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Man is the

Architect of
his life…
Pathology
An Introduction….

Dr. Venkatesh M. Shashidhar.


Associate Professor of Pathology
Fiji School of Medicine
Study of Disease:
Epidemiology
Etiology - Causes
Pathogenesis - Evolution
Morphology - Structural
Changes
Clinical Significance –

Pathology
Functional Changes
Management
Complications
Prevention
Pathology
Study of what is abnormal or
wrong or disease…!
“Scientific Study of Disease”
Normal  Abnormal  Treat
Pathology

“Is the foundation of medical


science and practice.
Without pathology, the
practice of medicine would
be reduced to myths and
folklore”
Diagnosis
What is “Diagnosis”?
– The formal name(s) used to describe a patient’s
disease
– The process of identifying a disease based on the
patient’s symptoms, the doctor’s findings, and the
results of investigations and laboratory tests
What do you need to make a diagnosis?
– A system of classification that supplies the
necessary names, definitions, and criteria
– The means to ascertain the defining characteristics
of a disease in the individual patient
History of Pathology
“animism” – Philosophies of Plato –
God/devil
Magic – Primitive thoughts
Humors – Phlegm – excess/deficiency –
c300
Abiogenesis – Spontaneous – upto c1800
Environmental – Modern – 1850 to present
Genetic – Molecular pathology – 20th
century
Past and Present….!

In the past, .. people


mistook magic for
medicine…!
Now people mistake
medicine for magic….!
Scope of Pathology
Experimental Pathology
Clinical Pathology
Subdivisions of clinical
Pathology:
Histopathology Histopathologist
Cytopathology Cytologist
Haematology Haematologist
Microbiology Microbiologist
Immunology Biochemist
Chemical Pathology Geneticist
Genetics Toxicologist
Toxicology Forensic Pathologist
Forensic Pathology Molecular Biologist
Learning Pathology:
General Pathology
–Common changes in all tissues.
E.g.. Inflammation, cancer,
ageing.
Systemic Pathology
–Specific changes in organs.
E.g.. Goiter, pneumonia, breast
cancer.
Study of Disease: (Pathology)
Epidemiology
Etiology - Causes
Pathogenesis - Evolution
Morphology - Structural Changes
Clinical Significance – Functional
Changes
Management
Complications
Prevention
Etiology:
Environmental agents:
– Physical
– Chemical
– Nutritional
– Infections Multifactorial:
– Immunological
– Psychological
Genetic Factors:
– Age
– Genes
Multifactorial Etiology:
Diseases are “caused” due to internal
or external factors.
Multifactorial:
No more “one cause to one disease”
Genetic factors affect acquired
diseases and environment has
profound effect on genetic diseases.
Classification of Diseases:
Developmental – genetic, congenital.
Inflammatory – Trauma, infections,
immune, etc.
Neoplastic – tumors cancers
Degenerative – ageing.
Pathogenesis:
“Sequence of events in the response
of cells & tissues to a
stimulus/pathogen” starting from the
initial stimulus to the ultimate
expression of disease.”
Gross and microscopic Structure,
Function, Chemistry & molecular
mechanisms.
Morphology:
Structural and associated functional
changes in cells, tissues and organs
that are characteristic of the disease
or condition.
Clinical Significance:
Functional derangements and its
clinical manifestations resulting from
the morphologic changes.
Signs and symptoms, course and
prognosis of disease depend on the
morphology.
Techniques in Pathology:
Gross Pathology:
Light Microscopy
Histochemistry, Biochemical
Immunohistochemistry
Electron Microscopy
Cell Cultures, Medical Microbiology
Molecular Pathology
Sample Case:
Clinical Details:
34 year Fijian male
Neck swelling, 2-3 months,
Fever, weight loss,
no other lymphadenopathy
Lymphnode biopsy done
Right neck mass
Lymphnode Biopsy

•Diffuse
tumour

•Capsule
Lymphnode Biopsy

•Large cells
•Mitotic
figures
Histiocytic/Tcell NHL
Diffuse pattern – no follicles.
Large cells with moderate cytoplasm
Plenty of mitotic figures, Nuclei are
vesicular prominent nucleoli
Features suggest T-cell NHL – malignant
lymphoma.
Needs further marker studies for typing &
management.
cancer Chemotherapy.
Pathology Summary:
Etiology:
– Carcinogenesis. DNA Damage, Mutation.
Pathogenesis:
– Uncontrolled cell division, tumor.
Morphology:
– Enlarged lymphnodes, liver, spleen,
microscopically – lymphoma cells.
Clinical Features:
– Fever, Wt loss, tumor-Ln, Liver, Spleen.
"Never does a man portray
his character more vividly
than when he is proclaiming
the character of another."
Winston Churchill
1874-1965, Former British Prime Minister