Download - Pathology Lecture Series
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PATHOLOGY LECTURE
SERIES
Butch Dumdum
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Outline
• Day 1 (Geneal Path!l!"y# – Int!ducti!n$ Cellula Ada%tati!n$Ti&&ue In'uy
– Inammati!n (Acute and Ch!nic#
– Hem!&ta&i&$Th!m)!&i&$ and In*act – +e!%la&ia
• Day , (Sy&temic Path!l!"y# –
C!mm!n &y&temic di&ea&e& (Path!l!"ical)a&i& !* di&ea&e#
– Radi!l!"ic C!elati!n (Dia"n!&tic Radi!l!"y#
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Int!ducti!n$ Cell - Ti&&ue
Dama"e
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Path!l!"y
De.niti!n
• Path!l!"y i& the &tudy (logos# !*&u/ein"0di&ea&e& ( pathos#
• In!le& )a&ic medical &cience& andclinical %actice t! ine&ti"ate& !* thecau&e& (eti!l!"y# !* the di&ea&e& andthe mechani&m (%ath!"ene&i
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Ba&ic temin!l!"y inPath!l!"y
• Di&ea&e
• Eti!l!"y
•
Path!"ene&i&• Dia"n!&i&
• Clinical mani*e&tati!n 3 Si"n& and
&ym%t!m&• P!"n!&i&
• E%idemi!l!"y
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Di&ea&e 0 di&3ea&e
• Di&ea&e i& a c!nditi!n in 5hich the %e&ence !*an a)n!mality !* the )!dy cau&e& a l!&& !*n!mal health
•
Idi!%athic 6 n! identi.a)le cau&e&• Iat!"enic 6 !ccu a& a e&ult *!m medical
teatment
• C!n"enital 6 di&ea&e e7i&tin" at )ith ! )e*!e
)ith$ in!le& in the deel!%ment !* *etu&• Ac8uied 3 deel!%& %!&t 6*etally
• +!&!c!mial 6 due t! )ein" in a h!&%italeni!nment&
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Eti!l!"y
• Re*e& t! the &tudy !* the cau&e !*the di&ea&e
• Geneal cate"!ie& !* eti!l!"icala"ent&: "enetic a)n!malitie&$in*ectie a"ent&$ chemical$ adiati!n$mechanical tauma$ malnutiti!n
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Path!"ene&i&
• I& a mechani&m !* the di&ea&e 5hicheti!l!"y !%eate& t! %!duce the%ath!l!"ical and clinical
mani*e&tati!n
•
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Dia"n!&i&
• Re*e& t! the %!ce&& !* attem%tin" t!detemine ! identi*y a %!&&i)le di&ea&e! di&!de>
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P!"n!&i&
• Re*e& t! the e7%ected !utc!me !* adi&ea&e>
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C!m%licati!n and &e8ualae
• C!m%licati!n 6 i& the !n&et !* thedi&ea&e in a %e&!n 5h! i& aleadyc!%in" 5ith an!the e7i&tin" di&ea&e>
• Se8ualae 6 un5anted !utc!me& !*hain" di&ea&e ! ae the e&ult !*tauma
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Clinical ani*e&tati!n
• Ae the &i"n& and &ym%t!m& !eidence !* di&ea&e
• Si"n& 6 !)'ectie alteati!n that can)e !)&ee ! mea&ued )y an!the%e&!n: %ul&e ate$ )l!!d %e&&ue$
Tem%eatue etc
• Sym%t!m& 6 &u)'ectie e7%eience&e%!ted )y the %e&!n$ c!m%lain&&uch a& %ain$ nau&ea$ !mitin" etc
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E%idemi!l!"y
