Arsi University

Health Science College

Introduction to pathology

Dr. Birhanu
(General Doctor of Medicine & Lecturer )
Email: brieferric@gmail.com

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 Pathology
 Is a study(logos) of suffering(pathos).

 Is the scientific study of diseases.

 Is the bridging discipline between basic sciences and

clinical practice.

 Itexamines the structural and functional changes at

cell, tissue and organ levels underlying a disease.
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 …
 Usesmolecular, microbiologic, immunologic and
morphologic techniques to explain the reasons why signs
and symptoms manifested by patients develop.

 Pathology is the foundation of medical science and practice.

 Withoutpathology, the practice of medicine would be

reduced to myths and folklore.

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 …
 Istraditionally divided into GENERAL PATHOLOGY and
SYSTEMIC(SPECIFIC) PATHOLOGY.

 General pathology: studies the basic response of cells

and tissues to abnormal stimuli that underlie any disease
process.

 Systemic(specific) pathology: studies the specific

responses of specialized organs and tissues to well-defined
stimuli.
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 …
 There are four aspects of any disease that are core to the
field of pathology:
Etiology

Pathogenesis

Morphologic changes

Functional derangements and clinical manifestation.

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 Core…
Etiology :
o Refers to the cause of a disease which can be
intrinsic(genetic) or extrinsic(acquired, e.g. Infectious,
nutritional, chemical or physical).
o Can be Primary(idiopathic). Disease Disease

Disease
Disease
Disease

•One etiologic
agent -
several
One etiologic agent- • Several etiologic diseases, as
one disease, as Malaria agents - one smoking.
disease, as 6
 Core…
Pathogenesis:
Refers to the sequence of events that occur in cells and
tissues in response to the etiologic agent, from the initial
stimulus to the ultimate expression of the disease.

The mechanism of disease development

The pathogenic mechanism could take place in the latent

or the incubation period.

It will lead to morphological changes. 7

 Core…
Morphologic changes:
o Are the structural alterations that are either characteristic or
diagnostic of a disease.
o They include:
 Gross changes: can be detected by the naked eye as changes
in size, shape, surface (3 S), color, consistency and cut
section of the organ (3C).
 Microscopic changes: include cellular and extracellular
changes that characterize the disease.
o May be disease specific, i.e. pathognomonic.
o Lead to Functional derangement and clinical
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 Core…

Functional derangement and clinical

manifestation:
 Refers to alteration of the normal function.
 Is responsible for clinical features(signs and symptoms),
fate or course, and complications of the disease.
 Examples of functional abnormalities causing ill health
include:
 Excessive secretion of nasal mucus in the common cold
 Insulin lack in diabetes mellitus
 Impaired nerve conduction
 Impaired contractility of a muscular structure. 9
 Disease & its Course
Disease is defined as an abnormal variation in structure or
function of any part of the body

Latent interval & incubation period of a disease:

 The time lapse between introduction of a noxious agent and
manifestation of the disease.

 Inthe context of carcinogenesis, this time period is referred

to as the latent interval; it is often two or three decades.

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 …

 In case of infectious causes, this period is called incubation

period & it is often measured in days or weeks.
 IP of----measles (8-10 days), mumps(12-25 days),
tetanus(1day-several months)…..

Convalescence period
 The time after disease manifestation until the patient regains
full health.
 Some diseases may be communicable from “carriers” in this
period.
 Common terms in the nomenclature of disease

Primary and secondary

 They may be used to describe the causation of a
disease.

Primary in this context means that the disease is

without evident antecedent cause.

 Other words which have the same meaning in this context

are essential, idiopathic and cryptogenic
 Common…

 Primary hypertension
 Secondary means that the disease represents a
complication or manifestation of some underlying lesion.
 Secondary hypertension
Acute and chronic
 Terms used to describe the dynamics of a disease.
 Acute conditions have a rapid onset, often but not always
followed by a rapid resolution.
 Common…

 Chronic conditions may follow an acute initial episode, but

often are of insidious onset, and have a prolonged course
lasting months or years.

 Subacute,a term not often used now, is intermediate

between acute and chronic.

Benign and malignant

 Benign and malignant are emotive terms used to classify
certain diseases according to their likely outcome.
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 General classification of disease
The most widely used general classification of disease is
that based on pathogenesis or disease mechanisms.
 Congenital
genetic
non-genetic
 Acquired
Inflammatory
Hemodynamic
Growth disorders
Injury and disordered repair
Disordered immunity
Metabolic and degenerative disorders 15
 Causes of disease
 Environmental
 Genetic or
 Both
Environmental factors
1. Physical agents
2. Chemicals
3. Nutritional deficiencies & excesses
4. Infections & infestations
5. Immunological factors
6. Psychogenic factors
Genetic
 These are hereditary factors that are inherited genetically from parents.
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 Subdivisions of clinical
pathology
 Pathology is a vast subject with many ramifications.
 Major subdivisions include:
 Histopathology: the investigation and diagnosis of disease
from the examination of tissues
 Cytopathology: the investigation and diagnosis of disease
from the examination of isolated cells
 Hematology: the study of disorders of the cellular and
coagulable components of blood
 Microbiology: the study of infectious diseases and the
organisms responsible for them
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 Subdivisions…

 Immunology: the study of the specific defense mechanisms

of the body
 Chemical pathology: the study and diagnosis of disease
from the chemical changes in tissues and fluids
 Genetics: the study of abnormal chromosomes and genes
 Toxicology: the study of the effects of known or suspected
poisons
 Forensic pathology: the application of pathology to legal
purposes (e.g. investigation of death in suspicious
circumstances).
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 Techniques of pathology Examination

(1) Gross Examination Of Tissues (Naked Eye

Examination).

(2) Microscopic Examination Of Tissues.

(3) Molecular Pathology Techniques.

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…

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…

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 Types of specimens for pathologic
examination
1. Biopsy:
Is the removal of a selected portion of the diseased living
tissue or organ for pathological examinations to diagnose
the disease.

Put it in adequate amount of 10% formalin before sending

it to the pathologist.

Tissue should be examined grossly (macroscopically) &

microscopically.
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
 Types of specimen…
2. Autopsy:
 Necropsy and postmortem examination are synonymous

 Isan examination of the dead body to identify the cause of

death.

 Tissue specimen is removed from dead bodies.

 This can be done for:

-- forensic (legal) or
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 Types of specimen…
3. Cytology:
 Examination of cells.

 The diseased cells are obtained by:

 Fine needle aspiration (FNA): in palpable sites as the breast,
thyroid gland and lymph nodes.

 Exfoliative cytology: It is used in diagnosis of malignant cells that

are shed in urine, sputum and vaginal smears.

 Abrasive cytology: Cells are dislodged from skin or mucous

membrane by various tools. 24
 ...

Cytopathology is used in:

 Screening for early detection of cancer
 Diagnosis of symptomatic cancer
 Diagnosis of inflammatory condition, infections
 Surveillance of patients on cancer treatment.

Advantage:
 It is cheap
 It takes less time
 It needs no anesthesia
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