Transcript Introduction to Radiographic Pathology

Spring 2012
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Pathology
 Pathogenesis
 Acute vs. Chronic
disease
 Disease
 Signs vs. Symptoms
 Diagnosis
 Prognosis
 Sequelae
 Etiology
 Epidemiology
 Syndrome
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Causes of Disease
 Normal agents
 Bacteria, viruses,
trauma, and heat
 Adverse reactions to
 Poor infection control
 Nosocomial
 No known cause
 Idiopathic
medical treatment
 Iatrogenic
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Technique Adjustments
 Subtractive
 Additive
 Lytic
 Sclerotic
 Destructive
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Disease Tracking
 CDPH
 NCHS
 CDC
 Monitoring
 Trends
 Epidemics
 Intervention
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Life Expectancy
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Health Care Costs and Changes
 Delivery Methods
 Ambulatory care
 Inpatient services
 Health care costs
 Increasing costs
 Sources of funding




Medicare
Medicaid
Private insurance
Cash
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Disease Classifications
 Hereditary
 Congenital
 Inflammatory
 Metabolic
 Degenerative
 Traumatic
 Neoplastic
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What is the difference between
Congenital and Hereditary?
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Congenital
 In utero
 Maternal infections, radiation, trauma or drugs
 Usually cannot be recognized before birth
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Hereditary
 Genetically transmitted from either parent to child
 Genetic testing can detect these before birth
 Intervention
 Terminate pregnancy
 Make decisions
 46 chromosomes
 44 automsomal
 2 are X and Y
 XY
 XX
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Hereditary Terms
 Homozygous
 Mutations
 Heterozygous
 Autosomal Dominant
 Dominant Genes
 Autosomal Recessive
 Recessive Genes
 Sex linked disorders
 Codominant Genes
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 Homozygous- genes are same for a trait
 Blue and blue
 Heterozygous- genes differ from each parent
 Blue (recessive) and Brown (dominant)
 Dominant Genes-always produce effect
 Recessive Genes- traits manifest only if person is
homozygous
 Codominant Genes- both traits are expressed
 AB blood types
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Autosomal Dominant  Transmitted from one
generation to next.
 Affects males and females
 Either can transmit
 Affected father + Unaffected
Mother
 = ½ children will have
disease
 Not all will demonstrate the
trait
 Some may demonstrate
differently
 EX:
 Polydactyly
 Marfan’s syndrome
Autosomal Recessive
 Disorders when a person in
homozygous
 Parents may not show
disease but siblings may
 EX:



cystic fibrosis
Tay-sachs
Sickle cell anemia
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Sex Linked Disorders
 Most transmitted through
 Mutations- alterations in
DNA that become permanent
hereditary change if they
affect gonadal cells
 Generally as a result of a
defective X chromosome
 Y chromosomes are small
and carry few genes
 Virtually all are recessive
heterozygous female
 To sons
 1-2 chance of receiving
mutant gene
 Affected fathers transmit to
ALL daughters
 EX:
 Color blindness
 Hemophilia
 Muscular Dystrophy
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Inflammatory Diseases
 What is inflammatory disease?
 Body’s reaction to a injurious agent
 Primary causes



