Review paper

i. Explain briefly the following term

1) Necrosis (Necrosis is the death of cells or tissues which are still part of the
living organism.)

2) Inflammation (Inflammation is the response of living tissues to cellular

injury. It involves both innate and adaptive immune mechanisms.)

3) Neoplasm (synonymous with tumor, is an abnormal mass of tissue resulting

from autonomous disordered growth which persists after the initiating
stimulus has been removed.)

4) Metastasis (Metastasis is the process whereby malignant cells spread from

their site of origin—primary tumor—to distant sites forming secondary
tumors.)

5) Oncogenes (are genes that are present in normal cells and which encode for
proteins involved in growth and differentiation.)

6) Anaplasia (means “to form backward,” implying a reversion from a high

level of differentiation to a lower level.)

7) Nutmeg liver: It is a typical pathological change for liver congestion. In the

center of the lobule, the central vein and sinusoids are distended with blood;
in the peripheral the existing parenchyma shows fatty degeneration.
Macroscopically, the cut surface of the liver shows a dark red network with a
yellow background, which is called nutmeg liver.

8) Thrombosis: Thrombosis is the process of a solid from the constituents of the

blood within living blood vessels or the heart, the resultant is termed a
thrombus.

9) Concentric hypertrophy: It can be found in hypertensive heart disease. In

compensable stage, the left ventricle turns hypertrophy but the chamber is
normal, which is called concentric hypertrophy.
 10) Aschoff cell: The hallmark of acute rheumatic fever is the presence of the
granuloma called Aschoff body. It contain a central focus of fibrinoid necrosis
surrounded by large macrophages with vesicular nuclei and central
concentrated chromatin like eagle-eye, which are called Aschoff cell.

11) Ghon complex :Ghon focus is in the distal airspaces of the lower part of the
upper lobe or the upper part of the lower lobe, usually close to the pleura,
there is a inflammatory consolidation, drain lymphangitist and hilar lymphoid
tuberculosis is termed the primary complex.

12) Pulmonary carnification: in lobar pneumonia, organization of the exudate

may convert a portion of the lung into solid tissue.

13) Pseudolobules: are the nodules formed in the process of fibrous septa
separating the normal liver lobules.
.
14) Early gastric carcinoma: a lesion confined to the mucosa and submucosa,
regardless of the presence or absence of perigastric lymph node metastases

15) Small liver carcinoma: it is given to the condition when there is only one
cancer nodule in the live with the diameter less than 3 cm or two tumor
nodules could be found but the total diameter of the two is less than 3 cm.

16) Barette esophagus: esophagus squamous epithelium is replaced by columnar

mucous-secreting epithelium in the lower esophagus as a result of chronic
esophagus injury

ii. Fill in the blanks

1) The most common morphologically apparent adaptive changes are: atrophy
(decrease in cell size), hypertrophy (increase in cell size), hyperplasia
(increase in cell number), metaplasia (change in cell type)
2) The purpose of inflammation is to localize and eliminate the causative agent,
limit tissue injury and restore tissue to normality.

3) All tumors, benign and malignant, have two basic components: (1)
proliferating neoplastic cells that constitute their parenchyma; (2) supportive
stroma made up of connective tissue and blood vessel.

4) The common routes of cancer spread are lymphatic spread, blood stream
spread and transcoelomic spread.
5) Chronic congestion can generally result in edema, hemorrhage, cell injury and
tissue fibrosis.

6) Mixed thrombus is composed by fibrin, platelet, leukocytes and erythrocytes.

7) The complicated lesions of the atherosclerosis include hemorrhage, eruption,

thrombosis and aneurysm. (calcification, narrowing are also right)

8) In China, the hypertension is defined as the systemic blood pressure is

constantly over 140mmHg () and/or 90mmHg (diastolic)

9) Mitral stenosis usually results in pulmonary congestion and then right heart
failure.

10) The complications of peptic ulcer include hemorrhage, perforation, stenosis

and carcinoma.

11) hydatidiform mole contains cystic, grape-like strucfures; absence of

vascularization of villi ;center substance of the villi is a loose, myxomatous,
edematous stroma;.The chorionic epithelium, almost always shows some
degree of proliferation of both cytotrophoblast and syncytiotrophoblast,
intermediatrophoblast.

12) Breast carcinoma were classificated into noninfiltrating carcinoma and

infiltrating carcinoma .

13) The primary carcinomas of liver are mainly derived from hepatocytes and bile
ducts.
14) The main complications of portal hypertension in cirrhosis are:
Splenomegaly, Ascites, Varicose venous channels.

15) The main locations of gastric carcinomas are: pylorus and antrum.

16) The main histological types of gastric carcinomas are: the intestinal type and
diffuse type.

