Pathology. The study of diseases that can cause Diagnosis.

the identification of a disease an

abnormalities in the structure or function of various individual is believed to have
organ system.
Prognosis. Predicted course and outcome of the
disease
Disease. Pattern of the body’s response to some
form of injury that causes variation of normal Morphology. the structure of cells or tissue
conditions.
- Disturbance in the function or structure of Epidemiology. the investigation of disease in large
the human body. groups

Manifestations of Pathologic Processes

Pathologic process can be defined as following:
Inflammation. Initial response of body tissues to
● Congenital and Hereditary
local injury
● Inflammatory
● Degenerative Process:
● Metabolic process Dialiation of arterioles, capillaries, and
● Traumatic venules (hyperemia)
● Neoplastic Heat and redness
Venules and capillaries become abnormally
Terminologies permeable (allowing exudate in the
Etiology. Study of the cause of a disease: surrounding tissue)
● Viruses Swelling produces pressure on sensitive
● Bacteria nerve endings (Pain)
● Trauma Fever. common in inflammatory conditions
● Heat
● Chemical agents Clinical signs of acute inflammation
● Poor nutrition ● Rubor (redness)
● Calor (heat)
Iatrogenic. diseases caused by physicians or their ● Tumor (Swelling)
treatment ● Dolor (pain)
● Loss of function
Nosocomial. infections at the acute care facility
Events that occur in Inflammatory response:
Community Acquired. infections that develop
1. Alteration in blood flow and vascular
outside the healthcare facility
permeability
Idiopathic. Underlying cause if unknown 2. Mitigation of circulating WBC to the
interstitium of the injured tissue
Acute. quick onset and last for a short period 3. Phagocytosis and enzymatic digestion of
dead cells and tissue elements
- e.g. Pneumonia
4. Repair of injury by generation of normal
- May be followed by lasting effects, sequelae
parenchymal cells of proliferation of
- stroke, or cerebrovascular accident,
granulation and eventual scar formation
resulting in long-term neurologic
deficits
Edema. Accumulation of abnormal amounts of fluid
Chronic. diseases may manifest more slowly and in the intercellular tissue spaces or body cavities
last for a very long time
● Localized - inflammatory reaction
- e.g. Multiple sclerosis, diabetes mellitus ● Anasarca - Generalized edema occurs with
experiencing hypoglycemia or hyperglycemia pronounced swelling of subcutaneous tissues
throughout the body
 ○ Congestive heart failure, Liver ● Dysplasia – loss of uniformity of individual
Cirrhosis, Renal disease cells and heir architectural orientation
○ Elephantiasis – local obstruction of
lymphatic drainage (filariasis) Neoplasia
- Latin words meaning “New Growth”h”
Ischemia. Refers to an interference with the blood (Tumor)
supply to an organ or part of an organ. - Abnormal proliferation of cells
- Can be Benign or Malignant
May be caused by:
- Cells acts as parasites, competing with
- narrowing of arterial structures
normal cells and tissues for their metabolic
(atherosclerosis)
needs
- thrombotic or embolic occlusion
- Cachexia – tumor cells flourish;
Ganglion cells and myocardial muscles cells undergo patient becomes weak and emaciated
irreversible damage if deprived of their blood - Oncology – Study of neoplasms.
supply for 3 to 5 mins. - Greek words “oncos”, meaning
tumor.
Commonly seen in Anemic or cyanotic patients.
Basic Components of Tumors
Infarct. Localized area of ischemic necrosis within a 1. The parenchyma (organ or tissue), made up
tissue or organ produced by occlusion of either its of proliferating neoplastic cells
arterial supply or its venous drainage.
a. Determines how the tumor behaves
● Necrosis - tissue death that may be caused by
lack of blood supply 2. The supporting stroma (tissue), made up of
● Gangrene - condition that results from death connective tissue, blood vessels, and possibly
of tissue due to lack of blood supply lymphatic vessels