• I& the &tudy !* tacin" %atte& !*di&ea&e !ccuence and tan&mi&&i!nam!n" %!%ulati!n& and )y
"e!"a%hic aea&>
• Incidence !* a di&ea&e6 i& the num)e!* ne5 ca&e& !ccuin" in &%eci.c
time !* %ei!d• Pealence !* a di&ea&e 6 i& the
num)e !* e7i&tin" ca&e& 5ithin a
%!%ulati!n& duin" the &%eci.c time 1,
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Pe.7e& and Su7e& andR!!t&
• R!!t3 the *!undati!n !* the 5!d
• Pe.7 6 %lace )e*!e the !!t t! m!di*y it&meanin"
•
Su7 6 %lace& a*te !!t t! m!di*y and "iee&&ential meanin" t! the !!t
1> Hy%eli%!%!teinemia
• Pe.7 hy%e (hi"he#
• R!!t& li%!%!tein
• Su7 3emia ()l!!d c!nditi!n#
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,> He%at!&%len!me"aly
• R!!t he%at! (he%a#$ &%len! (&%leen#
• Su7 3me"aly (enla"ement#
> enin"iti&
•R!!t menin" (menin"e
• Su7 3 iti& (inammati!n#
2> Tachycadia• R!!t cadia (heat#
• Pe.7 tachy 6 (*a&t0a%id#
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Relati!n&hi% )et5een Cell Ada%tati!n$Cell& de"eneati!n$ Cell Death
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NORMALCELLS
CELLS ADAPTATION
CELLSDEGENERATION
CELLS DEATH(NECROSIS/APOPTOSI
S
Injuries
Injuries
Injuries
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At h
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At!%hy• Shina"e !* the &iFe !* the
cell& )y the l!&t !* the cell&&u)&tance>
• The entie ti&&ue ! !"an&dimini&he& in &iFe and*uncti!n
• ay )e due t! decea&e in5!l!ad$ l!&t !* neeinneati!n&$ Lac !* )l!!d&u%%ly$ inade8uatenutiti!n$ l!&t !* end!cine&timulati!n and a"in"
%!ce&&>
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Hy%et!%hy• Incea&e the &iFe !* the
cell& and c!n&e8uentlythe &iFe !* the !"an&
• Incea&ed the &ynthe&i&!* &tuctual %!tein and!"anelle&
• Can )e %hy&i!l!"ic(e7:incea&e 5!l!adduin" e7eci&e$ uteinemy!metium duin"
%e"nancy# and%ath!l!"ic (hy%et!%hy!* my!cadium 6hy%eten&i!n0a!tic
ale di&ea&e# 1=
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Hy%e%la&ia• Incea&e the num)e !*
cell& in an !"an ! ti&&ue>(incea&e ate !* cellula
dii&i!n#
• Hy%et!%hy and
hy%e%la&ia ae cl!&elyelated (e7% "aid
uteu
• Can )e c!m%en&at!y
hy%e%la&ia (e7% lie#$h!m!nal hy%e%la&ia
(e7% uteu&$ )ea&t# and
%ath!l!"ical (e7%
end!metium# 1?
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eta%la&ia• I& a ee&i)le chan"e in 5hich !ne adult cell ty%e
i& e%laced )y an!the cell ty%e>
• Ada%tati!n !* cell& that &en&itie t! %aticula&te&& t! cell ty%e& )ette a)le t! 5ith&tand theade&e !* eni!nment
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Dy&%la&ia•
+!t a tue cellulaada%tati!n
• Aty%ical hy%e%la&ia
• A)n!mal chan"e in the&iFe$ &ha%e and
!"aniFati!n !* matuecell&
• St!n"ly a&&!ciated 5ithc!mm!n ne!%la&tic
"!5th• E7% CI+ 6 ceical
intae%ithelial ne!%la&ia$hi% dy&%la&ia
