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RAD 204 Pathology Basic Terminology

Lecture 2. Dr . Shai’. RAD 204 Pathology Basic Terminology. Week of 15.Septmeber .2013 College of Medical Sciences/ Radiological Sciences Department . I. INTRODUCTION. A. Objectives. 1. Define pathology 2. Discuss the core aspects of disease in pathology

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RAD 204 Pathology Basic Terminology

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  1. Lecture 2 Dr . Shai’ RAD 204 PathologyBasic Terminology Week of 15.Septmeber.2013 College of Medical Sciences/ Radiological Sciences Department

  2. I. INTRODUCTION

  3. A. Objectives • 1. Define pathology • 2. Discuss the core aspects of disease in pathology • 3. Know pathological manifestations of disease • 4. Know the diagnostic techniques used in pathology

  4. B. Definitions • Latin, Patho: disease, Logy: study of • Diseases: Abnormal Variations in Structure or Function of Any Part of the Body • WE study the aetiology, pathogenesis, morphologic changes & functional derangements and clinical significance

  5. 1. Aetiology • Cause • Known: primary aetiology {key to diagnosis and treatment development} • Unknown: Idiopathic • Classes • Genetic • Acquired • Infectious, Nutritional, Chemical, etc

  6. 2. Pathogenesis • Mechanism through which the cause operates to produce the pathological and clinical manifestations • Occurs in latent or incubation period • Leads to morphological changes: visible by naked eye, microscopes and diagnostic visualization

  7. 3. Morphology • Cell and Tissue Structure • Changes: structural alterations subsequent to pathogenesis • Allows pathologist to identify (diagnose) disease • And will lead to understanding of clinical signs and symptoms of disease

  8. 4. Functional derangements and clinical significance There are different diagnostic modalities used in pathology. Most of these diagnostic techniques are based on morphologic changes.

  9. 5. Diagnostic techniques used in pathology • Histopathology CytopathologyHaematopathology • Immunohistochemistry Microbiological Exam • Biochemical Exam Cytogenetics • Molecular Techniques Autopsy

  10. II. CELLULAR INJURY

  11. A. Objectives • 1. Define hyperplasia, hypertrophy, atrophy, hyperplasia, metaplasia & list some of their causes. • 2. Know the differences between reversible & irreversible forms of cell injury. • 3. Oncology Terminology • 4. Molecular Basis of Cancer

  12. B. Definitions • Cellular injury underlies ALL DISEASE • INJURIOUS AGENT > CELL > OUTCOMES: • Cell adapts to situation • Cell acquires a reversible injury • Cell acquires IRREVERSIBLE injury and dies by: • Necrosis (unprogrammed) • Apoptosis (programmed) • Outcome depends on type of injurious agent & on cellular factors • It depends on the Type, Severity, Duration of Injury & Type of cell

  13. 1. Cellular Adaptation • HYPERTROPHY • ATROPHY • HYPERPLASIA • METAPLASIA

  14. A. HYPERTROPHY • Increase in size of cells • Increased workload leads to increased protein synthesis • Leads to increased size and number of intra cellular organelles • Leads to increased cell size > increased ORGAN size • Eg. LV enlargement in hypertensive heart dz • Eg. Increased skeletal muscle during strenuous exercise

  15. B. ATROPHY • Atrophy is a decrease in the size of a cell. This can lead to decreased size of the organ. • The atrophic cell shows autophagic vacuoles which contain cellular debris from degraded organelles. • Atrophy can be caused by: • 1. Disuse • 2. Undernutrition • 3. Decreased endocrine stimulation • 4. Denervation • 5. Old age

  16. C. HYPERPLASIA • Hyperplasia is an increase in the number of cells. It can lead to an increase in the size of the organ. • It is usually caused by hormonal stimulation. It can be physiological as in enlargement of the breast during pregnancy or it can pathological as in endometrial hyperplasia.

  17. D. METAPLASIA • Replacement of one differentiated tissue by another differentiated tissue. • Examples include: • 1. Squamousmetaplasia: replacement of another type of epithelium by squamous epithelium. Eg. columnar epithelium of bronchus replaced by squamous epithelium in cigarette smokers • 2. Osseous metaplasia: replacement of a connective tissue by bone, for example at sites of injury.

  18. 3. Oncology Terminology • Tumour • An abnormal mass of tissue, resulting from autonomous disordered growth that persists after the initiating stimulus has been removed. • Results from genetic alteration and deregulated growth control mechanisms • -oma: means swelling • Anaplastic: poorly differentiated • Benign: localized cancers that do NOT invade other organs • Malignant: capable of invasion and spread to distant organs • Dysplasia: Disordered development of cells resulting in an alteration in size, shape and organization https://www.youtube.com/watch?v=rrMq8uA_6iA&list=PL88EDB2A96ED033AE

  19. Carcinoma in situ: • Epithelial neoplasm with cellular features associated with malignancy, but not yet invaded through epithelial basement membrane DID YOU KNOW? Japan: gastric carcinoma is 30 times more common than UK ? Why do you think this is?

  20. 4. Molecular Basis of Cancer

  21. Cell proliferation and division regulated by 2 opposing functions • Proto oncogenes: genes expressed in normal cells • Code for onco proteins, which positively regulate cell growth differentiation {growth factors, transcription factors, receptor molecules} • Healthy cells: tightly controlled • Unhealthy cells: mutation produce onco protein which is functionally altered eg hyperactive mutant ras protein affects intracellular pathway signalling • Or normal protein overproduced egmyconcogene in neuroblastomas • Includes: • Nuclear binding proteins (egc-myc) • Tyrosine kinaseproetins (egsrc) • Growth factors (eg platelet derived growth factor) • Receptors for growth ( egc-erb, HER 2), GTP binding proetins (egras)

  22. TumourSuppressor Genes (TSG) • Encode proteins that prevent or suppress tumour growth • If inactivated>>increased susceptibility to cancer • Eg. BRCA1 in breast cancer & ovarian cancer, located on chromosome 17q • P53 protein on 17p (implicated in many cancers) • RB1 in retinoblastoma, 17q • TSGs lose normal function by: • Mutations (hereditary / acquired) • Binding of TSG protein to viral gene proteins (HPV E6/7) • Complexing TSG protein to mutatnt TSG protein • If DNA damaged, TSG will promote cell apoptosis

  23. 5. Definitions … • Apoptosis: PROGRAMMED CELL DEATH • Active process • Single cell initiates own death under normal physiological conditions • Occurs in tissue modelling, embryogenesis, immune regulation, and deregulated in tumours

  24. https://www.youtube.com/watch?v=9KTDz-ZisZ0&list=PL88EDB2A96ED033AEhttps://www.youtube.com/watch?v=9KTDz-ZisZ0&list=PL88EDB2A96ED033AE • OVERVIEW (25 MIN) • https://www.youtube.com/watch?v=niBCqgM1Pb4

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