Podcast
Questions and Answers
How does pathology serve as a critical link within the broader spectrum of medical sciences?
How does pathology serve as a critical link within the broader spectrum of medical sciences?
- By integrating basic scientific research with clinical practice, offering a foundational understanding of disease mechanisms for clinical application. (correct)
- By isolating the study of disease to only observable symptoms, thereby streamlining therapeutic inventions.
- By focusing solely on surgical interventions, thus linking theoretical knowledge directly to practical treatments.
- By separating diagnostic procedures from therapeutic strategies, creating a more specialized approach to patient care.
In the context of modern pathology, which of the following best describes the relationship between etiology, pathogenesis, morphology, and clinical manifestations in the progression of a disease?
In the context of modern pathology, which of the following best describes the relationship between etiology, pathogenesis, morphology, and clinical manifestations in the progression of a disease?
- Etiology initiates a cascade leading to pathogenesis, which then manifests as morphological changes, ultimately resulting in clinical signs and symptoms. (correct)
- There is a cyclical relationship where clinical manifestations feedback to alter etiology, creating a continuous loop of disease development.
- Morphological changes directly cause pathogenesis, which independently leads to clinical manifestations without influence from etiology.
- These aspects operate independently, with clinical manifestations directly influencing etiology and pathogenesis.
Why are diseases like diabetes, atherosclerosis, and various cancers often described as multifactorial within the context of pathology?
Why are diseases like diabetes, atherosclerosis, and various cancers often described as multifactorial within the context of pathology?
- Because their etiologies are primarily environmental, with genetics playing a negligible role.
- Because they are the result of complex interactions between genetic predispositions, environmental influences, and lifestyle factors. (correct)
- Because they can be treated using a variety of methods, reflecting uncertainty about their exact causes.
- Because they only manifest clinically after a long period, making it difficult to pinpoint a single cause.
What is the primary distinction between general and systemic pathology in terms of their focus and scope of study?
What is the primary distinction between general and systemic pathology in terms of their focus and scope of study?
How does molecular pathology enhance our understanding and approach to disease diagnosis and treatment, distinguishing it from traditional anatomic and clinical pathology?
How does molecular pathology enhance our understanding and approach to disease diagnosis and treatment, distinguishing it from traditional anatomic and clinical pathology?
In surgical pathology, what is the significance of clinical-pathological correlation, and how does it influence the diagnostic process?
In surgical pathology, what is the significance of clinical-pathological correlation, and how does it influence the diagnostic process?
How do intraoperative (Frozen Section) examinations in surgical pathology critically impact surgical decision-making, and what are the key limitations?
How do intraoperative (Frozen Section) examinations in surgical pathology critically impact surgical decision-making, and what are the key limitations?
What is the clinical significance of assessing the adequacy of excision during surgical procedures, and how is this determined by pathological examination of surgical margins?
What is the clinical significance of assessing the adequacy of excision during surgical procedures, and how is this determined by pathological examination of surgical margins?
A surgical pathology report indicates 'T2N1M0' for a breast cancer specimen. What is the most accurate interpretation of this staging information?
A surgical pathology report indicates 'T2N1M0' for a breast cancer specimen. What is the most accurate interpretation of this staging information?
From a diagnostic perspective, why is it crucial to differentiate between reactive cellular changes and dysplastic or neoplastic cells in cytopathology?
From a diagnostic perspective, why is it crucial to differentiate between reactive cellular changes and dysplastic or neoplastic cells in cytopathology?
In the context of cytopathology, what distinguishes exfoliative cytology from interventional cytology in terms of specimen collection methods, and how does this influence the types of samples obtained?
In the context of cytopathology, what distinguishes exfoliative cytology from interventional cytology in terms of specimen collection methods, and how does this influence the types of samples obtained?
How has the contribution of Aurel Babes to cervical cancer screening been historically contextualized in relation to that of George Papanicolaou?
How has the contribution of Aurel Babes to cervical cancer screening been historically contextualized in relation to that of George Papanicolaou?
In forensic pathology, what distinguishes a forensic autopsy from a clinical autopsy in terms of purpose, authorization, and scope of investigation?
In forensic pathology, what distinguishes a forensic autopsy from a clinical autopsy in terms of purpose, authorization, and scope of investigation?