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Cell De"eneati!n (+!nlethal In'uy#
• +!nlethal in'uy may %!duce cellde"eneati!n
• ani*e&ted a& a a)n!mality !*)i!chemical *uncti!n$ &tuctualchan"e& ! c!m)inati!n>
• It& ee&i)le )ut may )ec!me
iee&i)le (nec!&i&0a%!%t!&i
• ay %!duce clinical di&ea&e>
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+ec!&i& (Lethal In'uy#
• De.niti!n 6 un%!"ammed celldeath and liin" ti&&ue&> (!%%!&ite t!a%!%t!&i
• Iee&i)le
• Acc!m%anied 5ith )y )i!chemicaland m!%h!l!"ical chan"e&
• Due t! hy%!7ia$ chemical&u)&tance&$ *ee adical$immun!l!"ic e&%!n&e$ in*ecti!n& etc
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Sta"e& !* +ec!&i&
• Early changes m!%h!l!"ically n!mal
• Nuclear changes %yn!&i& 6 ch!matinclum%& int! c!a&e &tand&$ nucleu&
)ec!me &hunen• Cy!"las#ic changes denatuati!n !*
cyt!%la&mic %!tein and l!&t !*i)!&!me&$ &5ellin" !* mit!ch!ndia anddi&u%ti!n !* !"anelle mem)ane& andaut!ly&i& !ccu ia ly&!&!me&
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Ty%e !* +ec!&i&
• Di/eent cell& &h!5& di/eentm!%h!l!"ic chan"e& a*te they unde"!nec!&i&> Ba&e !n that nec!&i& can )e
cla&&i.ed int!1> C!a"ulatie nec!&i&
,> Li8ue*actie nec!&i&
> Ca&e!u& 0 "ummat!u& nec!&i&2> Gan"en!u& +ec!&i&
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C!a"ulatie +ec!&i&• Ty%ically !ccu in &!lid !"an: heat$ idney$ adenal
"land&• Due t! hy%!7ia (may)e *!m &eee i&chemia !
chemical#
• +!mally$ thi& nec!tic cell& etain& it& cellula !utline>
•
Denatuati!n !* %!tein al)umin cau&e& c!a"ulati!n>
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Li8ue*actie +ec!&i&
• +!mally !ccu& in C+S5hich a/ect& neu!nand neu!"lia cell&
• A&&!ciated 5ith *!cal
)acteial and *un"u&in*ecti!n&
• The a/ected cell&c!m%letely di"e&t )yhyd!lytic enFyme& thu&chan"e& the ti&&ue int!li8uid i&c!u& ma&&>
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Ca&e!u& +ec!&i&
• Ca&e!u& 6 chee&elie a%%eaance
• A&&!ciated 5ith
tu)ecul!u&%ulm!nay (TB#in*ecti!n$ e&% )y
yc!)acteium Tu)ecul!&i&
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Gan"en!u& +ec!&i& ("an"ene#
•
E7ten&ie ti&&ue nec!&i&• Diide int! t5!: dy and 5et
• Dy 6 !ccu& in e7temitie& a&a e&ult& !* i&chemic
c!a"ulatie nec!&i& due t!ateial !)&tucti!n
• et 6 !ccu& in e7temitie&and intenal !"an a& ae&ult& !* li8ue*actienec!&i& due t! )acteialin*ecti!n>
• Ga& 6 nec!tic ti&&ue in*ected)y cl!&tidium %e*in"e&
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Cau&e& !* Cell In'uy
• O7y"en de%iati!n
• Chemical a"ent&
• In*ecti!u& a"ent&
• Immun!l!"ic eacti!n&
• Genetic de*ect&
•
+utiti!nal im)alance&• Phy&ical a"ent&
• A"in"
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O7y"en de%iati!n
• Hy%!7ia 6 !7y"en de.ciency
• Due t! i&chemia 6 l!&t0lac !* )l!!d&u%%ly (due t! ateial )l!ca"e !