17) The most common malignant tumors of digestive tract: carcinoma of stomach,
large intestine and esophagus.

18) The main histological types of lung carcinomas are: Squamous cell
carcinoma, Adenocarcinoma and Small cell carcinoma.

19) The vast majority of lobar pneumonia is caused by peumococci (or

Streptococcus pneumoniae).

20) Alveolar emphysema is classified into: centriacinar, panacinar and periacinar

emphysema.
iii. Answer the following questions
1) Explain briefly the differences between benign and malignant tumor?
(Benign tumor usually grow slowly, capsulated, non-invasive, do not
metastasize, well differentiated, whereas malignant tumor usually grow fast,
non capsulated, invasive, metastasize, poorly differentiated. The only
absolute criterion for malignancy is invasion.)

2) How are neoplasms named? (Tumor nomenclature is based on histogenesis

and behavior. Histogenesis gives information about the type of cell from
which the tumor has arisen, while behavior gives information on whether the
cell is benign or malignant. Cell of origin + Suffix ‘oma’ for benign tumor,
‘carcinoma’ for malignant neoplasms of epithelial cell origin, ‘sarcoma’ for
malignant neoplasms of mesenchymal cell origin)

iv. Which factors relate to the thrombosis?

There are three factors: endothelial injury, alterations in normal blood flow and
hypercoagulability. The most important factor is the endothelial injury; itself only
can initiate coagulation and thrombosis. Normal blood flow is laminar. The
turbulence and stasis will contribute to thrombosis.

v. Please analyze the basic pathologic change of the acute viral hepatitis.
1) Degeneration of hepatocytes: ballooning degeneration and fatty
degeneration.
2) Necrosis of hepatocyes: spotty necrosis-scattered as single cells,
acidophilic degeneration, piecemeal necrosis-refers to apoptosis of liver
cells at the margin of the portal tracts, bridging necrosis-forming areas of
bridging between vessels, panacinar necrosis.
3) Infiltration of portal tracts by lymphocytes and other inflammatory cells.
4) Regeneration of hepatocytes and hyperplasia of Kupffer cells and, in later
stage, fibroblasts.
5) Sometimes, cholestasis.

What are the the basic pathologic change of chronic glomerulonephritis

1)The kidneys are symmetrically contracted
2)surfaces are red-brown and diffusely grenular, closely
3) atrophy and scarring of the glomeruli and Bowmen's spaces, complete
replacement "hyalinization" of the glomeruli .
4) atrophy tubules
5) interstitial fibrosis Lymphocytic (and, rarely, plasma cell) infiltrates

What are the the basic pathologic changes of tuberculosis

 1) lesion of exudation: serous inflammation, fibrinous inflammation, neutrophil
cells infiltrated locally in earlier period –macrophages, these changes
usually occur in lung ,chorion, synovial membrane and menings,Exudate
may be absorbed or develop to hyperplasia or necrotic lesion.
2)Lesion of hyperplasia: Tubercle with diagnostic value is formed, The tubercle
or tuberculostic granulomtous is composed of epithelioid cells, langhans giant
cells, lymphocytes,fibroblasts, collagen, and characteristic caseous necrosis
presents in the center of the granuloma, epithelioid cells derived from
macrophages, epithelioid cells are fusiform or polygon in shape and have
abundant light eosiphilic cytoplasma ith indistinct cell boundary,Their nuclei
are spherical or oval containing 1 or 2 nucleoli.Chromosomes are less and even
present as vacuolus .
3) Lesion of necrosis: Typical streamineous cheesy substanceis is delicate and
uniform, Microcopically: red granular and structureless appearance,Contain a
number of M.tuberculosis that causes aggravation and progression of TB

1. What are histological changes of chronic bronchitis?

Answer:
A. Injury and repair of mucosa epithelium, including columnar epithelia degeneration,
necrosis, desquamation, cilia lost and squamous metaplasia;
B. Changes of glands, including mucous glands hyperplasia and hypertrophy, goblet
cells proliferation.
C. Lesion of bronchial wall, including inflammatory infiltration and proliferation of
smooth muscle, etc.

2. What are stages and complications of lobar pneumonia?

Answer
Stages: congestion, red hepatization, gray hepatization and resolution stage.
Complications: suppurative pleuritis; pulmonary carnification; bacteremic
dissemination; lung abscess.

3. What are reasons of ascites in liver cirrhosis?

Answer
 Increase in hydrostatic pressure in portal veins
 Decrease in plasma osmotic pressure due to lowered albumin synthesis by
damaged liver cells.
 Failure to eliminate endogenous steroid hormones results in secondary
hyperaldosteronism, causing sodium and water retention.