What role do various scientific disciplines, such as geology, entomology, and ballistics, play in forensic pathology, and how do they contribute to a comprehensive understanding of a death investigation?
What role do various scientific disciplines, such as geology, entomology, and ballistics, play in forensic pathology, and how do they contribute to a comprehensive understanding of a death investigation?
How does the investigation of deaths caused by COVID-19 illustrate an overlap between clinical and forensic pathology?
How does the investigation of deaths caused by COVID-19 illustrate an overlap between clinical and forensic pathology?
In the context of pathology, if multiple causes can lead to the same morphological changes and clinical manifestations, what implications does this have for diagnosis and treatment strategies?
In the context of pathology, if multiple causes can lead to the same morphological changes and clinical manifestations, what implications does this have for diagnosis and treatment strategies?
From a functional perspective, explain the role of pathology in providing a 'rational and scientific basis for clinical care and therapy'.
From a functional perspective, explain the role of pathology in providing a 'rational and scientific basis for clinical care and therapy'.
In examining a surgical specimen, what key elements are considered during the macroscopic examination phase, and how do these inform subsequent microscopic analysis and diagnostic decision-making?
In examining a surgical specimen, what key elements are considered during the macroscopic examination phase, and how do these inform subsequent microscopic analysis and diagnostic decision-making?
Why would additional test such as IHC stains to use of special stains, depending on differential diagnosis, to genetic sequencing or even electron microscopy be necessary?
Why would additional test such as IHC stains to use of special stains, depending on differential diagnosis, to genetic sequencing or even electron microscopy be necessary?
From a historical perspective, how did Dr. Miklos Nissly's forensic work during the Holocaust provide critical insights into human experimentation and contribute to international justice efforts?
From a historical perspective, how did Dr. Miklos Nissly's forensic work during the Holocaust provide critical insights into human experimentation and contribute to international justice efforts?
If the term Pap smear came from Dr George Nicolas Papa Nicole who published in the year of 1928, was he the first study cervix anatomy?
If the term Pap smear came from Dr George Nicolas Papa Nicole who published in the year of 1928, was he the first study cervix anatomy?
When can clinical autopies serve for research?
When can clinical autopies serve for research?
General pathology studies the common reactions of cells and tissues to injury or harmful stimuli. What is the tissue specificity?
General pathology studies the common reactions of cells and tissues to injury or harmful stimuli. What is the tissue specificity?
From the choices provided, what best describes what cytopathology main focus is?
From the choices provided, what best describes what cytopathology main focus is?
Examine the statement, "an adequate sample specimen is taken from the outside of the target", is this statement accurately describing adequate concept in Cytopathology?
Examine the statement, "an adequate sample specimen is taken from the outside of the target", is this statement accurately describing adequate concept in Cytopathology?
Given the options, what best determines the cause, manner, and mechanism of death?
Given the options, what best determines the cause, manner, and mechanism of death?
In what cases will forensic evidence not be needed?
In what cases will forensic evidence not be needed?
The purpose of surgical pathology can be define as?
The purpose of surgical pathology can be define as?
The term negative margins refer to?
The term negative margins refer to?
The black signs showed normal cermical non keratinizing squamous epithelium. What structure indicates that?
The black signs showed normal cermical non keratinizing squamous epithelium. What structure indicates that?
How much percentage of residents choose a combined apcp?
How much percentage of residents choose a combined apcp?
According to the video, which of the items mentioned are considered specimens?
According to the video, which of the items mentioned are considered specimens?
Are the medical procedures collecting cells less invasive or similar compared with the procedures in surgical pathology?
Are the medical procedures collecting cells less invasive or similar compared with the procedures in surgical pathology?
In what year was forensic pathology was first recognized by American Board of pathology?
In what year was forensic pathology was first recognized by American Board of pathology?
What is the time frame allotted for examination intraoperatively during the surgery?
What is the time frame allotted for examination intraoperatively during the surgery?
How do the roles of biochemistry, molecular biology, and genetics collectively contribute to the understanding of disease processes within the scope of pathology?
How do the roles of biochemistry, molecular biology, and genetics collectively contribute to the understanding of disease processes within the scope of pathology?
