RADIOLOGIC

PATHOLOGY

PATRICK KYLE C. IGNACIO, MHA, RRT

 PATHOLOGY
 It is the study of diseases that can cause
abnormalities in the structure or function of
various organs systems.
 Disease is a pattern of response of the body

to some form of injury.

 PATHOGENESIS
 Pathogenesis will lead to observable changes
that are known as manifestations.
◦ Sign
◦ Symptom
◦ Syndrome
◦ Etiology
MOST PATHOLOGIC CONDITIONS:
 Inflammation
 Edema
 Ischemia
 Infarction
 Hemorrhage
 Alterations of Cell Growth
 Neoplasia
 Hereditary diseases
 Disorders of immunity
 Acquired Immunodeficiency Syndrome
 INFLAMMATION
 Initial response of the body tissues to local
injury. Among the various types of injury are:
◦ penetrating trauma
◦ infectious organisms
◦ irritating chemical substance.
 FOUR EVENTS IN INFLAMMATION
1. Alterations in blood flow and vascular
permeability.
2. Migration of circulating white blood cells to
the interstitium of the injured tissue.
3. Phagocytosis and enzymatic digestion of
dead cells and tissue elements
4. Repair of injury by regeneration of normal
parenchymal cells or proliferation of
granulation tissue and eventual scar
formation.
1.
 The earliest body response to local injury is
dilation of arterioles, capillaries, and venules
leading to a dramatic increase in blood flow
and around the injury site.
 This hyperemia produces heat and redness

associated with inflammation.

 It allows passage of a protein rich plasma

across vessel walls into the interstitium.

2.
 Leukocytes of the circulating blood migrate to
the area of injury.
 The removal of injurious agents such as

bacteria makes possible to repair the injury

that triggered the inflammatory responses.
5 CLINICAL SIGNS OR SYMPTOMS
 Redness
 Heat
 Swelling
 Pain
 Loss of function

Some bacterial organism produce toxins that

damage the tissues and incite an inflammatory
response
 EDEMA
 Is the accumulation of abnormal amounts of
fluid in the intercellular tissue spaces or body
cavities.
 Localized Edema
◦ May result from inflammatory with the escape of
protein rich intravascularly fluid into the
extravascular tissue or a local obstruction.
 Generalized Edema
◦ Occurs most frequently in patients with congestive
heart failure, cirrhosis of the liver, and certain
forms of renal disease.
 ISCHEMIA
 It is refers to interference with the blood
supply to an organ that deprives its cells and
tissues of oxygen and nutrients. It may be
caused by narrowing of arterial structures, as
in atherosclerosis, or by thrombotic or
embolic occlusion.
 INFARCTION
 It is a localized area of ischemic necrosis
within a tissue or organ produced by
occlusion of either its arterial supply or its
venous drainage.
 HEMORRHAGE
 Rupture of the blood vessel. Rupture of a
large artery or vein is almost always caused
by some form of injury , such as trauma,
atherosclerosis, or inflammation or neoplastic
erosion of the vessel wall.
 It may lead to accumulation of blood
 Levels of hemorrhage
◦ Petechiae
◦ Purpura
◦ Ecchymosis
ALTERATION OF CELL GROWTH
 It is the changes in the number and sizes of
cells, their differentiation, and their
arrangement may develop in response to
physiologic stimuli.
◦ Aplasia
◦ Atrophy
◦ Hypertrophy
◦ Dysplasia
 NEOPLASIA
 Literally means “new growth” and refers to an
abnormal proliferation of cells that are no
longer controlled by factors that govern the
growth of normal cells.
 TUMOR CLASSIFICATION

