‫‪PATHOLOGY‬‬

‫‪Practical RRs‬‬

‫بسم اهلل الرمحن الرحيم‬

‫الحمد لله الذي بنعمته تتم الصالحات‪ ،‬هذا وما كان من توفيق وسداد فمن الله وما كان من خطأ أو زلل أو نسيان فمن أنفسنا ومن الشيطان‪،‬‬

‫وفقنا الله وإياكم لخيري الدنيا والآخرة وأعاننا وإياكم على ذكره وشكره وحسن عبادته‪ ،‬تذكروا د‪ .‬محمد تغيان و د‪ .‬أحمد السيد بدعوة صادقة‬

‫لعل الله ان يرفع قدرهم و يوسع مدخلهم ويسكنهم الفردوس الأعلى وأن يجعل اهلل هذا العمل في ميزان حسناتهم‪.‬‬
 1.Lobar pneumonia ( Gray hepatization ):

- The covering pleura: thick, dull, and opaque

- The cut section of lung tissue shows consolidation, grayish-yellow color
and anothracotic particles
- the bronchi and bronchioles are normal

- ‫ الإضافة‬: the hilar lymph nodes are anthracosed

• causes:
Droplet infection by pneumococci from patient or carrier

• Complications:
1-Lung abscess in diabetic patient
2-local spread of infection can cause empyema
3-toxaemia causes AH
 2. Bronchiectasis:

- The covering pleura is thick, dull, and opaque

- The cut section of lung tissue shows destruction and replacement by
granulation tissue
- yellowish foci of suppuration
- The bronchial and bronchioles showing marked dilatation

• Causes:
1. Bronchopneumonia
2. Congenital abnormalities
3. Bronchial obstruction (due to mucous plugs, tumors, enlarged lymph
nodes)

• Complications:
1. Lung abscess and gangrene
2. Local spread of infection causing empyema
3. Lung fibrosis causing right-sided
 3.Tuberculous pneumonia with cavitation:

- Multiple grayish-yellow caseous nodules

- Varying in size throughout the lung
- Large nodules show central caseation, breaking down and forming
cavities.

• Cause:
Inhalation of an aerosol containing TB bacteria.

• Complications:
1. Meningitis
2. Pott's disease
3. Hepatitis
4. lymphadenitis
 3. Bronchogenic carcinoma:

- The cut section of the tumor mass is large and rounded

- Color: grayish-pink
- Capsule: Not
- Consistency: solid
- cut surface: hemorrhage and necrotic
- Infiltration: infiltrates the lung tissue up to the pleura.

• Causes:
1. Smoking
2. Air pollution
3. Radiation exposure

• Complications:
1. Bronchial obstruction
2. Hemoptysis
3. Local spread to pleura, blood spread to liver, brain, bone
4. Emphysema
 4. Laryngeal carcinoma:

- specimen from: epiglottis, larynx, upper part of trachea

- Shape: oval - Site: base of epiglottis to trachea
- Surface: sold grayish-white, not capsulated, firm to hard, destructive
lesion involving vocal cords.

• Causes:
Chronic laryngitis, leukoplakia, squamous cell papilloma.

• Complications:
1. Airway obstruction
2. Voice abnormalities
3. Neck disfigurement
6. Hydronephrosis of the Half of a kidney:
- Outer surface:
1. Lobulated
2. Shows peri-nephric hat
3. With an area of hemorrhage
- The cut section shows:
1. Marked dilatation of the Pelvi-Calyceal System
2. Multiple variable-sized locules
3. Marked thinning of the renal cortex
‫الإضافة‬:
- U1-C → outer surface. Smooth
- Cut section: Dilated cysts have a smooth lining with no neoplastic
growth

• Causes:
1. Obstructive lesions in the bladder, urethra, prostate caused by tumor or
stricture or benign prostatic hyperplasia (BPH) → bilateral.
2. Obstructive lesions in the kidney or ureter by tumor or stones →
unilateral.

• Complications:
1. Renal failure
2. Secondary hypertension
3. Pyonephrosis
7. Renal cell carcinoma:
 (photo):
- Photograph shows cut section of a part of the kidney
- The lower part looks grossly normal
- The upper pole is completely replaced by a large, rounded yellowish-
white mass
- Cut of the tumor: Heterogeneous, hemorrhage, necrosis
- u4-i: Cut surface shows whitish areas of dystrophic calcification.
- u4_H: Cut surface → Some solid whitish areas, some cystic areas.

(Jars):
-The lower pole looks grossly normal
- The upper pole is replaced by a rounded, well-defined, firm to the hard
tumor mass, Non-Capsulated.
- Cut surface of the tumor: Yellowish-white, solid, hemorrhage, necrosis.

- Outer surface (‫)لأنها جار‬: Smooth, pink, peri-nephric fat, hemorrhage.

- u4-b → Tumor mass is enclosed within the renal capsule.

- u4-c&d: Areas of fat in the hilum.

• Complications:
1. Hematuria
2. Hydroureter
3. Spread
• Risk factors:
1. Smoking
2. Obesity
3. Hypertension
4. Acquired cystic kidney disease
 8. Nephroblastoma (Wilms tumor):

- A part of the enlarged kidney of a child.

- Outer surface: Irregular, perinephric fat, sub-capsular hemorrhage.
- Cut surface: Large oval, pink, solid, not capsulated.
- Fleshy mass, replacing most of the middle zone, hemorrhage, necrosis.
- Periphery of the tumor: thin normal renal tissue.
- The upper pole shows perinephric fat.
 9. Bladder cancer:
- u6-b (Malignant mass female): Urinary bladder at the small lower end of
both ureters, outer surface irrgular, white, with perivesical fat, and the
tumor mass arising from posterior wall.
- u6-C (Ulcerative mass): Urinary bladder: lower end of both ureters and
pear-shaped prostate, outer surface normal, with perivesical fat, and the
tumor mass arising from the anterior wall, complete ulceration of the
overlying mucosa.
:‫مواصفات الورم نفسه في الجارين‬

- Shape: Solitary large, Color: Grayish white, Capsule: Not, Consistency:

Firm to hard,
Cut section: Solid, yellowish, hemorrhage, necrosis.
- Infiltration of the bladder wall.
• Risk factors:
1. Schistosoma haematobium
2. Cigarette smoking
3. Drugs such as cyclophosphamides.
• Complications:
1. Hematuria
2. Hydroureter
3. Pyelonephritis