INTRODUCTION TO PATHOLOGY

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 COMPETENCIES

• PA1.1-Describe the role of a pathologist in diagnosis and

management of disease

• PA1.2-Enumerate common definitions and terms used in Pathology

• PA1.3-Describe the history and evolution of Pathology

 PATHOLOGY
• The term pathology is derived from two Greek words: pathos,
meaning disease, and logos, meaning science
• Pathology is the science that studies diseases.
• It plays a important role in diagnosing the various diseases.
• Contributing significantly to accurate diagnosis, effective
treatment strategies, and improved patient outcomes.
 TERMINOLOGY
• PATHOS means suffering- Greek word.
• LOGOS means study.
• PATHOLOGY IS STUDY OF ABNORMALITIES THAT OCCUR
IN NORMAL ANATOMY AND PHYSIOLOGY OF BODY.
• The term PATHOPHYSIOLOGY is study of disordered function.
• PATHOLOGISTS are diagnosticians of disease.
 TERMINOLOGY
• HEALTH:Is defined as a condition in which a human being is in
complete accord with surroundings mentally and physically.
• DISEASE: Loss of ease or comfort.
• Health and Disease are relative states.
• Wide range of normality e.g., height ,weight and changes at
cellular level are considered.
 TERMINOLOGY CONTD…..
• PATIENT :Person affected by disease
• LESIONS: Changes in tissues produced by disease
• MORPHOLOGY :Examination of diseased tissues
• GROSS OR MACROSCOPIC EXAM: Naked eye examination
• MICROSCOPIC EXAMINATION.
• ETIOLOGY :Factors responsible for disease
• PATHOGENESIS :Mechanism by which the lesion is produced
 TERMINOLOGY CONTD……
• DIAGNOSIS : Arriving at the answer
• PROGNOSIS: Outcome of the disease
• TREATMENT
• PREVENTION
AS IS YOUR PATHOLOGY SO IS YOUR MEDICINE
 DIVISIONS IN PATHOLOGY
• Histopathology
• Cytopathology
• Hematology
• Clinical pathology
• Experimental pathology
• Molecular pathology
• Medical genetics
• Autopsy
 HISTOPATHOLOGY AND CYTOLOGY
• Histopathology. It deals with the study of tissues removed from the living
body.
• It forms the bulk of tissue material for the pathologist.
• It includes study of tissue by paraffin embedding techniques and by frozen
section for rapid diagnosis.
• Cytopathology. Though a branch of anatomic pathology, cytopathology has
developed as a distinct subspecialty now
• It includes study of cells shed off from the lesions (exfoliative cytology) and
• Fine-needle aspiration cytology (FNAC) of superficial and deep-seated
lesions for diagnosis.
 HISTOPTHOLOGY
• Microscopic examination: It requires tissues be cut with a microtome into thin sections
that can be stained with routine stains such as hematoxylin and eosin (H & E).
• Two types of sectioning methods are most commonly used: frozen sections and paraffin-
embedded or permanent sections.
• Frozen sections: Frozen sections are cut by using cryostat (microtome in a refrigerated
chamber) or freezing microtome from tissue that has been hardened rapidly by freezing
(hence termed frozen section).
• Permanent sections: In most instances, pathologists rely on the study of better-
preserved tissue by conventional permanent tissue sections with paraffin embedding
technique stained with hematoxylin and eosin.
• Ancillary staining and analytical methods: Histochemistry (special stains),
immunohistochemistry, and electron microscopy are ancillary technique in surgical
pathology that may be helpful or necessary supplements for diagnosis.
• Special stains may aid in the diagnosis of one or another type of tumor (i.e., differential
diagnosis) and classification.
• Examples include special stains for mucins, amyloid, lipids and glycogen,fungi,pigments
and connective tissues.
 FROZEN SECTION
• The frozen section procedure is
a pathological laboratory
procedure to perform
rapid microscopic analysis of a
specimen
• Rarely, cryo sections are used to
detect the presence of substances
lost in the traditional histology
technique, for example lipids.
• They can also be used to detect
some antigens masked by formalin
 HISTOPTHOLOGY
• Histopathology is the study of tissues removed from living patients to
help with diagnosing a disease.
• Histopathology includes subdivisions like:
• Dermatopathology
• Neuropathology and
• Nephropathology
• Hepatobiliary pathology
• GI Pathology
• Renal pathology etc.
 CYTOPATHOLOGY