Considering the complexity of biological systems, what is the most significant implication of the fact that multiple etiologies can lead to similar morphological changes and clinical manifestations in different diseases?
Considering the complexity of biological systems, what is the most significant implication of the fact that multiple etiologies can lead to similar morphological changes and clinical manifestations in different diseases?
How does the study of general pathology differ from that of systemic pathology in terms of scope and application?
How does the study of general pathology differ from that of systemic pathology in terms of scope and application?
In the context of pathology training and board certification, what is the principal advantage of pursuing a combined Anatomic and Clinical Pathology (AP/CP) residency?
In the context of pathology training and board certification, what is the principal advantage of pursuing a combined Anatomic and Clinical Pathology (AP/CP) residency?
How does molecular pathology integrate with traditional pathology disciplines (anatomic and clinical) to enhance our understanding of disease?
How does molecular pathology integrate with traditional pathology disciplines (anatomic and clinical) to enhance our understanding of disease?
Given the multidisciplinary nature of surgical pathology, how does effective collaboration among surgeons, radiologists, and pathologists impact patient outcomes?
Given the multidisciplinary nature of surgical pathology, how does effective collaboration among surgeons, radiologists, and pathologists impact patient outcomes?
What are the potential consequences of discrepancies between intraoperative (frozen section) diagnoses and final surgical pathology diagnoses on patient management and clinical outcomes?
What are the potential consequences of discrepancies between intraoperative (frozen section) diagnoses and final surgical pathology diagnoses on patient management and clinical outcomes?
In surgical pathology, why is the assessment of surgical margins critical in oncological resections, and what implications do positive margins have for patient prognosis and treatment?
In surgical pathology, why is the assessment of surgical margins critical in oncological resections, and what implications do positive margins have for patient prognosis and treatment?
How does the TNM staging system contribute to clinical decision-making and patient management in oncology?
How does the TNM staging system contribute to clinical decision-making and patient management in oncology?
What are the key differences between the approaches to specimen collection and analysis in surgical pathology versus cytopathology, and how do these differences influence their respective diagnostic capabilities?
What are the key differences between the approaches to specimen collection and analysis in surgical pathology versus cytopathology, and how do these differences influence their respective diagnostic capabilities?
How does the concept of 'adequacy' in cytopathology influence the reliability and accuracy of diagnostic interpretations, and what measures are taken to ensure specimen adequacy?
How does the concept of 'adequacy' in cytopathology influence the reliability and accuracy of diagnostic interpretations, and what measures are taken to ensure specimen adequacy?
To what extent did Aurel Babes' contribution to cervical cancer screening differ methodologically and historically from that of George Papanicolaou, and how has medical history recognized their respective roles?
To what extent did Aurel Babes' contribution to cervical cancer screening differ methodologically and historically from that of George Papanicolaou, and how has medical history recognized their respective roles?
How does forensic pathology uniquely contribute to legal and criminal justice systems, beyond the scope of clinical pathology?
How does forensic pathology uniquely contribute to legal and criminal justice systems, beyond the scope of clinical pathology?
Given the interdisciplinary nature of forensic pathology, how do diverse scientific fields, such as entomology, geology, and ballistics, contribute to a comprehensive death investigation?
Given the interdisciplinary nature of forensic pathology, how do diverse scientific fields, such as entomology, geology, and ballistics, contribute to a comprehensive death investigation?
In what ways did Dr. Miklos Nissly's forensic work during the Holocaust differ from standard forensic practices, and what impact did his findings have on international justice efforts?
In what ways did Dr. Miklos Nissly's forensic work during the Holocaust differ from standard forensic practices, and what impact did his findings have on international justice efforts?
Considering the role of pathology in providing a 'rational and scientific basis for clinical care and therapy,' how does this inform the selection and application of therapeutic interventions?
Considering the role of pathology in providing a 'rational and scientific basis for clinical care and therapy,' how does this inform the selection and application of therapeutic interventions?
How does the intraoperative consultation (frozen section) service impact surgical decision-making, and what are the inherent limitations of this technique?
How does the intraoperative consultation (frozen section) service impact surgical decision-making, and what are the inherent limitations of this technique?
Why is it crucial to differentiate between reactive cellular changes and dysplastic or neoplastic cells in cytopathology, and what techniques are employed to make this distinction?
