01 Introduction to Pathology

Page 1: Introduction

• Comprehensive Radiographic Pathology - Eisenberg R.

• Chapter one outlines Pathology.

Page 2: Objectives

• Classify common diseases by x-ray attenuation.

• Familiarize with changes in technical factors for radiographs.

• Explain pathological terms.

• Describe inflammation, edema, infarction, hemorrhage, and neoplasia.

• Outline AIDS precautions in radiography.

• Briefly describe image production techniques (ultrasound, CT, MRI, SPECT, PET).

Page 3: Pathology Definition

• Study of diseases causing structural or functional abnormalities in organ systems.

Page 4: Key Terminology

• Disease: Disturbance of function/structure.

• Pathogenesis: Sequence of events post-injury leading to observable changes.

• Symptom: Patient's subjective perception of disease.

• Sign: Objective manifestations detected by a physician.

• Syndrome: Group of signs indicating a specific disturbance.

Page 5: Terminology Continued

• Etiology: Study of disease causes.

• Nosocomial: Diseases from poor infection control (e.g., MRSA).

• Neoplasia: Alterations in cell growth (tumors).

• Iatrogenic: Caused by treatment.

• Idiopathic: Of unknown cause.

• Immune: Body response to stimulation.

• Hereditary: Genetic source.

Page 6: Classification of Diseases

• Acute: Quick onset, short duration.

• Chronic: Slow onset, long-lasting.

• Diagnosis: Naming of the disease.

• Prognosis: Prediction of disease course and outcome.

Page 7: Epidemiology and Related Terms

• Epidemiology: Study of diseases in large groups.

• Prevalence: Number of cases in a population.

• Endemic: High prevalence in a specific region.

• Epidemic: Disease appearing in large numbers over a wide area.

• Mortality rate: Deaths caused by disease.

• Morbidity rate: Sickness interfering with daily life.

Page 8: Diseases & Radiography

• Pain during adjustments (e.g., fractures).

• Changes in projections for visualization.

• Adjustments in exposure factors (density changes).

• Considerations for immunocompromised patients.

• Communicable disease precautions.

Page 9: Skeletal System Attenuation

• Additive (increased attenuation): Conditions like osteomyelitis, Paget's disease.

• Destructive (decreased attenuation): Conditions like osteoporosis, tumors.

Page 10: Disease Classification Categories

• Inflammatory

• Neoplastic

• Congenital and hereditary

• Immune

Page 11: Inflammatory Disease Types

• Infective: Microorganism invasion.

• Toxic: Biological poisoning.

• Allergic: Overreaction of immune system.

• Autoimmune: Antibody formation against body tissues.

Page 12: Inflammatory Process Stages

• Chemical injury

• Physical injury

• Cell death

• Microbial injury

• Capillary dilation

• Increased permeability

• Leukocyte attraction

• Blood flow increase

• Fluid extravasation

• White cell migration

• Systemic response (fever, leukocytosis).

Page 13: Associated Signs of Inflammation

• Fever

• Toxins from bacteria

• Presence of pus

• Abscess

• Bacteremia

• Granuloma

Page 14: Edema

• Abnormal fluid accumulation in tissues/cavities.

• Localized: Inflammation/obstruction.

• Generalized: Includes conditions like heart failure.

Page 15: Ischemia & Infarction

• Blood supply interference may cause organ death.

• Can be compensated by collateral circulation.

• Tissues vary in sensitivity to hypoxia.

Page 16: Infarct & Gangrene

• Infarct: Local ischemic necrosis from blood flow occlusion.

• Gangrene: Severe arterial disease leading to necrosis.

Page 17: Hemorrhage

• Result from ruptured blood vessels due to injury.

• Hematoma: Trapped blood within tissues.

• Hemothorax, hemoperitoneum, hemarthrosis: Blood in body cavities.

Page 18: Alterations of Cell Growth

• Changes in cell number/size can affect function.

• Atrophy: Size/number reduction.

• Hypertrophy: Size increase in response to demand.

• Dysplasia: Loss of uniformity in cells.

Page 19: Neoplasia

• Abnormal cell proliferation independent of growth factors.

• Benign: Resembles original cells; easier to remove.

• Malignant: Invades/destroys tissues; metastasizes.

Page 20: Tumors Structure

• Parenchyma: Proliferating neoplastic cells.

• Stroma: Supporting tissue and vessels.

Page 21: Tumor Naming Conventions

• -oma: Benign tumors (e.g., fibroma).

• Carcinoma: Malignant epithelial tumors (e.g., adenocarcinoma).

Page 22: Tumor Characteristics

• Sarcomas: Highly malignant connective tissue tumors.

• Undifferentiated: No relation to original tissue.

Page 23: Tumor Spread Mechanisms

• Seeding: Invading natural cavities.

• Lymphatic spread: Common in carcinomas.

• Hematogenous spread: Tumor cells in circulation.