• Though a branch of anatomic

pathology, cytopathology has
developed as a distinct sub
specialty now.
• It includes study of cells shed
off from the lesions (exfoliative
cytology) and fine-needle
aspiration cytology (FNAC) of
superficial and deep-seated
lesions for diagnosis
 DIVISIONS IN PATHOLOGY
• HAEMATOLOGY. Hematology deals with the diseases of blood.
• CLINICAL PATHOLOGY. Analysis constituents of urine, semen, CSF and
other body fluids.
• EXPERIMENTAL PATHOLOGY. This is defined as production of disease
in the experimental animal and its study.
• MOLECULAR PATHOLOGY. The detection and diagnosis of
abnormalities at the level of DNA of the cell is molecular pathology.
• Recent advancements in molecular biologic techniques resulted in
availability of these methods as a tool in diagnostic pathology.
 DIVISIONS IN PATHOLOGY
• G. MEDICAL GENETICS. This is the branch of human genetics that
deals with the relationship between heredity and disease.
• There have been important developments in the field of medical
genetics e.g. in blood groups, inborn errors of metabolism,
chromosomal aberrations in congenital malformations and neoplasms
etc.
• Autopsy
 AUTOPSY
• The main purposes of autopsy are:
• i) Confirming the cause of death
• ii) Establishing the final diagnosis and
• iii) Study of therapeutic response to treatment.
• 2. Education of the entire team involved in patientcare by:
• i) Making autopsy diagnosis of conditions which are missed clinically e.g.
pneumonia, pulmonary embolism, acute pancreatitis, carcinoma
• ii) Discovery of newer diseases made at autopsy [Link]’s syndrome,
Legionnaire’s disease, severe acute respiratory syndrome (SARS)
• The significance of a careful postmortem examination can be summed up
in the old saying ‘the dead teach the living’.
 ROLE OF PATHOLOGIST
• Early Detection and Diagnosis
• Definitive Diagnoses: Many diseases present overlapping clinical
symptoms, challenging accurate diagnosis.
• Pathology provides final answers by uncovering the underlying
cellular alterations.
• Molecular Insights: Molecular pathology analyzes genetic and
molecular abnormalities within cells.
• For instance, targeted therapies in cancer are often based on
molecular pathology findings.
 ROLE OF PATHOLOGIST

• Unmasking the Silent Onset: Pathology helps uncover these hidden

cancers enabling early detection.
• Guiding Surgical Procedures: Before and during surgeries, pathologists
provide critical guidance.
• Personalized Medicine: Pathology helps in personalized treatment plans
by assessing the characteristics of a patient's disease.
• Molecular profiling helps identify biomarkers that can predict treatment
responses, allowing clinicians to choose therapies with higher chances of
success and fewer adverse effects.
• Monitoring Treatment Efficacy.
 HISTORY OF PATHOLOGY
• Prehistoric Times to Medieval Period: During prehistoric time,religion,
magic are linked to diseases.
• It was believed that the disease was the outcome of ‘curse from God’
or it had supernatural origin from ‘evil eye of spirits.’
• Hippocrates: The real practice of medicine began with the great
Greek clinical genius Hippocrates (460–370)
• He is regarded as ‘the Father of Medicine’.
 HISTORY OF PATHOLOGY
• Celsus first described four cardinal signs of inflammation namely
rubor (redness), tumor (swelling), calor (heat), and dolor (pain).
• Galen postulated humoral theory, later called Galenic theory.
• According to this theory, the illness was considered as due to
imbalance between four humors (or body fluids)- blood,
• Lymph, and
• Biliary secretion from the liver.
HUMAN ANATOMY AND ERA OF GROSS PATHOLOGY