educe en!u& daina"e#
• Hy%!7ia al&! can !ccu& ia – Lac !* !7y"en in&ide )l!!d
– Reducti!n in !7y"en cayin" ca%acity inRBC (anemia#
– Ca)!n m!n!7ide %!i&!nin"
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Chemical a"ent&
• !&t !* the chemical &u)&tance& cancau&e cell in'uy
•
in&ecticide&$ CO$ a&)e&t!&$ ethan!l$thea%eutic& du"& etc
• Thi& a"ent& can cau&e cell death )y
– Altein" mem)ane %emea)ility – Altein" !&m!tic h!me!&ta&i&
– Altein" inte"ity !* an enFyme
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In*ecti!u& a"ent
• iu&e&$ )acteia$ *un"i$ %aa&ite&$helminth&
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Immun!l!"ic Reacti!n&
• Aut!immune di&ea&e 6 immunitya"ain&t it& !5n ti&&ue& >
etc
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Genetic De*ect&
• A)n!malitie& t! the "en!me& 3mutati!n
• Thi& ch!m!&!me an!maly i&a&&!ciated 5ith mi&&in"$ !ie"ulaitie& ! e7ta in %!ti!n !*ch!m!&!mal D+A
• Synd!me D!5n$ AlFheimeJ&Di&ea&e$ Huntin"t!n& Di&ea&e etc
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+utiti!nal Im)alance
• Cau&e )y diectly ! indiectly lac !*e&&ential nutient& (malnutiti!n#
• O it may)e elated t! e7ce&&ie !**!!d intae (Dia)etic ellitu
•
• Calcium de.ciency 6 !&te!%!!&i&
• itamin C 3 Scuy
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Phy&ical A"ent&
• Tauma$ e7teme& !* tem%eatue$adiati!n$ electical &h!c all hae5ide an"in" e/ect& !n cell&>
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A"in"
• A"ed cell& )ec!me la"e$ le&& a)let! diide and multi%ly
• L!&e thei a)ility t! *uncti!n&$ !
*uncti!n a)n!mally>
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SE$%ENCE O& E'ENTS
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SE$%ENCE O& E'ENTS• NORMAL HISTOLOG • 'ASODILATATION • INCREASED 'ASC%LAR PERMEA)ILIT • LEA*AGE O& E+%DATE • MARGINATION, ROLLING, ADHESION • TRANSMIGRATION (DIAPEDESIS- • CHEMOTA+IS • PMN ACTI'ATION • PHAGOCTOSIS. Rec!gnii!n, Aach#en,
Engul#en, *illing (0egra0ai!n !r0igesi!n-
• TERMINATION • 1223 RESOL%TION, SCAR, !r CHRONIC
IN&LAMMATION are he hree "!ssi4le
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IN&LAMMATION•'ASC%LAR E'ENTS•CELL%LAR E'ENTS (PMN!r P!lyM!r"h!nuclearNeur!"hil, Leu9!cye:,
5POL6, Neur!"hil,Granul!cye, Neur!"hilicGranul!cye
•5 6
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AC%TE
IN&LAMMATIONNeur!"hil
P!ly#!r"h!nuclearLeu9!cye, PMN, PML
5Leu9!cye6
Granul!cye,Neur!"hilicgranul!cye
5P!ly76
HISTORICAL
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Ru4!r
Cal!r
Tu#!r
D!l!r
;h (unci!
laesa
HISTORICAL
HIGHLIGHTS(Egy",
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STIM%LI!r acue in=a##ai!n
• IN&ECTIO%S
•
PHSICAL•CHEMICAL•
Tissue Necr!sis• &!reign )!0ies (&)s-
• I##une 5res"!nses6, !r
5c!#"le>es6
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'ascular Changes• Changes in 'ascular&l!? an0 Cali4er
• Increase0 'ascularPer#ea4iliy
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PERMEA)ILIT •
DILATATION•En0!helial 5ga"s6
•Direc Injury•Leu9!cye Injury
•Trans!cy!sis
(en0!/e>!-
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LEA*AGE O&PROTEINACEO%S
&L%ID (E+%DATE,NOT TRANS%DATE-
E+TRA'ASATION !
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E+TRA'ASATION !PMNs
• MARGINATION (PMN@s g!!?ar0 ?all-
• ROLLING (u#4ling an0HEAPING-
• ADHESION• TRANSMIGRATIO
N (DIAPEDESIS-
ADHESION MOLEC%LES
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ADHESION MOLEC%LES(glyc!"r!eins- aecing
ADHESION an0 TRANSMIGRATION
• SECRETINS (r!#
en0!helial cells-
• INTEGRINS (r!# #any
cells-
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CHEMOTA+IS
P+& "!in" t! the &ite !*in'uyM
A
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LE%*OCTE
5ACTI'ATION6• ti""eedM )y the !/endin" &timuli *!
