Asian College Foundation

RADIOLOGIC PATHOLOGY
MANUAL

Sheena Grace Y. Cocamas, RRT

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CHAPTER 1. REVIEW OF THE HUMAN BODY

A. Body Cavities

Life is an amazing adventure that offers a wide range of encounters, feelings, and learning opportunities. It includes all living
creatures, from the most basic to the most sophisticated, including humans. Humans are made of a complex structure that is
beyond the scope of anyone. A human body is therefore a work of art.

Body Cavities

Body cavities are fluid-filled spaces within the body that house and protect internal organs. They are separated by membranes and
other structures. The two largest body cavities in humans are:

Ventral Cavity – also known as ANTERIOR

Thoracic Cavity: Contains the lungs and heart, divided into pleural cavities (each housing a lung) and the pericardial cavity
(housing the heart).

Abdominopelvic Cavity: Subdivided into the abdominal cavity (containing digestive organs like the stomach, liver, and intestines)
and the pelvic cavity (containing reproductive organs, bladder, and rectum).

Dorsal Cavity – also known as POSTERIOR

Cranial Cavity: Houses the brain.

Spinal Cavity: Encloses the spinal cord.

B. Component Unit of Life

The basic unit of life is the cell. Cells are the smallest structural and functional units of an organism, capable of performing all life
processes. Here are some key points about cells:

Structure: Cells are composed of various organelles, each performing specific functions. Key organelles include the nucleus
(containing genetic material), mitochondria (powerhouse of the cell), and ribosomes (protein synthesis).

Types: There are two main types of cells:

Prokaryotic Cells: Simple cells without a nucleus (e.g., bacteria).

Eukaryotic Cells: Complex cells with a nucleus (e.g., plant and animal cells).

Functions: Cells carry out essential functions such as metabolism, energy production, and reproduction. They also respond to
environmental stimuli and maintain homeostasis.

CELL ORGANIZATION

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 C. Directional Terms and Body Planes

Directional Terms

Directional terms are used to describe the locations of structures in relation to other structures or locations in the body. Here are
some common directional terms:

Anterior (Ventral): Toward the front of the body (e.g., the chest is anterior to the spine).

Posterior (Dorsal): Toward the back of the body (e.g., the spine is posterior to the chest).

Superior (Cranial): Toward the head or upper part of a structure (e.g., the head is superior to the abdomen).

Inferior (Caudal): Away from the head or toward the lower part of a structure (e.g., the stomach is inferior to the heart).

Medial: Toward the midline of the body (e.g., the nose is medial to the eyes).

Lateral: Away from the midline of the body (e.g., the arms are lateral to the chest).

Proximal: Closer to the origin of the body part or the point of attachment (e.g., the elbow is proximal to the wrist).

Distal: Farther from the origin of the body part or the point of attachment (e.g., the fingers are distal to the elbow).

Superficial: Toward or at the body surface (e.g., the skin is superficial to the muscles).

Deep: Away from the body surface; more internal (e.g., the lungs are deep to the rib cage).

Body Planes

Body planes are imaginary lines that divide the body into sections. They are used to describe locations and movements of body
parts:

Sagittal Plane: Divides the body into right and left parts.

Midsagittal (Median) Plane: Divides the body into equal right and left halves.

Frontal (Coronal) Plane: Divides the body into anterior (front) and posterior (back) parts.

Transverse (Horizontal) Plane: Divides the body into superior (upper) and inferior (lower) parts.

D. Quadrants and Regions of the Body

Abdominal Quadrants

The abdomen is divided into four quadrants by two imaginary lines: one vertical (midsagittal plane) and one horizontal
(transumbilical plane) intersecting at the navel. These quadrants help in localizing pain, tenderness, and other symptoms:

1. Right Upper Quadrant (RUQ)

o Major organs: Liver, gallbladder, right kidney, portions of the stomach, small and large intestines.

2. Left Upper Quadrant (LUQ)

o Major organs: Stomach, spleen, left kidney, pancreas, portions of the liver, small and large intestines.

3. Right Lower Quadrant (RLQ)

o Major organs: Appendix, right ureter, portions of the small and large intestines, reproductive organs (right ovary
and fallopian tube in females).

4. Left Lower Quadrant (LLQ)

o Major organs: Left ureter, portions of the small and large intestines, reproductive organs (left ovary and
fallopian tube in females).

