Lecture 1, Introduction
The field of pathology is devoted to understanding the causes of disease and the changes in
cells, tissues, and organs that are associated with disease and give rise to the presenting
signs and symptoms in patients.
What is a disease?
• An abnormality that causes loss of health (‘ill health’)
• Disease: set of features (signs, symptoms, morphological and functional manifestations)
What is normal?
‘normal’: most frequent state in a population defined by age distribution, gender, etc.
Systematic description
• Epidemiology→ Where, in which population
• Cause (’causa’ or etiology) → Etiology refers to the underlying causes and modifying
factors that are responsible for the initiation and progression of disease.
• Pathogenesis (disease mechanisms) →how does it happen
• Symptoms, manifestations
• Complications & sequelae
• Prognosis→ when will someone be cured
• Mortality
Terminology
• Prefixes (hyper-, meta, hypo-, etc)
• Suffixes (-itis (inflammation), -oma, -oid, etc)
• Eponyms: Crohn’s disease (naming the disease after the person that first described it)
In total ~40.000 diagnoses/year
Histology (~ 25.000):
Biopsies
Resections
Frozen sections
,Cytology (~ 15.000): →based on single cells
Fine needle aspirations (lymphnode)
Brushes (biliary tract)
Fluids (ascites, pleural fluid)
Smears (uterine cervix)
Urine
Liquor
Additional:
Obtain as much information as possible from cells and tissues (molecular diagnostics) → not
only describing what is under the microscope but also looking at genomics etc. This is
important for integrated diagnoses. Don’t treat diseases but patients.
Autopsies: Body, brain, spinal cord, eyes (for research purposes or explanations)
1. Registration of the material that arrives to the department
2. Cutting room
3. Cutting → Will for instance show depth of the tumor and risk factors around it
4. Cutting→ cassets
, 5. Tissue processing
Wax is important so the light can go through the tissue.
6. Tissue processing
7. Evaluation by residents and pathology specialists
, What information is relevant?
• Diagnosis
•benign vs. malignant?
•type of tumor?
• Prognosis
•TNM classification?
•radicality
• Prediction
•Response to treatment?
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