P+& t! –1- Pr!0uce eic!san!i0s
(arachi0!nic aci0 0eriBaiBes-• Pr!saglan0in (an0 hr!#4!>anes-
• Leu9!rienes
• Li"!>ins
–- %n0erg! DEGRAN%LATION
–
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PHAGOCTOSIS
• RECOGNITION
• ENG%L&MENT
•
*ILLING(DEGRADATION/DIGESTION-
CHEMICAL
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CHEMICAL
MEDIATORS• &r!# "las#a !r cells• HaBe 5riggering6si#uli
• %sually haBe s"eci8carges
• Can cause a5 6
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HISTAMINE
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HISTAMINE
• Mas Cells,4as!"hils
•
POER&%L'as!0ila!r• 'as!aciBe5a#ine6
• IgE !n #as
cell
SEROTONIN
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SEROTONIN•
(;HT$ ;7Hy0r!>y7
Try"a#ine-• Plaeles an0Ener!Chr!#anCells
• Als! Bas!0ilaai!n,4u #!re in0irec
• EB!9es NFOF
synhease (a
COMPLEMENT
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COMPLEMENTSSTEM
• 2c!#"!nens, in
circulaing"las#a
• Muli"le
sies !aci!n, 4uLSIS ishe
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*ININ SSTEM• )RAD*ININ is *E c!#"!nen,
aa@s
• ALSO r!# circulaing "las#a
• ACTIONS – Increase0 "er#ea4iliy – S#!!h #uscle c!nraci!n, NON
Bascular
–PAIN
C O G
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CLOTTING
&ACTORS•
Als! r!# circulaing "las#a• C!agulai!n, iFeF, "r!0uci!n! 84rin
• &i4rin!lysis
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EICOSANOIDS
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EICOSANOIDS(ARACHIDONIC ACID DERI'ATI'ES-
•Par ! cell#e#4ranes
•1- Pr!saglan0ins (inclFThr!#4!>anes-
•- Leu9!rienesM%LTIPLE ACTIONS AT MAN
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P l 0i
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Pr!saglan0ins
(hr!#4!>anes inclu0e0-
•Pain•&eBer
•Cl!ing
L 9 i
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Leu9!rienes
•Che#!a>is
•'as!c!nsrici!n
•
Increase0Per#ea4iliy
Li i
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Li"!>ins
• INHI)IT che#!a>is
•'as!0ilaai!n
•
C!unerac aci!ns! leu9!rienes
Plaele AciBaing &ac!r
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Plaele7AciBaing &ac!r(PA&-
• Ph!s"h!li"i0
•
&r!# MAN cells,li9e eic!san!i0s
• ACTI'ATEPLATELETS,"!?erully
CTO*INES/CHEMO*IN
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CTO*INES/CHEMO*INES• CTO*INES are PROTEINS "r!0uce0
4y MAN cells, 4u usuallyLMPHOCTES an0 MACROPHAGES,
nu#er!us r!les in acue an0 chr!nicin=a##ai!n
–TN&, IL71, 4y#acr!"hages
• CHEMO*INES are s#all "r!eins?hich are aracans !r PMNs
(J2-
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L MAL
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CONSTIT%ENTS• PRIMAR • Als! calle0
AK%ROPHILIC,!r NON7
s"eci8c
• Myel!"er!>i0ase
• Lys!y#e()acF-
• Aci0
Hy0r!lases
• SECONDAR •
Als! calle0SPECI&IC
• Lac!errin
• Lys!y#e
• Al9alinePh!s"haase
• C!llagenase
&REE RADICALS
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&REE RADICALS• O 6 (S%PERO+IDE-
•HO (PERO+IDE-
•OH7 (HDRO+L RADICAL-
•'ER 'ERDESTR%CTI'E
NE%ROPEPTIDES