• The development of human anatomy took place at the beginning of

this period with the art works and drawings of human muscles and
embryos by famous Italian painter Leonardo da Vinci
• Antony van Leeuwenhoek (1632–1723), a cloth merchant by
profession in Holland, invented the first ever microscope by grinding
the lenses.
• Marcello Malpighi (1624–1694) observed the presence of capillaries
by using microscope.
• Malpighi is known as “the father of histology”
 ERA OF TECHNOLOGY DEVELOPMENT AND CELLULAR PATHOLOGY

• Till the end of the 19th century, the study of morbid anatomy was
confined largely to autopsy-based study and thus remained as a
retrospective science.
• Rudolf Virchow (1821–1905) in Germany first did the microscopic
examination of diseased tissue at cellular level.
Virchow is known
as the father of
modern pathology
 LANDMARKS IN MODERN PATHOLOGY

• Karl Landsteiner (1863–1943) described major human blood groupsin

1900 and is considered “father of blood transfusion”.
• Ruska and Lorries in 1933 developed electron microscope. This helped to
identify the ultrastructure of cell and its organelles.
• George N Papanicolaou (1883–1962), a Greek-born, American pathologist
is known as ‘father of Exfoliative cytology’.
• In 1930s, he developed exfoliative cytology for early detection of cervical
cancer.
• William Boyd (1885–1979), psychiatrist-turned pathologist was by an
eminent teacher-author in pathology during 20th century. His
• MM Wintrobe (1901–1986) discovered hematocrit technique.
 MODERN PATHOLOGY
• Watson and Crick in 1953 described the structure of DNA of the cell. v
• Tijo and Levan in 1956, identified chromosomes and their correct number in
humans (46 = 23 pairs).
• Nowell and Hagerford in 1960, identified Philadelphia chromosome t(9;22) in
chronic myeloid leukemia.
• In situ hybridization (ISH) was introduced in 1969. In this, a labeled probe is used
to detect and localize specific RNA or DNA sequences ‘in situ’ (e.g., in the original
place).
• Its later modification uses fluorescence microscopy (FISH) to detect specific
localization of the defect on chromosomes.
• Recombinant DNA technique was developed in 1972
• Kary Mullis in 1983, introduced polymerase chain reaction (PCR).
 MODERN PATHOLOGY
• Ian Wilmut and his colleagues at Roslin Institute in Edinburgh in 1997,
performed mammalian cloning
• Stem cell research: It started in 2000s by harvesting the primitive
stem cells
• Human Genome Project (HGP): By HGP, it is possible to readnature’s
complete genetic blueprint used in making of each human being (i.e.,
gene mapping).
TELEPATHOLOGY AND VIRTUAL MICROSCOPY

• Tele pathology is defined as the practice of diagnostic pathology at a

distance.
• In this, a remote pathologist (receiving side) opines on histological,
cytological electronic (digital) images which are transferred over a
telecommunication network from a different location(sending side).
• Components: The various components of tele pathology network
include:
• A conventional light microscope
• Devise to capture the image, i.e., a camera mounted on a microscope
TELEPATHOLOGY AND VIRTUAL MICROSCOPY

• Telecommunication link between the sending and receiving sites.

• A work station at the receiving site of high-quality.
• Advantages/benefits: Tele pathology makes it faster and easier to share
medical images.
• Pathologists in different locations can view images simultaneously and
discuss diagnoses through teleconferencing.
• Pathologist can consult pathologists who are specialized in area of concern,
such as liver pathology or lung pathology.
• It allows pathologists, surgeons and radiologists to communicate with each
other over diagnostic dilemmas and overcoming the barrier of distance.
 CONCLUSIONS
• Knowledge and understanding of pathology is essential for all
doctors.
• Medical practitioners and specialists should know the causes,
mechanisms, nature and type of disease, and understand the
language spoken by the pathologist in the form of laboratory reports.
• “For the student of any year of medical course the discipline of
pathology forms a vital bridge between initial learning phase of
preclinical sciences and the final phase of clinical subjects”
 WHAT TO EXPECT IN EXAM

• TELEPATHOLOGY
• HISTOCHEMISTRY
• FROZEN SECTION
 INSTRUCTIONS
• Pathology Record
• Log book
• SDL note book
• Q&A for charts
• FA/Tutorial
• H&E Pencils
 THANK YOU
Good Luck and Enjoy Your Studies