Introduction to Pathology

Asst.Prof.Dr.Ghasak Ghazi
Pathology
Year 2
 Definition of Pathology
• It is a discipline that bridges clinical practice and basic
science
• It is the science that studies diseases in four main
concepts :
1. The cause of the disease (etiology)
2. The mechanism by which the disease happens
(pathogenesis)
3. The morphological changes characteristic of the
disease including the gross or macroscopical
changes that are seen by the naked eye and the
microscopical (histopathological ) changes
that are seen under the microscope
4. The main clinical features of the disease
 Main Branches of Pathology
1. Histopathology
• This branch deals with tissue specimens from all the body.

2. Cytopathology
• Is the study of individual cells that are either shed off
spontaneously (exfoliative cytology) e.g epithelial cells shed
in urine or in sputum
• OR cells that are aspirated from the tissue using a fine
needle (fine needle aspiration )

3 .Hematology
• Is the branch that deals with the diagnosis of all blood
diseases.
 Pathological Examination of
specimens
• This includes many levels of examination
A. Gross examination
B. Microscopical examination
C. Special techniques
 (A) Gross Examination
• This is a thorough direct eye examination of the
biopsy
• Biopsy : Is a piece of tissue that is excised from
the body and submitted to histopathological
examination
• Biopsies are of 2 Types
I. Excisional biopsy
• When the entire lesion is removed surgically
and sent to histopathological examination
such biopsy is performed for small lesions
II. Incisional Biopsy
• when only part of the lesion is removed
surgically and sent for examination.
• This is done for large lesions that are difficult
to remove in total and for lesions that are
adhering to adjacent tissue

• Excisional biopsy is usually preferred to incisional

as it acts as diagnostic and curative by removing
the whole lesion
• After taking the biopsy it must be immediately
fixed by formalin of other fixatives to prevent
autolysis of tissue
Important points in describing the
gross specimen
• The first step in histopathological diagnosis is
description of the gross specimen and there are
important points to describe in each biopsy
1. Origin (organ)
2. Dimentions by using a ruler
3. Colour
4. Consistancy (soft ,hard ,rubbery)
• After describing the gross sample it must be
cut into standard pieces of 1-1.5cm x 1-1.5cm
• Then, it is submitted for processing to produce
the histopathological slides for microscopical
examination.
 (B) Microscopical examination
• The routine stain by which histopathological
sections are examined is the Hematoxyline
and eosin stain (H&E)
• There are many other stains used to stain
different components of the tissue to help
confirm the diagnosis.
 (C) Special techniques
• In most of the cases the pathological diagnosis can
be done by the first two methods however,
sometimes there is need for special techniques
to help confirm the diagnosis, these are
1) Special stains that can stain different components
of the tissue e.g.
PAS for carbohydrates
Oil Red O for fatty tissue
Prussian blue for iron
Silver stain for parasites,fungi,basement
membrane
And many others
2) Frozen section
• This method is used when urgent intra-operative
diagnosis is needed whereby the biopsy obtained is
rapidly frozen ,cut and stained and examined , the
pathologist should be able to give a result to the
surgeon in about 20 minutes.

3) Immunohistochemistry
• This method aims at detecting certain tumor markers to
help in diagnosis of tumors

4) Cytogenetics
• For detection of certain chromosomal abnormalities
(mutations)that are associated with many tumors
especially tumors of lymph node (lymphomas ) and
leukemias.
5) Molecular pathology
• Which includes many methods like Polymerase
chain reaction (PCR) , Flow cytometry(FC) , Insitu
hybridization (ISH) all these methods aim at
identifying specific nucleic acid sequence in the
tissue of biopsy.

6) Electron microscopy
• To study the ultrasturcture of tissue which helps
detect the origin of lesion in cases where the
origin is not known.