Introduction
• Pathology - a branch of medicine studying diseases
• outer and inner factors causing diseases - etiology
(TB - caused by Mycobacterium tuberculosis)
Introduction
• how and why - development - pathogenesis
(infectious endocarditis - thrombembolism - multiple
abscesses)
• related disciplines: anatomy, histology,
microbiology, clinical chemistry, hematology,
laboratory medicine
Methods used in pathology
• autopsy
• search for changes in dead patients, correlation with clinical
symptoms - feed-back
• educational role
• chronic toxicity studies (pharmaceutic industry)
• pathological autopsy is different from anatomic autopsy and
forensic autopsy
• gross examination, microscopy, special methods
(cultivation, chemical tests, etc.)
Methods used in pathology
• biopsy (surgical pathology)
• 80% of workload
• since 1950!
• microscopical diagnostics, for living patients
• histology, cytology (exfoliative-Pap test; fluids, fine needle
aspiration cytology)
Methods used in pathology
• specimens:
• fluids (physiological - urine; pathological - pus, ascites)
• endoscopic samples (gastroscopy, colonoscopy,
bronchoscopy, etc.)
• tru-cut needle biopsy (liver, kidney, prostate)
• diagnostic excisions (skin, breast, pancreas)
• entire organs (hysterectomy, mastectomy, lung resection,
colectomy)
• pathological dx = golden standard (important for treatment)
(A. Hailey: Final diagnosis)
How to handle specimen
for histology
• fixation (×frozen section)
• clinical information (identification!!!!; symptoms;
preliminary diagnosis; what do you expect from
pathologist)
History of pathology
• Vesalius
• 1475 - Sixtus IV. - permits to use cadavers in teaching of medical
students
• 1485 - Clement VII. - the same
• 18th cent. - Jean Baptist Morgagni (1682-1772) - 700 autopsies case reports - clinico-morphologic correlations - founder of modern
pathology
• 19th cent. - Karl Rokitanski (Austria) - born 1804 in Hradec
Králové, University of Vienna, 50 000 of autopsies - only gross
examination
• Rudolf Virchow - founder of modern pathology (classification of
tumors, mitosis, apoptosis, causal relationships) - Berlin (Charité)
History of pathology
• our country:
• Jesenius 1600, 1605 - two public autopsies
• Prof. Jaroslav Hlava - end of 198th cent. - his last pupil was Dr.
Antonin Fingerland (1900-1999)
• 1928 - Dept. of Pathology in Hradec Králové - inspiration = Mayo
Clinic (clinicopathologic conferences, close cooperation,
continuous education)
Organization of education
• general pathology - main principles
• systemic pathology - diseases and pathologic processes in
different organ systems
• lectures - www.lfhk.cuni.cz/patanat (Aleš Ryška, MD,
PhD; Karel Dědič, MD, PhD)
• practical classes - Karel Dědič, MD, PhD (excursion at the
Department, autopsy, surgical pathology, microscopy)
Organization of education
• textbooks:
• Basic Pathology (Cumar, Cotran, Robbins)
• Oral Pathology (van der Waal, van der Kwast)
• you MUST know before start of your practical
classes: normal anatomy, normal histology of most
important organs, basic embryology, normal
physiology)
Organization of education
• pay close attention to other disciplines!!! (pathophysiology,
microbiology, biology, biochemistry)
• credits - examination of histologic slides
• exam - lectures, practicals, Robbins, van der Waal
• 49 583 3748 Dr. Ryška
• 49 583 2287 Dr. Dědič
• 49 583 2611 Mrs. Hejnová (secretary)
Good luck !