Introduction to Pathology

Introduction to Pathology Class

  • Course Details

    • Year: 1

    • Course Code: FFP1

    • Lecture by: Prof. Siobhan Glavey

    • Date: 8th October 2025

    • Email: pathteachcoord@rcsi.ie

    • Institution: RCSI (Royal College of Surgeons in Ireland)

    • Irish Translation: Coláiste Ríoga na Máinleá in Éirinn

Learning Outcomes

  • Define pathology along with its subspecialties and clinical relevance to medicine, surgery, and patient management.

  • Describe various types of tissue sampling and outline the processes involved in macroscopic and microscopic examinations of tissues.

  • Distinguish between microscopic and macroscopic evaluations of tissue samples.

  • Explain the purpose and importance of performing autopsies.

  • Differentiate between two types of autopsies: coroner’s autopsy and hospital autopsy.

  • Summarize the assessment methods used in pathology.

  • Outline terminology frequently used in pathology.

Welcome to Pathology

  • Pathology is considered the basis of clinical medicine, highlighting the importance of distinguishing between healthy and diseased states.

  • Understanding disease requires an understanding of normal body function.

  • The study of pathology provides insights into:

    • Clinical presentations of diseases.

    • Potential complications arising from diseases.

    • Prognosis of diseases.

    • Management strategies for diseases.

    • Treatment options available.

    • Causes of death.

Subspecialties of Pathology

  • Pathology encompasses various subspecialties, including but not limited to:

    • Histopathology: The study of tissue diseases.

    • Haematology: The study of blood and blood disorders.

    • Microbiology: The study of microorganisms.

    • Chemical Pathology: The study of biochemical changes in diseases.

    • Immunology: The study of the immune system related to disease.

Role of a Pathologist

  • Pathologists serve multiple roles such as:

    • Diagnosticians utilizing microscopy, genomics, and digital pathology.

    • Educators in the field.

    • Researchers contributing to scientific advancements.

    • Laboratory supervisors.

  • Ethical Considerations

    • Issues surrounding consent for using human tissues in teaching and research are critical, as pathologists are custodians of human tissues sent to the laboratory.

The Evolving Role of the Pathologist

  • Innovations in pathology include:

    • Digital pathology and the integration of artificial intelligence.

    • Participation in multidisciplinary meetings for comprehensive patient care.

Functions of a Pathology Lab

  • The typical workflow in a pathology lab includes:

    • Receiving specimens and corresponding request forms.

    • Conducting macroscopic assessments of tissue samples.

    • Performing microscopic assessments to identify cellular characteristics.

    • Applying staining techniques, such as immunohistochemistry and fluorescent in-situ hybridization (FISH), to detect cell types and abnormalities.

    • Conducting molecular testing to identify genetic abnormalities.

    • Digital imaging and storage of samples for future reference.

    • Issuing pathology reports summarizing findings.

    • Engaging in multidisciplinary discussions (MDM) when necessary.

Case Studies in Pathology

  • Examination of pathology specimens from patients enhances learning and clinical knowledge.

Cancer Under the Microscope

  • Understanding cancer morphology includes stages:

    • Normal Cells: Typically structured and functioning cells.

    • Hyperplasia: An increase in cell number appearing normal microscopically but can be a precursor for malignancies.

    • Dysplasia: Abnormal cell appearance without being cancerous, indicating potential progression toward malignancy.

    • Cancer: Cells displaying overt malignancy with abnormal structures and functions exacerbated by hyperplasia and dysplasia changes.

Next Generation Cell Pathology

  • Innovations include examining DNA from single cells or small circulating cell populations.

    • Potentially less invasive alternatives to traditional biopsies.

    • Applications for research include single-cell sequencing and studying "persister cells" that can lead to cancer recurrence post-treatment.

Autopsy

  • Defined as a post-mortem examination to establish cause of death, it is crucial in:

    • Correcting inaccuracies in pre-mortem diagnoses in approximately 20% of cases.

    • Excluding foul play in particular cases.

    • Providing an excellent teaching opportunity for pathology students and professionals.

    • Requires informed consent, especially in the case of hospital autopsies.

Types of Autopsies

  • Coroner’s Autopsy:

    • Ordered by the coroner primarily to rule out foul play.

    • The next of kin cannot refuse the autopsy.