Why is it crucial to differentiate between reactive cellular changes and dysplastic or neoplastic cells in cytopathology, and what techniques are employed to make this distinction?
Given the statement 'an adequate sample specimen is taken from the outside of the target', how accurately does this reflect the concept of adequacy in cytopathology?
Given the statement 'an adequate sample specimen is taken from the outside of the target', how accurately does this reflect the concept of adequacy in cytopathology?
How does the time frame allotted for intraoperative frozen section examinations impact the diagnostic procedures a pathologist can perform, and what are the implications for patient care?
How does the time frame allotted for intraoperative frozen section examinations impact the diagnostic procedures a pathologist can perform, and what are the implications for patient care?
Given that forensic pathology was first recognized by the American Board of Pathology in 1959, what were the primary factors that led to this formal recognition?
Given that forensic pathology was first recognized by the American Board of Pathology in 1959, what were the primary factors that led to this formal recognition?
How does the clinical information of a pathological specimen influences the pathologist's investigation process?
How does the clinical information of a pathological specimen influences the pathologist's investigation process?
How does intraoperative examination of specimens potentially guide or alter treatment decisions during surgical procedures?
How does intraoperative examination of specimens potentially guide or alter treatment decisions during surgical procedures?
What factor best determines the cause, manner, and mechanism of death?
What factor best determines the cause, manner, and mechanism of death?
What is the intended purpose of surgical pathology?
What is the intended purpose of surgical pathology?
What does the term 'negative margins' refer to?
What does the term 'negative margins' refer to?
Knowing the normal cervix is non keratinizing squamous epithelium, what structure indicates that?
Knowing the normal cervix is non keratinizing squamous epithelium, what structure indicates that?
If surgical pathology focuses on whole tissues, and cytopathology specializes in cells, what distinguishes forensic pathology's area of focus?
If surgical pathology focuses on whole tissues, and cytopathology specializes in cells, what distinguishes forensic pathology's area of focus?
What situations warrant a forensic autopsy, and how does it proceed?
What situations warrant a forensic autopsy, and how does it proceed?
How did pathologist Dr Miklos Nissly provide a testimony?
How did pathologist Dr Miklos Nissly provide a testimony?
The modern definition of pathology is:
The modern definition of pathology is:
Pathology uses techniques from multiple sciences. Which of the following is NOT one of the sciences mentioned?
Pathology uses techniques from multiple sciences. Which of the following is NOT one of the sciences mentioned?
What are the four key aspects that pathology operates with in regards to understanding disease?
What are the four key aspects that pathology operates with in regards to understanding disease?
A bacterial infection leading to inflammation is an example of what?
A bacterial infection leading to inflammation is an example of what?
What is the purpose of examining a surgical specimen?
What is the purpose of examining a surgical specimen?
What are the type of specimens?
What are the type of specimens?
The examination can be divided in three major components. Which choice reflects those components?
The examination can be divided in three major components. Which choice reflects those components?
What is the benefit of forensic autopsy?
What is the benefit of forensic autopsy?
In modern pathology, how do the structural, biochemical, and functional changes in cells, tissues, and organs primarily contribute to our understanding of disease?
In modern pathology, how do the structural, biochemical, and functional changes in cells, tissues, and organs primarily contribute to our understanding of disease?
Why is pathology considered a multidisciplinary field that bridges basic science and clinical medicine?
Why is pathology considered a multidisciplinary field that bridges basic science and clinical medicine?
How does the concept of 'etiology' in pathology interact with 'pathogenesis' to influence the development of disease?
How does the concept of 'etiology' in pathology interact with 'pathogenesis' to influence the development of disease?
What implications arise from the fact that multiple etiologies can result in similar morphological changes and clinical manifestations in disease?
What implications arise from the fact that multiple etiologies can result in similar morphological changes and clinical manifestations in disease?
How does general pathology differ from systemic pathology in addressing disease processes?
How does general pathology differ from systemic pathology in addressing disease processes?
How does molecular pathology enhance the precision of disease diagnosis and treatment strategies compared to traditional pathology methods?
How does molecular pathology enhance the precision of disease diagnosis and treatment strategies compared to traditional pathology methods?