Hemorrhage. Rupture of blood vessels a. Determines how the tumor is named

- Trauma, atherosclerosis, an inflammatory or
Benign Tumor.
neoplastic erosion of vessels
● Resemble the cells of origin in structure and
- Hematoma - trapped blood within
function
the body tissues
● Remain localized
- Petechiae - minimal hemorrhages
● Can be surgically removed
into the skin, mucous membranes, or
○ e.g., pituitary, islets of Langerhans,
serosal surface
brain, spinal cord, trachea, esophagus.
- Purpura - slightly larger
● -oma, Fibroma, Chondroma, Adenoma,
hemorrhages
Cystadenoma, Lipoma, Myoma, Angioma,
- Ecchymosis - larger (greater than 1 to
Papilloma (polyp)
2 cm) subcutaneous hematoma
Malignant Tumor (Cancer)
Alterations of Cell Growth
● Cancer – latin word karnikos meaning “crab”
● Atrophy – reduction in the size or number of
(has fingerlike projections)
cells in an organ or tissue
● Invades and destroys adjacent structures and
● Hypoplasia - underdevelopment
spread to distant sites (metastasize)
● Aplasia – failure to develop
● Poorly differentiated (may be impossible to
● Hypertrophy – increase in the size of cells in
etermine which organ they originate)
an organ or tissue
● Are called carcinomas
● Hyperplasia – increased number of cells
○ Affects epithelial tissues, skin, and
● Metaplasia - conversion of one cell type into
mucous membranes lining body
another cell type that is not normal for that
cavities
tissue
 ○ Adenocarcinoma, Basal cell - Presence or absence of metastases to lymph
carcinoma, Squamous Cell Carcinoma nodes and distant organs
- Determines the most appropriate therapy
Sarcoma
- Localized tumor – surgically removed
● Highly malignant tumors arising from
- Hodgkin’s disease – radiation therapy
connective tissues such as bone, muscle, and
- Prostate cancer – hormonal therapy
cartilage
- Chemotherapy
● Less common than carcinoma, but tend to
spread more rapidly TNM System
- The T refers to the size and extent of the
Carcinogens
main tumor. The main tumor is usually called
● substance that promotes carcinogenesis;
the primary tumor.
formation of cancer
- it can be 1, 2, 3 or 4, with 1 being
Chemical Carcinogens small and 4 large
Air and water pollution, cigarette smoke, - The N refers to the number of nearby lymph
asbestos, food, cosmetics, and plastic nodes that have cancer.
Excessive exposure to sunlight - it can be between 0 (no lymph nodes
containing cancer cells) and 3 (lots of
The spread of malignant cancer cells resulting in a lymph nodes containing cancer cells)
secondary tumor distant from the primary lesion is - The M refers to whether the cancer has
termed metastasis metastasized. This means that the cancer has
spread from the primary tumor to other
Malignant neoplasms disseminate to distant sites by
parts of the body.
one of three ways:
- it can either be 0 (the cancer hasn't
1. Seeding (Diffuse spread) within the body spread) or 1 (the cancer has spread)
- Cancerous cells travel to a distant site
In situ—Abnormal cells are present but have not
or distant organ system
spread to nearby tissue.
- Neoplasms invade body cavities
- GIT to the peritoneum to distant sites Localized—Cancer is limited to the place where it
started, with no sign that it has spread.
2. Lymphatic spread
- Major metastatic route of carcinomas Regional—Cancer has spread to nearby lymph
(Lung and breast) nodes, tissues, or organs.
- Depends on the site and natural
lymphatic drainage (sentinel node) Distant—Cancer has spread to distant parts of the
body.
3. Hematogenous spread
- Invasion of the circulatory system Unknown—There is not enough information to
- Complex process involving several figure out the stage.
steps
Grading of Malignant Tumor
- Invade and penetrate blood vessels,
● Assesses aggressiveness or degree of
travel as neoplastic emboli, can be
malignancy
trapped in small vessels
● Indicates its biological behaviour
- Certain types of cancer appear more
● Allows prediction of its responsiveness to
often as metastases from other areas
therapeutic agents
rather than originating in a given
● How abnormal the tumor cells and the tumor
organ
tissue look under a microscope
Staging of Malignant Tumor
- Extensiveness of a tumor at its primary site
Grade 1 ● Close intermarriages
● The cancer cells look very similar to normal ● Phenylketonuria, Cystic fibrosis (affects cells
cells and are growing slowly that produce mucus, sweat, and digestive
● (Well differentiated) (low grade) juices), Galactosemia, Glycogen and Lipid
storage diseases, Tay-Sachs disease (absence
Grade 2
of a vital enzyme called hexosaminidase-A
● The cells look unlike normal cells and are
(Hex-A)), Sickle cell anemia
growing more quickly than normal
● Moderately differentiated (intermediate Acquired Immunodeficiency Syndrome
grade) ● Commonly affects young homosexual men, IV
drug abusers, Hemophiliacs, and in
Grade 3
recipients of transfusions
● The cancer cells look very abnormal and are
● Characterized by a profound and sustained
growing quickly
impairment of cellular immunity that results
● Poorly differentiated (high grade)
in recurrent or sequectial oppurtunistic
Grade 4 infections and particularly aggressive form of
● Tumors tend to grow rapidly and spread Kaposi’s sarcoma
faster ● Affects the skin and causes an ulcerated
● (Undifferentiated) (high grade) hemorrhagic dermatitis
● Small bowel metastasis can produce reddish
GX or bluish red nodules
● means that the grade can't be assessed. ● Attributable to infection with retroviruses
● It is also called undetermined grade. (HIV)
● Pulmonary infections are common in
Hereditary Disease
patients with AIDS
- Passed from one generation to the next
● Pneumocystis Carinii Pneumonia (usually
- Reflects abnormality in the DNA
fatal if untreated)
- Enzyme deficiency
● GI manifestations
- Albinism (absence of pigmentation),
○ Rectum and colon, Shigellosis,
Phenylketonuria (build up of phenylalanine)
Amebiasis, Candidiasus, and
- Globin molecule defect
Giardiasis
- Sickle cell disease and thalassemia
(abnormal hemoglobin),
Glucose-6-Phosphate Dehydrogenase
Deficiency (adverse reaction to drugs)
- Mutations – alterations in DNA structure
- May become permanent if they affect
gonadal cells

Autosomal Dominant Disorders

● Transmitted from one generation to the next
(Hetrozygous)
● Achondroplasia (dwarfism),
Neurofibromatosis (tumors of the nervous
system), Marfan’s syndrome (disorder of the
connective tissue), Familial
Hypercholesterolemia (high levels of LDL in
the blood)

Autosomal Recessive Disorders

● Homozygous for the defective gene