Histopath - quiz 1

Etiology

the origin of the disease (underlying causes and modifying factors)

Pathogenesis

steps in the development of the disease

General pathology

• focuses on the cellular and tissue alterations caused by pathologic stimuli in most tissues

• broad

Systemic pathology

• examines the reactions and abnormalities of different specialized organs

• per organ system

Anatomic pathology

• surgical pathology

• focuses of the examination of organs, tissues, and body fluids for structural abnormalities including autopsy examination of cadavers

Clinical pathology

• laboratory medicine

• focuses on the examination of blood and other body samples for functional abnormalities

Pathologist

• medical doctor that examines bodies and body tissues

• involved in establishing the diagnosis of the disease

Cell injury

adaptive capability is exceeded or if the external stress is inherently harmful

Cell death

• one of the most crucial events in the evolution of disease in any tissue or organ

• a normal and essential process in embryogenesis, the development of organs and the maintenance of homeostasis

Retrogressive changes

Organ/tissues smaller than normal

Progressive changes

Organ/tissues larger than normal

Degenerative changes

Tissue have abnormalities

Aplasia

• Incomplete/defective development of tissue/organ

• most commonly seen in one paired structures

• represented only by a mass of fatty/fibrous tissue

Agenesia

Non-appearance of an organ

Hypoplasia

Failure of an organ to reach its full, mature size

Atresia

Failure of an organ to form an opening

Atrophy

• Refers to an acquired decrease in the size of a normally tissue or organ

• Reduction in cell size

Physiologic atrophy

• occurs as a natural consequence of maturation

• as in thymus and lymphoid tissue during puberty

Senile atrophy

• occurs in old age characterized by dry, lusterless, wrinkled skin

• sweat and sebaceous glands

Pathologic atrophy

refers to a decrease in size of organ, usually as a consequence of disease

Vascular atrophy

• due to lack of nutrition

• occurs if the blood supply to an organ or tissue becomes reduced below critical level

Pressure atrophy

• persistent pressure on the organ or tissue may directly injure the cells

• may secondarily promote diminution of blood supply

Starvation or hunger atrophy

• due to lack of nutritional supply

• may lead to wasting of tissues

Atrophy of disuse

• inactivity or diminished function of a tissue or organ may lead to narrowing of blood vessels

Exhaustion atrophy

• prolonged overwork

• of an endocrine organ may produce initial enlargement with ultimate slow progressive loss of parenchymal cells

Endocrine atrophy

diminished or absent endocrine stimulation may produce functional atrophy (G.H)

Hypertrophy

• refers to an increase in size of tissues or organs due to increase in size

• no new cells

True hypertrophy

usually seen in skeletal muscle, heart, kidneys, endocrine glands due to increased work load

False hypertrophy

due to edema fluid and connective tissue proliferation

Compensatory hypertrophy

involves one of paired organs when the opposite organ has been removed

Hyperplasia

• refers to an increase in size of an organ or tissue due to increase in the number of cells

• cell division

physiological hyperplasia

• resulting from normal stimuli

• hormonal such as breast tissue growth and uterus during pregnancy

Pathologic hyperplasia

stimulation of growth factors, excess hormonal stimulation, viral infection, nodular

Degenerative changes

due to aberrations of cellular growth patterns

Metaplasia

• reversible change involving transformation in one type of adult cell to another

• ex. Ciliated pseudostratified columnar epithelium → stratified squamous epithelium (chronic smoker)

Dysplasia (atypical hyperplasia)

• is the regressive alteration in adult cells manifested by variation in size, shape, and orientation

• usually reversible and do not lead to tumor formation - changes in structure

Anaplasia

• undifferentiated cell

• usually used as criterion toward malignancy

• irreversible, more primitive cells

Neoplasia

• tumor

• continuous abnormal proliferation of the cells without control (no purpose or function)

Parenchyma

• active elements, tumor cells, tumor itself

• requires nutrients

Stroma

• connective tissue, framework

• supply nutrients

Benign tumors

• are those that do not produce death

• tumor is localized and does not metastasize

• suffix - oma

Malignant tumors

• will produce death eventually

• invasive and destroys adjacent areas

• collectively referred to as sarcoma

Metastasis

• tumor implants continuous with the primary tumor

• most reliable feature of malignancy

• cancer cells penetrate into blood vessels, lymphatics and body cavities

Seeding within body cavities

• neoplasm penetrates into a natural field

• most often in the peritoneal cavity

Lymphatic spread

most common pathway for CARCINOMAS

Hematogenous spread

most common pathway for sarcomas

Staging

is based on the size of the primary lesion, its extent of spread to regional lymph nodes and the present or absence of metastases

UICC - International Union against Cancer'

AJCS - Amereican Joint Committee on Cancer staging

2 major agencies concerned with the staging of malignant diseases

Size of invasion, T1234 - with increasing size of the primary lesion

A “T” score is based upon the ?

Lymph node involvement, N0123 - indicates progressively advancing nodal disease

The “N” score indicates the extent of ?

Distant metastasis are present, M01 - whether there are distant metastases

The “M” score indicates whether ?

Teratomas

• type of neoplasm

• compound tumors

• Greek: “monstrous tumors"“

• Tumor with normal tissue or organ components that are inappropriate to surrounding tissues

• May contain hair, teeth, bones and very rare eyeballs, torso, and hands

Inflammation

• protective response of the tissues of the body to irritation or injury

• composed of a series of physiologic and morphologic changes in the blood vessels, blood components and surrounding connective tissues

• purpose of protecting the body against injury

Rubor, Tumor, Calor, Dolor, Functio laesa

what are the 5 cardinal signs of inflammation

Rubor

• redness

• due to arteriolar and capillary dilatation with increased rate of blood flow towards the site of injury

Tumor

• swelling

• due to increased capillary permeability

• causing extravasation of blood fluid; recruitment of phagocytes

Calor

• heat

• due to transfer of internal heat to the surface or site of injury

• brought about by increased blood content

Dolor

• pain

• due to pressure upon the sensory nerve by the exudate/tumor

Functio laesa

• diminished function

• destruction of the functioning units of the tissue

Acute inflammation (exudative inflammation)

• a rapid response to an injurious agent that aims to rapidly bring mediators of inflammation

• vascular and exudative

• predominantly PMNs

Increased neutrophils and macrophage

what is the hallmark for acute inflammation?

Exudation

the escape of fluid, proteins and blood cells from the vascular system into interstitial tissue or body

Exudate

increase specific gravity, increased protein with infection

Transudate

low specific gravity (low fluid)

Serous inflammation

serum secretion from serosal mesothelial cells/certain PTB

Fibrinous inflammation

exudation of large amount of fibrinogen (diptheria, rheumatic pericarditis, early stage of pneumonia)

Catarrhal inflammation

hypertension of the mucosa

Hemorrhagic inflammation

admixture of blood and other elements of exudate/bacterial infection and others

Suppurative/purulent inflammation

pus/purulent exudate

Effusion

accumulation of serous fluid

Pus

creamy fluid composed of large number of PMNs and necrotic tissue debris

Abscess

large accumulation of pus

Pustule

small accumulation of pus

Subchronic inflammation

represents and intergrade between acute and chronic

Chronic inflammation

• persistence of the injuring agent for weeks/years

• vascular and fibroblastic

• predominantly mononuclear (macrophages, lymphocytes, plasma cells) but PMNs may also be preent