What critical role does clinical-pathological correlation play in surgical pathology, and how does it influence diagnostic accuracy and patient management?
What critical role does clinical-pathological correlation play in surgical pathology, and how does it influence diagnostic accuracy and patient management?
What factors determine the 'adequacy' of a specimen in cytopathology, and why is this concept crucial for reliable diagnostic interpretations?
What factors determine the 'adequacy' of a specimen in cytopathology, and why is this concept crucial for reliable diagnostic interpretations?
In what ways does the integration of diverse scientific disciplines, such as geology, entomology, and ballistics, enhance forensic pathology's comprehensive approach to death investigations?
In what ways does the integration of diverse scientific disciplines, such as geology, entomology, and ballistics, enhance forensic pathology's comprehensive approach to death investigations?
How does the analysis of surgical margins during tumor resection influence patient prognosis and subsequent treatment strategies?
How does the analysis of surgical margins during tumor resection influence patient prognosis and subsequent treatment strategies?
Given the interdisciplinary nature of surgical pathology, what consequences arise from a lack of collaboration among surgeons, radiologists, and pathologists?
Given the interdisciplinary nature of surgical pathology, what consequences arise from a lack of collaboration among surgeons, radiologists, and pathologists?
What are the main objectives of a forensic autopsy that differentiate it from a clinical autopsy, particularly in the context of legal and justice systems?
What are the main objectives of a forensic autopsy that differentiate it from a clinical autopsy, particularly in the context of legal and justice systems?
How do the varied specimen collection methods in surgical pathology, such as resections and biopsies, each uniquely contribute to diagnostic precision and clinical management?
How do the varied specimen collection methods in surgical pathology, such as resections and biopsies, each uniquely contribute to diagnostic precision and clinical management?
Considering that a single etiological agent can initiate diverse pathogenic mechanisms in different tissues and organs, what challenges does this present for both diagnosis and therapy?
Considering that a single etiological agent can initiate diverse pathogenic mechanisms in different tissues and organs, what challenges does this present for both diagnosis and therapy?
The TNM staging system is applied as what purpose?
The TNM staging system is applied as what purpose?
How does intraoperative consultation, particularly using frozen section analysis, impact immediate surgical decision-making, and what inherent diagnostic limitations must surgeons and pathologists consider during this process?
How does intraoperative consultation, particularly using frozen section analysis, impact immediate surgical decision-making, and what inherent diagnostic limitations must surgeons and pathologists consider during this process?
Given that AP/CP combined residency programs are chosen by 80% of residents, in what specific ways does certification in both anatomical and clinical pathology enhance a pathologist's professional capabilities and adaptability in diagnostics?
Given that AP/CP combined residency programs are chosen by 80% of residents, in what specific ways does certification in both anatomical and clinical pathology enhance a pathologist's professional capabilities and adaptability in diagnostics?
Explain how the unique focus of forensic pathology on human remains and crime-related lesions distinguishes its role from that of surgical and cytopathology: What unique contribution does this emphasis make to legal and medical contexts?
Explain how the unique focus of forensic pathology on human remains and crime-related lesions distinguishes its role from that of surgical and cytopathology: What unique contribution does this emphasis make to legal and medical contexts?
Considering the differing specimen requirements and analytical focal points in surgical pathology compared to cytopathology, how does each discipline uniquely contribute to patient diagnosis and care strategies?
Considering the differing specimen requirements and analytical focal points in surgical pathology compared to cytopathology, how does each discipline uniquely contribute to patient diagnosis and care strategies?
In cases where initial surgical margins appear negative but later stain positive for specific tumoral markers—beyond the 20-minute intraoperative period—what protocols guide subsequent clinical actions, and how do these actions aim to improve patient outcomes?
In cases where initial surgical margins appear negative but later stain positive for specific tumoral markers—beyond the 20-minute intraoperative period—what protocols guide subsequent clinical actions, and how do these actions aim to improve patient outcomes?
Flashcards
Modern Pathology
Modern Pathology
The study of structural, biochemical, and functional changes in cells, tissues, and organs that underlie disease.
Etiology
Etiology
The cause of a disease.
Pathogenesis
Pathogenesis
Biochemical, molecular, and genetic mechanisms of disease development.