Page 24: Cancer Staging

• Grading: Assesses tumor aggressiveness.

• Staging: Assessing tumor extent/metastasis.

• Treatment options include radiation, hormonal, and chemotherapy.

Page 25: Hereditary Disease Types

• Congenital: Present at birth due to genetic abnormalities.

• Hereditary: Developmental disorders genetically transmitted.

Page 26: Diseases of Immunity

• Body immunological response to foreign substances.

Page 27: Types of Immunity

• Active: Forming antibodies against vaccines (long-term).

• Passive: Administering preformed antibodies (short-term).

Page 28: Immune Reactions

• Allergy: Rapid anti-body release reaction.

• Cytotoxic reaction: Destruction of cells by antigens.

• Delayed reaction: Previous sensitization reaction.

Page 29: AIDS Overview

• Acquired immunodeficiency syndrome; leads to opportunistic infections.

• Caused by HIV, transmitted through sexual interaction/blood contact.

Page 30: Radiographic Appearance of AIDS

• Kaposi's sarcoma shows multiple nodules in small bowel imaging.

Page 31: Pneumocystis Carinii Pneumonia Imaging

• Shows bilateral consolidation indicating severe pneumonia or pulmonary edema.

Page 32: Neurologic Manifestations of AIDS Imaging

• CT shows ring-enhancing lesions from cryptococcal abscesses.

Page 33: AIDS Treatment Challenges

• No cure; focus on quality of life and symptom management.

• Antiviral drugs used; healthy lifestyle recommended.

Page 34: Specialized Imaging Techniques - Ultrasound

• Non-invasive; differentiates cystic and solid structures.

Page 35: Ultrasound Images of Abdomen

• Scans of heart, gallbladder, and major vessels imaged.

Page 36: Ultrasound of Renal Carcinoma

• Hyperechoic area identified within a mass in the kidney.

Page 37: Ultrasound of Multiple Pregnancy

• Shows normal architecture in one fetus, abnormal in another.

Page 38: Breast Ultrasound Imaging

• Anechoic mass with well-defined edges identified.

Page 39: Wrist Ultrasound Imaging

• Cystic structure seen near metacarpals.

Page 40: Ultrasound Guides Localization

• Needle localization for surgical biopsy verified by mammography.

Page 41: Limitations of Ultrasound

• Acoustic barriers can hinder solid organ imaging.

Page 42: Computed Tomography Overview

• Produces cross-sectional images; sensitive to tissue density differences.

Page 43: CT Scan Example

• Normal lower abdomen scan depicting various organs.

Page 44: CT Scout Image

• Represents scan slices for guidance.

Page 45: High-Resolution CT of Lung

• Pneumothorax visualized in emphysematous patient.

Page 46: Three-Phase CT Scanning Protocol

• Demonstrates arterial, venous, and excretory phases in abdomen.

Page 47: CT Angiography

• 3D imaging of aorta and associated arteries displayed.

Page 48: 3D CT Images of Skull

• Illustrates craniosynostosis in a child and normal skull anatomy.

Page 49: Magnetic Resonance Imaging Introduction

• Important for CNS, musculoskeletal, abdomen; uses magnets and radio waves.

Page 50: MR Image of Abdomen

• Shows liver, gallbladder, and blood vessels in a transverse scan.

Page 51: MR Image of Brain

• Different imaging techniques show brain structures with varying contrasts.

Page 52: MR Imaging of Lumbar Spine

• Disk protrusion visualized using proton density fast spin echo.

Page 53: MR Angiography Examples

• Shows normal circulatory features in the brain and abdomen.

Page 54: Nuclear Medicine Overview

• Involves radiopharmaceuticals; sensitivity to certain diseases but less anatomical detail.

Page 55: Nuclear Medicine Bone Scan

• Demonstrates normal scan in a patient with hypercalcemia.

Page 56: Indium 111 Octreotide Scan

• Illustrates hepatic carcinoma metastases.

Page 57: SPECT Overview

• Creates 3D images from rotating gamma camera, limited to camera size.

Page 58: SPECT Brain Imaging

• Reconstructed images presented in transverse, sagittal, and coronal views.

Page 59: SPECT Cardiac Imaging

• Images show heart functionality at rest and stress levels.

Page 60: Positron Emission Tomography Overview

• Uses radionuclide tracers to create detailed metabolic images.

Page 61: Normal PET Scan Representation

• Bladder, heart, and kidney imaged in multiple planes.

Page 62: PET in Chemotherapy Assessment

• Before and after therapy scans compare uptake of fluorodeoxyglucose.

Page 63: PET Cardiac Imaging

• Highlights normal perfusion patterns in heart scans.

Page 64: PET Myocardial Viability

• Assess ischemia and viability through perfusion scans.

Page 65: PET Brain Imaging

• Displays normal brain metabolism across various imaging planes.

Page 66: Conclusion

• Summary of major imaging techniques and their applications in medical pathology.