 Anaplastic
 Neoplasm are divided into:
◦ Benign(-oma)-resemble their cells of origin in
structure and in function.
◦ Malignant-invades and destroy adjacent structures
and spread to distant sites to cause death.
-carcinoma
-sarcoma
-lymphoma
 Benign Tumor
VS.
Malignant Tumor
GENERAL CHARACTERISTICS OF BENIGN AND
MALIGNANT DISEASE
BENIGN CHARACTERISTICS MALIGNANT
Expanding, pushing Local Spread Infiltrative and
invasive
Rare Distant spread Metastisize early or
late by lymphatics,
blood or seeding
Well differentiate Differentiation Well differentiated
to
underdifferentiated
Little Effect on host Life theatening
Normal Doubling time Normal
Characteristics Benign Malignant
Growth rate Slow Rapid
Differentiation Good Poor
Local growth Expansive Invasive
Destruction Little Much
Vessel invasion None Frequent
Metastasis None Frequent
Effect on host Often insignificant Significant
 CLASSIFICATION OF NEOPLASMS
TISSUE ORIGIN BENIGN MALIGNANT
Glandular epithelium Adenoma Adenocarcinoma
Squamous epithelium Papilloma Squamous cell
carcinoma
Connective tissue Leimyoma Leimyosarcoma
smooth muscle
Hematopoetic Leukemia
Lymphoreticular Lymphoma
Neural Neuroma Blastoma
 THREE PATHWAYS OF MALIGNANT NEOPLASM
 
 Seeding
 Lymphatic spread
 Hematogenous spread
 CANCER RISK FACTORS

 EXTERNAL
 Exposure to Chemicals
 Viruses
 Ionizing Radiation
 INTERNAL
 Hormones
 Genetic Mutation
 Disorders of the Immune System
 GENERAL CANCER SYMPTOMS

 UNEXPECTED WEIGHT LOSS – about 10 lbs.

 FEVER
 FATIGUE
 PAIN
 SKIN CHANGES
 CHANGE IN BOWEL/BLADDER FUNCTION
 UNHEALING SORE
CLASSIFICATION OF TUMOR

 GRADING
 STAGING
 TNM SYSTEM
 T – tumor
 N – has spread to NODES
 M – metastasis, has spread to other organs.
CLASSIFICATION DESCRIPTION OF TUMOR
STAGE 0, Occult lesion; no evidence clinically
T0N0M0
STAGE I, Small lesion confined to organ of origin with no
T1N0M0 evidence of vascular or lymphatic spread or
metastasis
STAGE II, Tumor of less than 5cm. invading surrounding tissue
T2N1M0 and first-station lymph nodes but no evidence of
metastasis
STAGE III, Extensive lesion greater than 5cm. with fixation to
T3N2M0 deeper structure and with bone and lymph invasion
but no evidence of metastasis
STAGE IV, More extensive lesion than above or with distant
T4N3M1 metastasis.
 HEREDITARY DISEASE
 It is a disease that are passed from one
generation to the next through the genetic
information contained in the nucleus of each
cell.
 HEREDITARY DISEASES
 Down’s syndrome
 Turners syndrome
 Klinefelter’s syndrome
 Phenylketonuria
 Homocystinuria
 Alkaptonuria
 Cystinuria
 Marfans syndrome
 DOWN’S SYNDROME

 Is the most common of the trisomy disorders

that are caused by the presence of an extra
autosomal chromosome that results in an
individual having 3 strands of a certain
chromosomes instead of normal 2.
 TURNERS SYNDROME

 Is a characterized by primary amenorrhea,

sexual infantilism, and short stature.
 KLINEFELTER’S SYNDROME

 Is a disorder characterized by small testes

that fail to mature or produced sperm.
 PHENYLKETONURIA
 Is an inborn error of metabolism in which an
enzyme deficiency results in the impaired
conversion of phenylalanine to tyrosine.
 HOMOCYSTINURIA
 Is an inborn error of the metabolism of the
amino acid methionine that causes defect in
the structure of the collagen or elastin
 ALKAPTONURIA
 Is a rare inborn error of metabolism in which
an enzyme deficiency leads to an abnormal
accumulation of homogentisic acid in the
blood and urine.
 CYSTINURIA
 Is an inborn error of amino acid transport
characterized by impaired tubular absorption
and excessive urinary excretion of several
amino acids.
 MARFANS SYNDROME
 Is an inherited generalized disorder of
connective tissue with skeletal and
cardiovascular manifestations.
 ACQUIRED IMMUNODEFICIENCY
SYNDROME
 Most commonly affects young homosexual
males and intravenous drug abusers is
characterized by a profound and sustained
impairment of cellular immunity.