassay
3. Electrophoresis and Chromatography
Less commonly used techniques in clinical practice
1. Electron microscopy

2. Digital image analysis

3. Electron Probe Microanalysis (X-ray microanalysis)

4. Flow Cytometry

5. Chemical and Physical analysis of substances of

biological interest
• Ultracentrifugation
• X ray diffraction techniques

6. Fluorescent Tracing techniques

7. Autoradiography
8. Tissue Culture
9. Radioactive isotope techniques
10. Techniques derived from Molecular Biology
 Filter Hybridization techniques
 In situ Hybridization
 Inter-phase Cytogenetics
 Polymerase Chain reaction (PCR)
 DNA Micro arrays
 Micro-dissection
 Study of Oncogenes
Lesion in Lung – Light Microscopy
 Electron
micrograph
Electron micrograph of skeletal muscle
Scanning Electron micrograph of RBC
Histochemical demonstration of fat in adipocytes (Osmium tetraoxide stain)
Histochemistry to show contents of Goblet cells
Enzyme Histochemistry of skeletal muscle showing succinate
dehydrogenase and ATPase
Fluorescent Microscopy showing Nuclear DNA and RNA
Immunohistochemistry
Fluorescent
in-situ
hybridization
(FISH)
In-situ hybridization for EB virus (enzyme reaction)
Flow Cytometry
RT- PCR of small cell tumor to detect
chromosomal translocations
Cell in Metaphase of Mitosis (Confocal
Microscopy)
Cell in Anaphase of Mitosis (Confocal Microscopy)
Contribution of some
Eminent Scientists
 Anton von Leeuwenhoek
• An uneducated Dutch tradesman and draper (1632 - 1723)
was responsible for significant scientific discoveries.
• Contributed greatly in development and improvement of
microscope.
• Later he also contributed much to the field of microbiology.
• He was the first person to have described single cell
organisms now called microorganisms.
• He was the first person to have observed bacteria, muscle
fibers, spermatozoa and blood flow in capillaries.
• His simple microscope made from glass lens which he
made himself created, a magnification of 200x could be
achieved. Prior to this, a magnification of 20x to 30x was
obtainable.
 Rudolf Virchow
• German pathologist and statesman (1821 -1902).

• One of the most prominent physicians of the 19th century.

• He was first to emphasize that disease arose because of

changes taking place in cells (Cellular theory of disease).

• Prior to this, it was believed that disease arose due to imbalance

in one of the four fluid humors of the body, viz: - blood, phlegm,
black bile and yellow bile.

• One of the earliest pathologist to have described leukemia.

• Coined the words thrombus and embolus.

• Made important contributions in describing inflammation, fatty

degeneration and amyloid degeneration.
 Percivall Pott
• English surgeon (1714 -
1788) known for his
pioneering work in
describing chemical
carcinogenesis for the
first time.
• He for the first time
described tuberculosis
of spine. In his honor
the disease now a days
is known as Pott's
disease.
 John Hunter
• English Surgeon (1728 -1793)
• An expert anatomist and museum builder. Collected
more than 14000 specimens in Hunter's museum.
• Hunter also helped to improve understanding of
1. human teeth,
2. bone growth and remodeling
3. inflammation
4. gunshot wounds
5. venereal diseases
6. digestion
7. child development
8. the separateness of maternal
9. and fetal blood supplies
10. role of the lymphatic system.
 René Laennec
• French physician (1781-
1826)
• Best known for
development of
stethoscope and the
practice of auscultation.
• Other medical
contributions include
understanding of
peritonitis, cirrhosis
and melanoma