Introduction to pathology &

causes of diseases
H.A. MWAKYOMA, MD
 WHAT IS PATHOLOGY
• Pathology is a study of diseases.
• The study provides understanding of the
processes (their causes, clinical effects
etc).
 Pathology
• -as a science-
• focuses on mechanisms by which cells
and tissues are injured, on structural and
functional consequences of injurious
stimuli on cells, tissues, and organs, finally
on the entire organism
• - it is a morphologic discipline-
describes pathological morphologic
findings in tissues and cells
 Pathology
• -as a medical discipline-
• deals with a performance and an
interpretation of laboratory procedures, leading
to diagnosis
• -these include many diagnostic and investigative
techniques and concern with interpretation of
laboratory procedures- examples: histologic
examination of surgical biopsies, cytological
examination of smears and FNA (fine needle
aspirates), bone marrow smears, etc.
 Pathology
• Two main fields of pathology as medical
discipline:
• (1) surgical pathology -deals with
interpretation of histological examination of
tissues and organs removed in surgery from
living patients
• (2) autopsy pathology -is concerned with
examination of gross, macroscopic and
histological changes in diseases studied in dead
persons
 Pathology
• Forensic pathology - is performed and practised
separately from pathology- in faculty hospitals, both
disciplines are closely related in small and district
hospitals
• - main task is to determine whether death was due
to natural or unnatural causes, such as caused by
accident, other person, murders etc.
• -in large medical centers and faculty
hospitals- pathologists usually subspecialize in a
distinctive discipline, i.e. cytology,
hematopathology, surgical pathology, gynecological
 Pathology
• surgical pathology report-diagnosis based
on microscopic and gross examination of
surgicals
• autopsy report-diagnosis of disease and
cause of death, describes morphologic
changes, studies pathogenetic
consequencies
 Pathology
• The study of pathology is divided into:
• general pathology- concerns with basic
reactions of cells and tissues to abnormal stimuli
that are common for a group of diseases or that
underlie all diseases or groups of diseases
• special pathology- examines specific
responses of specialized tissues and organs to
pathologic stimuli
• oncologic pathology- deals with
neoplastic processes (tumours)
 DEFINITIONS OF BASIC ASPECTS OF
DISEASE PROCESS
• Pathology
• medical discipline which provides the link
between basic biological sciences and the
practice of medicine. Pathology is a logical,
scientific basis of medicine
• is the study of changes which occur in cells and
tissues as a result of either genetic inborn or
environmental damage, is a study of diseases
• the study provides understanding of the
processes (their causes, clinical effects etc)..
 Pathology

• -in broader terms, pathology means also

study of the diseases, their causes,
prevention and classification
 Disease
• Disease- is defined as a physiological or
psychological dysfunction.
• -it can be caused by obvious
structural abnormalities, or may be less
well defined-without obvious
morphological damage, such as in
anorhexia nervosa- mental anorhexia
 Diseases
• All diseases have certain aspects which can form
the basis for classification- these include
• -pathology focuses on the following different
aspects of disease
• -epidemiology (occurrence and incidence of d.)
• -etiology (causes of disease)
• -pathogenesis (mechanisms of disease)
• -morphology of the tissue changes
• - clinical significance and consequencies
 Disease
• 1.epidemiology-provides a wider context for the
study, classification, and diagnosis of diseases
• -epidemiological data are important
• -for providing informations about causes of
diseases.
• -for identifying risk factors
• -for providing adequate health care, and planning
disease prevention, epidemiology records data
about
 .incidence-number of new cases occurring in a
defined population over a defined time period
 Disease
 prevalence-number of cases found in a
defined population at a stated time
 morbidity-number of diseased persons in a
given locality, nation etc. and mortality-
number of deaths to the population
 Disease
• 2.etiology studies causes of disease
• diseases result from the interaction
between individuals and their environment
• -the other diseases result from an
environmental factors acting in conjunction
with a genetic predisposition
• -in some instances the underlying cause of
a disease is obscure-idiopathic,
spontaneous, essential
 classification of diseases
• classification of diseases - based on the
etiologic factors, diseases can be
classified to two categories
• -congenital- present at birth, even though
they are sometimes recognized later
• -acquired- occur only later after births
(infectious, nutritional, chemical, physical,
radiation injury etc.)
 Disease
• 3.pathogenesis- etiopathogenesis
• -refers to the sequence of events in the
response of the cells, tissues, organs to
the injurious stimuli that may lead to a
disease
• -describes mechanisms of development of
disease
• -study of pathogenesis remains a main
domain of the scientific pathology
 Disease
• 4.morphological changes
• -structural alterations induced in cells and
tissues
• -refers to the structural alterations of cells
or tissues that are either characteristic or
diagnostic of a disease
• -there are gross/ macroscopic findings and
histological microscopic findings
 Disease
• 5.clinical significance
• -functional consequencies of morphologic
changes, as observed clinically
• -morphologic structural changes of cells,
tissues and organs are related to functional
disorders, morphologically altered tissues do
not provide normal functions, and these
consequent pathologic functions are studied
in details in many clinical disciplines-
pathology provides basic information with
respect to clinical outcome, prognosis, etc.
 Disease
• -symptoms- features of illness that
are noticed by patients
• -signs- clinical manifestation of the
disease which are recognized by clinicians
Type Basis Examples