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Abdominal Regions

For more detailed localization, the abdomen is also divided into 5. Umbilical Region
nine regions using two vertical (midclavicular lines) and two
horizontal lines (subcostal and intertubercular planes): o Located around the navel.

1. Right Hypochondriac Region o Major organs: Small intestine, transverse

colon.
o Located below the ribs on the right side.
6. Left Lumbar Region
o Major organs: Liver, gallbladder.
o Located in the middle left section.
2. Epigastric Region
o Major organs: Descending colon, left kidney.
o Located above the stomach.
7. Right Iliac (Inguinal) Region
o Major organs: Stomach, liver, pancreas.
o Located in the lower right section.
3. Left Hypochondriac Region
o Major organs: Appendix, cecum.
o Located below the ribs on the left side.
8. Hypogastric (Pubic) Region
o Major organs: Spleen, stomach.
o Located below the stomach.
4. Right Lumbar Region
o Major organs: Bladder, reproductive organs.
o Located in the middle right section.
9. Left Iliac (Inguinal) Region
o Major organs: Ascending colon, right kidney.
o Located in the lower left section.

o Major organs: Sigmoid colon

E. Surface Anatomy of the Body

Surface anatomy, also known as superficial anatomy, involves the study of the external features of the body. It helps in identifying
underlying structures through visual inspection and palpation. Here are some key regions and landmarks:
Head and Neck  Lumbar region: Lower back.

 Forehead: Frontal region. Upper Limbs

 Eyes: Orbital region.  Shoulder: Acromial region.

 Nose: Nasal region.  Arm: Brachial region.

 Mouth: Oral region.  Elbow: Cubital region (front: antecubital, back:

olecranal).
 Chin: Mental region.
 Forearm: Antebrachial region.
 Neck: Cervical region.
 Wrist: Carpal region.
Thorax (Chest)
 Hand: Manual region (palm: palmar, fingers: digital).
 Clavicle: Collarbone.
Lower Limbs
 Sternum: Breastbone.
 Hip: Coxal region.
 Ribs: Rib cage.
 Thigh: Femoral region.
 Pectoral muscles: Chest muscles.
 Knee: Patellar region (front), Popliteal region (back).
Abdomen
 Leg: Crural region.
 Umbilicus: Navel.
 Ankle: Tarsal region.
 Rectus abdominis: “Six-pack” muscles.
 Foot: Pedal region (sole: plantar, toes: digital).
 Linea alba: Midline tendinous seam.
Pelvis
Back
 Pelvic region: Lower torso between the abdomen and
 Scapula: Shoulder blade. thighs.
 Vertebral column: Spine.  Inguinal region: Groin area.

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F. BODY HABITUS

Body habitus refers to the common variations in the shape of the human body, which in turn determines the position of internal
viscera.

Body habitus indicates the body wall thickness and the placement of organs and hence determines technical and exposure factors
for radiographic density, contrast, and radiation dose 1,2.

Types

The four major types of body habitus are as follows 3:

HYPERSTHENIC
Also known as endomorphic. It is a larger build with the organs oriented as such:

 heart  stomach
o axis is almost transverse o high
 lungs o transverse and in the middle
o short  colon
o apices lie near the clavicles o around the periphery of the abdomen
 diaphragm  gallbladder
o high o high

STHENIC
Also known as average, mesomorphic. It is a moderately heavy build with the organs oriented as such:

 heart  colon
o moderately transverse o spread evenly with a slight dip in the
 lungs transverse colon
o moderate in length  gallbladder
 diaphragm o right upper abdomen
o moderately high

HYPOSTHENIC
- intermediate between the sthenic and asthenic body habitus types also known as slender
- similar to asthenic but the stomach, intestines and gallbladder are situated relatively higher in the abdomen

ASTHENIC
Also known as very slender, ectomorphic. It is a frail build with the organs oriented as such:

 heart  stomach
o nearly vertical and in the midline o low
 lungs o near the midline
o long  colon
o apices above clavicles o low
o may be broader above base o folds on itself
 diaphragm  gallbladder
o low o relatively lower
o close to the midline
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CHAPTER 2. COMMON TERMS DISCUSSED IN RADIOLOGIC PATHOLOGY

A. Pathology and Radiologic Pathology

Pathology is the study of disease.

Radiologic pathology is a specialized field that combines radiology and pathology to diagnose diseases through imaging
techniques. Radiologic pathology involves understanding diseases through imaging techniques and correlating these findings with
pathological data.

