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.