Morphology
Morphology
Signup and view all the flashcards
Clinical Manifestations
Clinical Manifestations
Signup and view all the flashcards
General Pathology
General Pathology
Signup and view all the flashcards
Systemic Pathology
Systemic Pathology
Signup and view all the flashcards
Anatomic Pathology (AP)
Anatomic Pathology (AP)
Signup and view all the flashcards
Clinical Pathology (CP)
Clinical Pathology (CP)
Signup and view all the flashcards
Molecular Pathology
Molecular Pathology
Signup and view all the flashcards
Surgical Pathology
Surgical Pathology
Signup and view all the flashcards
Gross Examination
Gross Examination
Signup and view all the flashcards
Microscopic Examination
Microscopic Examination
Signup and view all the flashcards
Frozen Section Examination
Frozen Section Examination
Signup and view all the flashcards
TNM Staging System
TNM Staging System
Signup and view all the flashcards
Negative Margins
Negative Margins
Signup and view all the flashcards
Positive Margins
Positive Margins
Signup and view all the flashcards
Cytopathology
Cytopathology
Signup and view all the flashcards
Exfoliative Cytology
Exfoliative Cytology
Signup and view all the flashcards
Fine Needle Aspiration (FNA)
Fine Needle Aspiration (FNA)
Signup and view all the flashcards
Adequacy
Adequacy
Signup and view all the flashcards
Cytopathology Purpose
Cytopathology Purpose
Signup and view all the flashcards
PAP Smear
PAP Smear
Signup and view all the flashcards
Forensic Pathology
Forensic Pathology
Signup and view all the flashcards
Autopsy
Autopsy
Signup and view all the flashcards
Clinical Autopsy
Clinical Autopsy
Signup and view all the flashcards
Forensic Autopsy
Forensic Autopsy
Signup and view all the flashcards
Death Assessment
Death Assessment
Signup and view all the flashcards
Study Notes
Pathology Overview
- Pathology's oldest definition means "science of suffering" from Greek roots.
- The modern pathology definition studies structural, biochemical, and functional changes in cells, tissues, and organs underlying disease.
- Pathology uses morphology, microbiology, immunology, and molecular genetics.
- It explains signs and symptoms and provides a basis for clinical care and therapy.
- Pathology bridges basic science and clinical medicine.
- It is the scientific foundation for all of medicine.
Core Concepts of Pathology
- Pathology operates with four aspects of disease: etiology, pathogenesis, morphology, and clinical manifestations.
- Etiology refers to the cause of the disease.
- Pathogenesis refers to the biochemical, molecular, and genetic mechanisms of disease.
- Morphology refers to the structural and functional alterations in cells, tissues, and organs.
- Clinical manifestations are the resulting clinical consequences of the changes.
- Etiology triggers pathogenic mechanisms.
- This leads to structural and functional changes, which cause clinical signs and symptoms.
- Biochemistry, molecular biology, and genetics explain pathogenesis.
- Anatomy and physiology explain morphology and morphopathology.
- Biology allows multiple causes for the same morphological changes.
- Some breast tumors may look identical but have different pathogenesis, leading to different treatments and outcomes.
- The same cause may trigger different pathogenic mechanisms in different tissues.
- Certain diseases are multifactorial, resulting from genetic and environmental factors.
Subdivisions of Pathology
- Pathology is subdivided into general and systemic pathology.
- General pathology studies common reactions of cells and tissues to injury.
- These reactions are often not tissue-specific.
- Bacterial infection leads to acute inflammation.
- Reactions are similar in different tissues.
- Systemic pathology examines alterations and mechanisms in diseases of particular organ systems.
- Examples are bone pathology, GI pathology, and GU pathology.
Pathology Training and Certification
- Pathology residency offers options for anatomic pathology (AP), clinical pathology (CP), or both.
- A general pathologist has certification in both AP and CP.
- Anatomic pathology examines specimens removed during surgery or biopsy.
- It investigates and diagnoses disease.
- It provides information for clinical management.
- Clinical pathology does laboratory analysis of body fluids and tissues.
- It investigates, diagnoses, and guides management.
- Molecular pathology combines anatomic pathology, genetics, molecular biology, and biochemistry.
- It studies disease at the molecular level.
- Both AP and CP offer fellowship training options in subspecialties.