B. Diagnosis and Prognosis

Diagnosis and prognosis are two important terms in the medical field, but they refer to different aspects of a patient’s health
condition:

Diagnosis: This is the identification of a disease or condition based on a patient’s symptoms, medical history, physical
examination, and diagnostic tests. For example, if a patient has a persistent cough, fever, and difficulty breathing, a doctor might
diagnose them with pneumonia after conducting a chest X-ray and other tests.

Prognosis: This is a prediction of the likely course and outcome of a disease or condition. It includes an estimate of the chances of
recovery, the expected duration of the illness, and the potential for complications. For instance, after diagnosing a patient with
pneumonia, a doctor might provide a prognosis indicating that with proper treatment, the patient is expected to recover fully
within a few weeks.

C. Endemic, Pandemic and Epidemic

Endemic: A disease is considered endemic when it is consistently present but limited to a particular region. This means the
disease’s spread and rates are predictable. For example, malaria is endemic in certain parts of Africa.

Epidemic: An epidemic occurs when there is a sudden increase in the number of cases of a disease above what is normally
expected in a specific area. For instance, an outbreak of measles in a community where it is not usually present would be
considered an epidemic.

Pandemic: A pandemic is an epidemic that has spread over multiple countries or continents, usually affecting a large number of
people. The COVID-19 outbreak, which spread globally, is a recent example of a pandemic.

In summary:

Endemic: Constant presence in a specific area.

Epidemic: Sudden increase in cases in a specific area.

Pandemic: Global spread across countries and continents.

D. Nosocomial and Community Acquired Diseases

Nosocomial Infections: Also known as hospital-acquired infections, these are infections that patients get while receiving treatment
in a healthcare facility. They typically develop at least 48 hours after admission and can be caused by various pathogens, including
bacteria, viruses, and fungi. Common examples include urinary tract infections from catheters, surgical site infections, and
pneumonia from ventilators.

Community-Acquired Infections: These infections are contracted outside of healthcare settings. They occur in the general
population and are not related to medical procedures or hospital stays. A common example is community-acquired pneumonia,
which people can get through everyday interactions.

In summary:

Nosocomial: Acquired in healthcare settings (e.g., hospitals).

Community-Acquired: Acquired in everyday environments outside healthcare settings.

E. Ischemia and Infarction

Ischemia: This occurs when there is a reduced blood flow to an organ or tissue, leading to a shortage of oxygen and nutrients
needed for cellular function. Ischemia can cause symptoms like pain, shortness of breath, and dizziness, depending on the affected
area. For example, myocardial ischemia affects the heart and can lead to chest pain (angina) and other symptoms.

Infarction: This is the result of prolonged ischemia, where the lack of blood flow causes tissue death. A common example is a
myocardial infarction, also known as a heart attack, which occurs when a part of the heart muscle dies due to a prolonged lack of
oxygen.

In summary:

Ischemia: Reduced blood flow causing oxygen shortage.

Infarction: Tissue death due to prolonged ischemia.

F. Prevalence and Incidence

Prevalence: This refers to the total number of cases of a disease that are present in a population at a specific time. It includes both
new and existing cases. Prevalence is often expressed as a percentage or proportion. For example, if 5% of a population has
diabetes at a given time, that is the prevalence of diabetes

Incidence: This refers to the number of new cases of a disease that develop in a population during a specific time period.
Incidence is usually expressed as a rate, such as the number of new cases per 1,000 or 100,000 people per year. For instance, if 50
new cases of diabetes are diagnosed per 1,000 people in a year, that is the incidence of diabetes.

In summary:

Prevalence: Total number of existing cases at a specific time.

Incidence: Number of new cases over a specific time period.

G. Symptomatic and Asymptomatic

Symptomatic:
Definition: Symptomatic refers to having noticeable symptoms or signs of a disease or condition.
Examples: If someone experiences coughing, fever, fatigue, or pain, they are symptomatic.

Asymptomatic:
Definition: Asymptomatic means having no apparent symptoms or signs of a disease or condition.
Examples: Some people infected with viruses (like COVID-19) may remain asymptomatic.

H. Etiology and Epidemiology and Idiopathic

Etiology focuses on the origin and causes of diseases.

Epidemiology studies the incidence, distribution, and control of diseases in populations.

Idiopathic refers to a condition or disease that arises without a known cause.

I. Acute and Chronic

Acute refers to a short-term condition or illness that develops rapidly.

Chronic refers to a long-lasting condition that persists over an extended period.