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NE%ROPEPTIDES
• Pr!0uce0 in CNS(neur!ns-
• S%)STANCE P
• NE%RO*ININ A
O%TCOMES O&
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O%TCOMES O&AC%TE IN&LAMMATION
• 1- 1223 c!#"leeRESOL%TION
• - SCAR
•
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M!r"h!l!gic PATTERNS! Acue IN&LAMMATION
(E+%DATE-
•Ser!us (?aery-
•&i4rin!us (he#!rrhagic, rich in
&I)RIN-•Su""uraiBe (P%S-
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)LISTER, 5aery6, iFeF,
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&I)RINO%S
P%S
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P%R%LENT
A)SCESS
POC*ET
O&
P%S
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P%R%LENT &I)RINOP%R%LENT
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%LCERATI'E
SE$%ENCE O& E'ENTS
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SE$%ENCE O& E'ENTS• NORMAL HISTOLOG
• 'ASODILATATION • INCREASED 'ASC%LAR PERMEA)ILIT • LEA*AGE O& E+%DATE • MARGINATION, ROLLING, ADHESION • TRANSMIGRATION (DIAPEDESIS- • CHEMOTA+IS • PMN ACTI'ATION • PHAGOCTOSIS. Rec!gnii!n, Aach#en,
Engul#en, *illing (0egra0ai!n !r0igesi!n-
• TERMINATION • 1223 RESOL%TION, SCAR, !r CHRONIC
in=a##ai!n
CHRONIC IN&LAMMATION
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CHRONIC IN&LAMMATION
(MONOS-
LMPHOCTMONOCTE
MACROPHAGE
HISTIOCTE
CA%SES !
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CA%SES ! CHRONIC IN&LAMMATION
•1- PERSISTENCE !Ineci!n
•- PROLONGED
E+POS%RE ! insul•
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Cellular Players
•LMPHOCTES
•
MACROPHAGES (a9a,
HISTIOCTES-• PLASMA CELLS• EOSINOPHILS
•
MAST CELLS
MORPHOLOG
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MORPHOLOG
• IN&ILTRATION
•
TISS%EDESTR%CTION
•
HEALING
GRAN%LOMAS
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GRAN%LOMASGRAN%LOMATO%S IN&LAMMATION
JCOMPONENTS
&I)RO)LASTS
LMPHS
HISTIOS
GRAN%LOMAS
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GRAN%LOMASGRAN%LOMATO%S IN&LAMMATION
CASEATING (T)-
NON7CASEATING
LMPHATIC
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LMPHATIC
DRAINAGE• SITE REGIONAL LMPH
NODES
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Hem!&ta&i&$Th!m)!&i&
and In*act
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Th!m)!&i& :Formation of solid mass in
circulation from the blood
constituents - (Thrombus)
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ich!5& tiad
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ich!5 & tiad
•Endothelial injury.
•
Alteration in the Bloodflow.
•
Hyercoa!ulability of theBlood.
Bl d l ll
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Bl!!d e&&el 5all
• Anti th!m)!tic *act!& He%ain lie &u)&tance $
Th!m)!m!dulin $ Inhi)it!& !*%latelet a""i"ati!n 6 ADPa&e$PGI, Ti&&ue %la&min!"en
actiat!
Bl d l ll
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Bl!!d e&&el 5all• P!th!m)!tic *act!& Th!m)!%la&tin $ !n ille)id
*act! $ Platelet actiatin"*act! $ Inhi)it! !* %la&min!"enactiat!