Congenital Genetic Hemophilia A

(absence of clotting factor
VIII)
Non-genetic Intrauterine rubeolla infection
(measles) leads to
deafness/blindness in the
fetus
Acquired Inflammatory Dermatitis (eczema,
inflammation of the skin)

Vascular Atherosclerosis

Growth and proliferation Tumors

disorders
Metobolic Gout (deposition of uric acid
crystals in joints and soft
tissues
Degenerative Alzheimer disease-demensia

Infective / Drug induced tbc / Renal failure

 THE ROLE OF PATHOLOGY IN DIAGNOSTIC
PROCESS: FROM CLINICAL REASONING TO
MOLECULAR BIOLOGY.
• patients present with symptoms and clinical
examination reveals signs which suggest a
diagnosis
• -examination of various specimens in pathology
laboratories helps to establish and confirm
diagnosis, and monitor the treatment
• Diagnosis is the act of identifying a disease in an
individual patient and is based on clinical history,
physical examination and pathology
investigation
 Diagnosis
• Diagnosis involves skills and laboratory
tests
• Special pathology techniques are used
• Special stains, immunohistochemistry
and molecular biology techniques are
routinely used
 The role of pathologist:
• Looking at samples of tissues (biopsies)
• Using the range of special laboratory
techniques
• Histology
• Autopsy
• Special stains
• Immunohistochemistry
• Electron microscopy
• Molecular biology techniques
 METHODS IN PATHOLOGY
Diagnostic and investigative techniques
used in pathology
• routine histological techniques –
fundamental for histopathologic diagnosis
– these techniques use different coloration
of cells and tissues and cell components
using different staining methods
 most commonly used staining
methods-
• hematoxylin and eosin stain- combination of
haematoxylin and eosin remains the gold standard,
method used for majority of histopathologic
diagnoses- method is now over 100 years old
• haematoxylin- is natural product of blue colour, is
used mostly for staining the nuclei- shows general
morphology of a tissue
• -eosin- the most frequently used partner stain
because it is easy to stain, and its red colour
contrasts well with blue colour of haematoxylin-
eosin stains cytoplasm
• special stains- HE is important as a general
staining procedure but it is sometimes necessary
to use other staining procedures in order to
demonstrate more selectively the particular
tissue components
• -connective tissue components, such as
collagens, muscle fibers can be demonstrated by
Van Gieson stain or trichrome stains

• reticulin (type III collagen) can be shown by

silver impregnation technique
• -basement membrane components (such
as type IV collagen, laminin) are well
demonstrated with the periodic acid-
Schiff (PAS) method, silver impregnation
according to Gomory, etc.
Recommended Reading Material

• 1. Cotran RS, Kumar V and Collins T.

Robbin: Pathologic basis of Diseases, WB
Saunders, Philadelphia.
• 2. Klatt EC and KumarV: Robbins
Review of Pathology. W. B. Saunders,
Missouri.
• 3. Harsh Mohan: Textbook of Pathology