J. Iatrogenic Reaction and Idiopathic Disease

Iatrogenic Reaction refers to adverse responses to medical treatment itself or caused by Physicians.
Idiopathic Disease refers to a disease that has no causative factor can be identified.

K. Signs vs Symptoms vs Syndrome

1. Sign:

 Definition: A sign is an objective indication of a medical condition that can be observed, measured, or detected by
others, typically a healthcare provider. It’s something measurable or visible.
 Examples:
o A fever (measured by a thermometer).
o Rash (visible on the skin).
o Elevated blood pressure (measured with a sphygmomanometer).
o Swelling (evident upon inspection).
 Note: A sign is something a doctor or someone else can observe, rather than something the patient feels.

2. Symptom:

 Definition: A symptom is a subjective experience or feeling that the patient reports, which cannot be directly observed
by others. It’s something the patient experiences and communicates but is not measurable or visible.
 Examples:
o Pain (e.g., "I have a headache").
o Fatigue (e.g., "I feel very tired all the time").
o Dizziness (e.g., "I feel lightheaded").
o Nausea (e.g., "I feel like I'm going to throw up").
 Note: Symptoms are what patients report, and they can't be directly observed or measured by others (at least not without
further investigation).

3. Syndrome:

 Definition: A syndrome refers to a collection of signs and symptoms that occur together and are characteristic of a
particular disease or condition. It’s a broader term than either sign or symptom because it encompasses multiple features
of a disease.
 Examples:
o Down syndrome: Characterized by specific physical traits, developmental delays, and intellectual disability (a
combination of signs and symptoms).
o Irritable Bowel Syndrome (IBS): A combination of symptoms like abdominal pain, bloating, diarrhea, and
constipation, but no specific sign (like a test result) that definitively confirms it.
o Cushing's syndrome: Caused by prolonged exposure to high levels of cortisol, showing a set of symptoms and
signs like weight gain, thinning skin, and muscle weakness.
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CHAPTER 3. BASIC PRINCIPLES OF RADIOLOGIC PATHOLOGY

A. GENERAL RADIOLOGIC PATHOLOGY

Pathology is the study of disease. Whereas, Radiologic pathology is a specialized field that combines radiology
and pathology to diagnose diseases through imaging techniques.

Radiologic pathology involves understanding diseases through imaging techniques and correlating these
findings with pathological data. Here are some general principles:

Imaging Modalities

X-rays: Useful for visualizing bones and detecting fractures, infections, and tumors.
CT Scans: Provide detailed cross-sectional images of the body, helpful in diagnosing complex fractures,
cancers, and vascular diseases.
MRI: Excellent for soft tissue evaluation, including brain, spinal cord, and joint abnormalities.
Ultrasound: Uses sound waves to image soft tissues and is commonly used in obstetrics, cardiology, and
abdominal imaging.
Nuclear Medicine: Involves the use of radioactive substances to diagnose and treat diseases, particularly useful
in oncology and cardiology.

B. CLASSIFICATION OF 1.3. Degenerative

DISEASE
1.4. Metabolic
1.1. Congenital and Hereditary
1.5. Traumatic
1.2. Inflammatory

1.6. Neoplastic

1.1. CONGENITAL AND HEREDITARY

Congenital:
Definition: Congenital disorders are present at birth and resulting from genetic or environmental
factors.

Hereditary:
Definition: Hereditary diseases are caused by developmental disorders genetically transmitted either
parent to a child through abnormalities of individual genes in chromosomes and are derived from
ancestors.

1.2. INFLAMMATORY
Definition: Inflammatory disease results from the body’s reaction to a localized injurious agent.

Types: Infective disease – results from invasion by microorganisms such as virus, bacteria or fungi.
Toxic disease – are caused by poisoning by biologic substances
Allergic disease – are an overreaction of the body’s own defenses

1.3. DEGENERATIVE
Definition: Degenerative diseases are caused by deterioration of the body. Some associated by the aging
process but some degenerative disease may exist in younger patients.

1.4. METABOLIC
Definition: Metabolic diseases is the sum of all physical and chemical processes in the body. These are caused
by the disturbance of the normal physiologic function of the body.

1.5. TRAUMATIC
Definition: Traumatic diseases may result from mechanical forces such as crushing or twisting of a body part or
from the effects of ionizing radiation to the body.

1.6. NEOPLASTIC
Definition: Neoplastic diseases results in new, abnormal tissue growth.
 : PROLIFERATION: Cell division.
: DIFFERENTIATION: Process of cellular specialization.
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