  • Hospital Autopsy:

    • Conducted with the permission or request from the next of kin.

Haematopathology

  • Involves analyzing blood samples, bone marrow, and lymph nodes to diagnose diseases, and investigations may include:

    • Anaemia

    • Leukaemia

    • Lymphomas

    • Bleeding disorders

    • Blood transfusion reactions

Pathology Course Content

  • The curriculum includes:

    • Histopathology

    • Haematopathology

    • Chemical Pathology

    • Molecular Pathology

    • Digital Pathology

Pathology Curriculum

  • Year 1 offers a variety of learning opportunities:

    • Lectures

    • Clinicopathological Conferences

    • Post-mortem tutorials available online on MOODLE

    • Computer Assisted Learning (CALPATH) on MOODLE

    • Pot/Lab sessions for hands-on experience

Lecture Structure

  • Lectures serve as the backbone of the learning process, employing:

    • A mixed approach to teaching.

    • An interactive, case-based learning style for better engagement.

    • Content is presented in a clinically relevant context to prioritize essential clinical issues.

  • Attendance for all lectures is crucial for academic success.

Clinical Pathological Conferences

  • These conferences are integral for demonstrating the link between pathology and clinical medicine:

    • Inclusion of clinical details, differential diagnoses, investigations, final diagnosis, and further investigations.

    • Discussions of pathology in multidisciplinary team (MDT) settings, informing management strategies and prognoses (e.g. in cases like Acute Appendicitis).

Computer Assisted Learning (CALPATH)

  • A supplementary resource available via Moodle that provides:

    • Self-testing formats useful for exam preparation.

    • Case-based studies for real-world relevance.

    • Access to macro and microscopic images for review.

    • Self-assessment components with definitions and terminology.

  • It acts to reinforce lecture learning and allow for independent study.

Lab and Pot Teaching

  • Presentation and demonstration of pathological specimens with clinical relevance.

Small Group Teaching

  • Participation is encouraged, regardless of familiarity with the topic, emphasizing:

    • The importance of attending sessions even when unsure about the material.

    • Each session itself serves as a valuable learning opportunity.

Recommended Textbooks

  • Underwood

  • Robbins Pathology

  • Pathology Illustrated

  • Stevens & Lowe

  • Kumar & Clarke

  • Pathophysiology of Blood Disorders: H. Franklin Bunn, Jon Casker.

Useful Websites

  • Medscape: www.medscape.com – Offers valued medical resources.

  • MedEdPORTAL | AAMC: www.mededportal.org – Known for educational publications beneficial for students and educators.

  • WEBPATH: http://library.med.utah.edu/WebPath/webpath.html#MENU – An image bank similar to CALPATH.

  • USMLE: www.usmle.org – Information regarding the three-step USMLE examination process.

  • National Board of Medical Examiners: www.nbme.org – A reputable educational resource.

  • Student Consult: www.studentconsult.com – An online platform for purchasing medical textbooks with multiple bonuses.

Social Media

  • Instagram Handle: @rcsi_pathsoc – Student-led resource providing tutorials and quizzes.

  • Facebook Page: https://www.facebook.com/pages/category/Society---Culture-Website/RCSI-Pathology-Society-103290917725192/ – Another student-led resource offering opportunities such as annual pathology quizzes.

Pathoma

  • A valuable tool for learning pathology with positive student feedback.

  • Resources provided by RSCI for USMLE preparation targeted at Year 3 and GEM 2 students.

  • Contact Email: usmle@rcsi.com for queries.

  • Fundamentals of Pathology Book by Pathoma available in RCSI library across various years.

  • Additional resource: Pathology by Osmosis via Elsevier (www.osmosis.org).

Pathology Prizes

  • RCSI Pathology Prize: Awarded to 1st place, with a certificate presented at the Consillio Manuque Awards Ceremony.

  • Beaumont Hospital Sheppard Prize: Medal awarded to 1st place.

  • Top-performing students invited to participate in both RCSI and Beaumont Hospital Sheppard prizes via a viva voca exam.

Summary

  • Understanding pathology is crucial for a foundational knowledge base in Medicine, Surgery, Paediatrics, and Obstetrics.

  • Knowledge of pathology is vital for performance in postgraduate exams and USMLEs; mastering pathology is a long-term investment in a medical career.