Invasion by microorganisms
 Infective diseases
Poisoning by biologic substances
 Toxic diseases
Overreaction of body’s own defenses
 Toxic diseases
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4 Stages of Inflammation
 1) Alterations of blood flow and vascular permeaability
 Dilation of arterioles, capillaries and venules
 Produces increased blood flow around injury site
 Causes heat, redness and pain
2) Migration of WBC to injured tissue
 Leukocytosis occurs
 Mainly leuckocytes such as neutrophils and
macrophages
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4 Stages of Inflammation
3) Phagocytosis
 WBC engulf and digest infecting organisms
4) Repair of injury
 Regeneration of normal cells
 Granuation tissue
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Inflammation
 Chronic inflammation:
 Damage caused by an injurious agent may not result in necrosis
 Longer duration of inflammation periods
 Acute inflammation:
 Heat
 Redness of skin
 Swelling
 Pain
 Loss of function
 Elevated body temperature
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Redness
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Heat And Fever
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Swelling
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Pain
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Loss of Function
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Localized Edema
Inflammatory Process
Lymph obstruction
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Generalized
Edema
•Usually occurs form
CHF, cirrhosis and many
renal diseases
•Gravity causes it to be
more prominent in lower
body
•Sedentary persons
•Lower back
•Lungs
•Sacral area
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Traumatic
 Disease that may result from mechanical forces
such as crushing or twisting of a body part or from
the effects of ionizing radiation on the body
 Fracture
 Wound
 Bruise/contusion
Neoplastic
 Defined as: new abnormal tissue growth
 Come from latin word “neoplasia” meaning new growth
 Abnormal proliferation that are not governed by laws
of normal cells
 Cell act as parasites competing with normal cells for
their metabolic needs
 Onocology- study of neoplasms
 Derived from greek word “oncos” which means tumor
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All tumors have 2 basic components
1) The organ tissue is made up of proliferating
neoplastic cells
2) The supporting tissue is made up of connective
tissue, blood vessels and possibly lymphatic cells.
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Grading (Differentiation)
 Used to assess biologic behavior and choice of
treatment
 Differentiated tumors
 Tend to grow slow
 Resemble cells of origin
 Poorly differentiated or undifferentiated
 Rapid growth
 Exhibits atypical characteristics and does not resemble
cells of origin
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TNM System
 Staging of cancer
 TNM system emerged in 1950s and endorsed by
AJCC
 T—Tumor
 N—Node (lymph node involvement)
 M—Metastases
 Addition of numbers indicates the extent of
malignancy and progressive increase in size or
involvement of tumor
Tumor Word Roots
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Benign Neoplasms
 Closely resemble their cells of origin in structure and
function
 Remain localized
 Can be surgically removed
 Can still have severe consequences
 EX:
 Pituitay tumore can cause pressure and destruction of
gland
 Pancreas- excessive insulin can be fatal
 Brain and spinal cord- impair or alter CNS function
 Trachea / esophagus- occlude air supply or swallowing
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Benign Tumors
 Consist of differentiated cells
 Add suffix OMA to root word
 Examples:
 Fibromas
 Chondromas
 Adenoma
 Lipomas
 Myomas
 Angiomas
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Malignant Neoplasms
 Invade and destroy adjacent structures
 Metastasize
 Poorly or undifferentiated so it may be impossible to
determine origin
 Cancer comes from the latin word crab, because it has
fingerlike projections that resemble crablike claws
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Malignant Neoplasms
 Carcinomas- epithelial origin
 Affects epithelial cells, skin and mucus membranes
 Comes from greek word “karkinos” which means crab
 Adenocarcinoma- malignancies from glandular tissue
 breast, liver, pancreas, and cells lining the GI tract
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Malignant Neoplasms Cont.
 Squamous cell carcinoma- tumors of connective tissue
 Resemble stratified squamous epithelia
 Lungs, head and neck regions
 Sarcomas- connective tissue
 Highly malignant and spread rapidly
 Bone, muscle, and cartilage
 Less common than carcinomas
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Metastatic Methods 4
1) Seeding- travels to distant sites and organs
2) Lymphatic-Spreads through lymphatic system
1) Especially lung and breast
2) major metastatic route of carcinomas
3) Invasion
1.
Spreads to other areas in close proximity
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Metastatic Methods cont.
4) Hematogenous- spreads through circulatory system
 Tumor cells invade and penetrate blood vessels
 Travel as emboli until they get stuck
 Invade wall in the vessel they are stuck
 Infiltrate to surrounding tissue
 Examples
 Abdominal carcinomas metastasize to liver

Because of flow of the portal vein blood to that organ
 Midline organs spread to vertebrae
 Neoplasms in organs that drain into inferior & superior vena cava,
such as kidneys spread to lung
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Carcinogens
 Chemicals that alter DNA
 Air and water pollution
 Cigarette smoke
 Asbestos
 Sun, bombs, and radiation
 Viruses that alter genetic material
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Treatment Options
 Surgical removal
 Well localized tumors with no metastases
 Radiation Therapy
 Fast growing
 Poorly or undifferentiated tumors
 Chemotherapy
 Cytotoxic substances used to kill neoplastic cells
 Kills good cells to causing significant complications
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Degenerative
 Degenerative—Disease caused by a deterioration of
the body
 May occur following traumatic injury, regardless
of age
 May occur as a hereditary illness
 Process of aging
 Factors affecting the rate of aging
 Hereditary
 Diet
 Enviromental factors
 Sedentary lifestyle
Degenerative Diseases
 Atherosclerosis
 Osteoporosis
 Osteoarthritis
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Metabolic Disease
 Disease caused by the disturbance of the normal
physiologic function of the body
 Metabolism is the sum of all physical & chemical
processes in the body
 To function
 Maintain homeostasis
Metabolic Disease
 Endocrine disorders


Hypersecretion
Insufficient secretion
 Fluid and Electrolyte imbalances

Dehydration
 Insufficient water
 Loss of too much water
 Can occur from:




Vomiting
Diarrhea
Diuretics
Athletic (very hard training)
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