R!le !* Platelet&
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R!le !* Platelet&
• Adhe&i!n
• Platelet elea&e eacti!n
• Platelet a""i"ati!n
C!a"ulati!n &y&tem
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C!a"ulati!n &y&tem
• Pla&ma
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Hy%ec!a"ula)ility !* the Bl!!d
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Hy%ec!a"ula)ility !* the Bl!!d
• Incea&ed c!a"ulati!n *act!&
• Incea&ed Platelet C!unt and
thei adhe&iene&&>• Decea&ed c!a"ulati!n
inhi)it!t& 6 Antith!m)in III
Alteati!n in the Bl!!d !5
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Alteati!n in the Bl!!d !5
• Tu)ulance and Sta&i&
• Platelet& nea end!thelial
linin">
!%h!l!"y
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!%h!l!"y• Site& 6 Heat $ Ateie&$ein&$ Ca%illaie&>
• Ateial Th!m)i 6 E/ect i&I&chemia
•
en!u& Th!m)i 6 E/ect i&Em)!li&m
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• G!&& 6 ai!u& &ha%e& ni
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&iFe&>
• Ateial th!m)i 6 hiteand mual
•
en!u& th!m)i 6 Red and!cclu&ie
•
0E Line& !* NahnM• Ateial & en!u& th!m)i
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% "*act!&
•
Genetic 6 De.ciency !*Antith!m)in$ P!tein C and S $
• Ac8uied 6 Old a"e $ P!l!n"edBed e&t $Imm!)ili&ati!n $ !al
c!ntace%tie& $ &m!in" $ Tauma*actue )un& $ Athe!&cle!&i& $aic!&e ein&$ Cance&
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+EOPLASIA
+e!%la&ia
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+e!%la&ia• +e! Pla&ia +e5 G!5th>
• Tum!u S5ellin" any &5ellin"• Clinically tum!u Q ne!%la&m (technically
inc!ect>>#
• illi& de.niti!n“A neoplasm is an abnormal mass of tissue, the growth
of which exceeds and is uncoordinated with that of the
normal tissue and persists in the same manner after
cessation of the stimuli which evoked the change”• “Cell division without control”
• Iee&i)le D+A dama"e$ e&ultin" in
aut!n!m!u& "!5th !* a)n!mal cell&
Cell %!%ulati!n 0 G!5th C!nt!l
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Cell %!%ulati!n 0 G!5th C!nt!l• P!li*eati!n Di/eentiati!n A%!%t!&i&
+!mal
Stem cell
A%!%t!&i&
O"an 0 Ti&&ue
Ne!"lasia Beni"n 3 ali"nant
C
Cacin!"enInitiat! P!m!t!
Inam
1>P!t!3Onc!"ene& ("!5th*act!
,>G!5th0Tum! &u%%e&&!"ene&>
>Gene& c!nt!llin" A%!%t!&i&>2>Gene& c!nt!llin" D+A Re%ai>
RASR)YC%4
G!5th Di&!de&
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+!n ne!%la&tic +e!%la&tic (P!lycl!nal# (!n!cl!nal#
G!5th Di&!de&
+!mal Ada%tati!n Beni"n ali"nant
Hy%e%la&iaHy%et!%hyA%la&iaAt!%hyeta%la&iaDy&%la&ia
Cell dii&i!n C!nt!l 3 Cacin!"ene&i&
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Beni"n 3li
)ENIGN• ell di/eentiated• Sl!5 "!5th
MALIGNANT• P!!ly di/eentiated• Ra%id "!5th
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ali"nant
11;
+ec!&i&
• Sl!5 "!5th• C!he&ie$• e7%an&ile• Ca%&ule• +! ina&i!n0in.ltati!n
• Ra%id "!5th• +!n C!he&ie$• +! ca%&ule• ina&i!n0in.ltati!n• eta&ta&e&>
+e!%la&m& +!menclatue
Oma 3 Tum!uCacin3!ma 6 Had Tum!uS S * T
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)enign Malignan
• Aden!ma 3 Adencacin!ma
• Pa%ill!ma 3 S8uam!u& cell ca>
•
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• Teat!ma 6 Tum!u !* Gem cell 6 multi%le ti&&ue&>Beni"n (matue# ! mali"nant (immatue#
• elan!ma (elan!3cacin!ma# 6 ali"nancy !*melan!cyte&>
• Semin!ma (Seminal cacin!ma# 6cacin!ma !* Te&te&>
• Leuemia 6 5hite )l!!d 6 Ca> !* Haem!%!ietic &temcell&>
• Lym%h!ma (Lym%h!&ac!ma#6 ali"nancy !*lym%h!cyte&>
• i7ed Tum!u& B!th e%ithelial - c!nnectie ti&&uec!m%!nent&> Ple!m!%hic aden!ma (Saliay "land#- Cacin!&ac!ma ()ea&t0uteu
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Cance Clinical
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Cance Bi!l!"y
• Srucure. – Paenchyma 6 +e!%la&tic cell&>
– Sr!#a. +!n ne!%la&tic 3 n!mal D+A
• &eaures. – Di/eentiati!n 6 atuati!n !* cell&>
– Rate !* G!5th 6 it!tic ate 0 Ki 9;
– L!cal ina&i!n 6 Hem!ha"e$ nec!&i&$
de&tucti!n – eta&ta&i& 6 Di&tant S%ead>
1,1
• Tum!& ae cl!nal (!ne %aent#
• But hae di/eent mutati!n& +!mal
cell
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di/eent &ha%e& - *eatue&>
•
Each ne5 mutati!n add& a ne5*eatue>
ali"nant cell&
cell
mutati!n
Thidmutati!n
Sec!ndmutati!n
9
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9
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%Em)y! Cance
Sel* "!5thaut! e"ulati!n
Limitle&& %!tentialAn"i!"ene&i&
Eade a%!%t!&i&Ina&i!n - in.ltati!n
Path!"ene&i& !* Lun" Cance>
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1,4
" "
K-RasC-myc
p53
Irritation Carcinogens Initiation Promotion Ca.
