The

word pathology is derived from two Greek words- pathos meaning suffering words- pathos and logos meaning study. logos

 Thus,

pathology is the scientific study of diseases i.e. it is the study of abnormal form and function and the relationship between them.

1- Etiology (Its cause). 2- Pathogenesis ( Mechanism of development). 3- Morphologic changes (gross and microscopic pictures). 4- Functional derangement (clinical significance of the disease).

1- Necropsy( Autopsy). Necropsy( 2-Biopsy. Biopsy.

 The

study of organs and tissues removed from the dead body for verification of the clinical diagnosis and treatment of the disease .  Includes: gross & microscopic examination.

 Pathological

study of surgically removed tissues or organs during life for diagnosis & therapy.  Includes: gross & microscopic examination.

Types of biopsies

Tissue biopsy
1. Surgical biopsy: a) Incisional biopsy. b) Excisional biopsy. 2. Tru cut (core) needle biopsy. 3. Endoscopic biopsy.

Cytology

1. Exfoliative cytology. 2. Fine needle aspiration Cytology (FNA) .

 Incisional

biopsy: Part of the lesion is

removed.

Excisional biopsy

The entire lesion is removed + a rim of normal tissue

Excisional biopsy

The entire organ is removed

-A small cylinder of tissue is removed from a lump using a cutting needle .

Core needle biopsy

 This

type of biopsy is performed using an endoscope introduced through a natural body orifice (e.g. rectum) or a small incision (e.g. arthroscopy).  A small forceps is used to take a sample from the lesion.  Samples are small fragments.

Endoscopic biopsy

Endoscopic biopsy

 It

is the study of individual cells. includes:

 Cytology

1.Exfoliative cytology. 2.Fine needle aspiration cytology. (FNA).

 Is

the study of cells in smears prepared from exfoliated cells. cells. e.g: pleural effusion urine smear from cervix . as a screening test for cancer in patients who have no clinical evidence of the disease.

 Used

 FNA

is used for preoperative assessment of palpable lesions.

-This involves the aspiration of cells or fluids from masses that occur in palpable sites e.g. breast, thyroid & lymph nodes. nodes.

Thyroid

Breast

-The aspirated cells are smeared, stained & examined.

-For diagnosis within minutes while surgery is taking place in suspected cases of cancer. -Uses: 1.Determine the nature of the lesion e.g.breast e.g.breast lump. lump. 2.Determine the adequacy of surgical margins e.g . malignant ulcer. ulcer. 3. In sentinel LN procedure, a LN containing tumour tissue prompts further LN dissection while a benign LN will avoid such a procedure.

 For

frozen section technique, the tissue is always transported fresh (unfixed). tissue is frozen and then sectioned. sections are ready for staining. staining.

 The  The

 Adequate.  Representative:

Piece of tissue submitted must be from the lesion & preferably include an adjoining area of healthy tissue.  Labeled.  Combined with adequate clinical information.

1. Fixation:
10% formalin (most commonly used).  Other fixatives: - 95% alcohol ( in cytologic smears)


- Liquid Nitrogen (in frozen sections )

Uses: 1.Prevents autolysis. 2.Hardens the tissues. 3.Preserves the specimen.

2.Dehydration: - By passing the tissue in ascending grades of alcohol 70%,95% & 100%. 70%,95% 100%. 3.Clearing : - by using certain reagents ( e.g. Xylol). 4.Impregnation in paraffin wax (soft paraffin): -Done automatically by an electric apparatus. 5.Blocking out : in hard paraffin wax.

6.Sectioning : - section cutting by microtome. 7.Staining: - H & E stain OR Special stains. 8.Mounting: -Covering the stained section by a colourless medium that preserves the section. -The commonest mounting medium is canada balsam.

Tissue that has been cut and placed in cassettes

Tissue embedded in paraffin

Cutting sections with the microtome

Formation of slides

Fat stained black by osmic acid

Iron stained blue by prussian blue

Iron overload in the spleen

Glycogen stained red by PAS

Mucin stained red by mucicarmine

1.The following substances can be used as fixatives except:

a)Formalin. b)Alcohol. c)Saline. d)Liquid nitrogen.

2.Which of the following can be used as a clearing agent ?

a)Xylol. b)formalin. c)water. d)Alcohol.

3.Specimens sent for frozen section are preserved in:

a)Formalin. b)Saline . c)Alcohol. d)None of the above.

A 48-year-old male comes to the physician because 48-yearof an odd discoloration of his skin. A full work up for this abnormal skin pigmentation shows diabetes mellitus & increased levels of serum ferritin & transferrin saturation. A liver biopsy was done . In addition to H&E ,which of the following is ,which the most appropriate stain to use for this specimen? a)Congo red. b)Periodic acid- Schiff. acidc)Prussian blue. d)Mucicarmine.