S#!9e
Anaplasia
C!l!n +!mal Aden!ma Cacin!ma
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C!l!n Cance C!mm!n ty%e 3 =@
Cacin!"ene&i
Sta"e - Gade !* Cance
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"Saging. P!"e&&i!n ! &%ead in the )!dy>
Gra0ing. Cell di/eentiati!n - Rate !* "!5th 6 ic!&c!%y>
ell di/eentiated (l!5 "ade# Aden!cacin!ma Gade Undi/> (hi"h"ade#
P!&tate Ca Glea&!n Gadin"
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"
1,=
L!5
G
ade
H
i"hG
ade
TNM Sta"in" !* tum!Lun" Ca
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Lun" CaSta"e 3 Anat> &ite
T< Tetiay &ite
TJ Ad'acent
e"i!n
N2 +! L+ met&>
N1 Pimay L+
N Se!nday L+
N< Tetiay L+M2
+! meta&ta&e&
M1
eta&ta&e&
Ba&ed !n 3 A+ATOY - LYPHATICS
T1
TJ
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Cance
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11
P!&tate Cance Sta"in"
eta&ta&i& Lym%hatic$ Hemat!"en!u&$ Diect>
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eta&ta&i&
P th i
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Path!"ene&i&
1> Cell l!!&enin"
,> B de"adati!n> Ina&i!n
2> L!c!m!ti!n
4> B adhe&i!n
9> Inta3a&ati!n;> Tum!uem)!lu&
=> Adhe&i!n
?> E7ta3a&ati!n
1@> An"i!"ene&i&11> G!5th>
1
hat chemical mediat!& ae in!led
• E3Cadhein$ 3catenin• ati7 etall!%!teina&e& (P#• C!lla"ena&e (n!t in )eni"n#• Actin Cyt!&elet!n$ chem!ine
Cance Dia"n!&i& e>"> Lun"Cance
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Cance>• Cell ! !rigin
• Rae ! gr!?h
• Diereniai!n
• L!cal InBasi!n• Measasis
• B!nchial E%ith>
• it!tic ate 6 "ade> – L!5$ Intemediate$ hi"h
• atuati!n !* cell& – ell 6 !d 6 P!! 6 Un di/>
• Tum!u Sta"e>> 1$,$$2>
• Di&tant S%ead>>
DIAGNOSIS: (Lung cancer)B!nch!"enic S8uam!u& cell Cacin!ma$ hi"h "ade$Sta"e T,$ +1$ 1$ Lie L+ (in.. patient details..).
DIAGNOSIS: (Lung cancer)B!nch!"enic S8uam!u& cell Cacin!ma$ hi"h "ade$Sta"e T,$ +1$ 1$ Lie L+ (in.. patient details..).
G a d e
S t a " e
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SYSTEIC PATHOLOGY
Athe!&cle!&i&
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y!cadial In*acti!n
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y
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LU+GS
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Tu)ecul!&i&
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ASTHA
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GIT
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RE+AL
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Sin
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Se7ually Tan&mitted
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AIDS
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