Surgical Pathology Definition
- Surgical pathology examines surgical specimens to establish a diagnosis and guide management.
- The workflow includes obtaining the specimen, examining it, and making a diagnostic decision.
- Specimens are obtained through medical procedures like surgery, biopsy, or fine needle aspirate.
- Specimens can also be non-biological, such as stents or implants.
- Specimens are examined by the pathologist outside the patient's body.
Surgical Pathology Team
- Surgeons or specialists obtain specimens.
- Various allied personnel are involved, including nurses, technicians, and pathologists.
Pathology: Clinical Correlation
- Pathologists need to be familiar with the clinical aspects of the case.
- All diagnostic procedures and tests need to be interpreted with consideration of clinical aspects.
Surgical Pathology Specimen Examination
- Examination includes gross examination, microscopic examination and intraoperative (Frozen Section) examination.
- The examination follows standardized rules.
- Gross examination includes anatomical origin, size, weight, and anomalies.
- Microscopic examination involves sectioning and staining the specimen.
- Microscopic examination is done in order to identify benign versus malignant tumors.
- Additional tests include immunohistochemistry, special stains, genetic sequencing, or electron microscopy.
- Intraoperative examination is done during surgery.
- Results communicated within 20 minutes.
- It is useful in order to help change management of the patient during surgery.
- TNM staging is used for tumors.
- T stands for tumor, N for lymph nodes, and M for metastasis.
- Results are communicated to the surgeon so they can change or alter the course of surgery.
Surgical Pathology: Margins
- Adequacy of excision ensures complete tumor removal with a margin of normal tissue.
- Negative margins mean no tumor cells found microscopically.
- If margins are negative the surgeon can finish.
- Positive margins mean tumor is still present.
- The complete excision requires additional removal.
- Additional surgery may be needed.
- Staining cannot be done in the 20 minutes allotted in the frozen section.
Surgical Pathology Residency and Fellowships
- The combined AP/CP residency lasts four years (80% choice).
- AP-only or CP-only programs last three years.
- Fellowships last one year (Neuropathology: two years).
- Specialties cover organs and systems.
TNM Staging System
- TNM staging classifies the extent of malignant tumors.
- It guides treatment, predicts prognosis, and standardizes communication.
- T (Tumor) refers to the size and extent of the primary tumor (T0 to T4).
- T0: No evidence of a primary tumor
- Tx: Tumor cannot be assessed.
- N (Nodes) refers to the spread to regional lymph nodes (N0 to N3).
- M (Metastasis) refers to the spread to distant organs (M0 or M1).
- M0: No distant metastasis
- M1: Distant metastasis present
- Higher T, N, or M values indicate more advanced disease.
- Localized cancers may be treated with surgery, while metastatic cancers require chemotherapy.
Overview of Cytopathology
- Cytopathology deals with cells, either free or in clusters.
- Surgical pathology deals with tissues.
- Cytopathology examines individual or grouped cells.
- Cytopathology also includes rare cases of tissue fragments.
- "Cyto" comes from the Greek "Kaitos".
Cytopathology Specimens and Collection
- Specimens are cells, either free cells or clusters of cells.
- Medical procedures for collecting cells are less invasive.
- Exfoliative cytology involves cells shed spontaneously or mechanically.
- Examples are pleural and peritoneal cavity cells.
- Mechanical removal is another example, such as PAP smear or bronchoscopy.
- Interventional cytology does fine needle aspiration (FNA).
- Cells are aspirated from a suspicious mass.
- Specimens may be smeared on a slide, stained, or centrifuged.
Cytopathology Exam
- Cytologic examination looks at cell morphology.
- Exam includes shape, size, nucleus to cytoplasm ratio, mitosis, and abnormalities.
- Adequacy is ensuring that the sample is from the target area and sufficient for diagnosis.
- Main purposes are detecting pre-cancerous or cancerous lesions.
- Cytology also diagnoses infections and immune diseases.
- It is useful to detect cell senescence, degeneration, and reactive changes.
- Cytopathology can examine almost all organs and systems.
- The most common use is the interpretation of cells from the uterine cervix (PAP smear).
- Dr Nicholas Papaniocole developed the PAP smear in 1928.
- Aurel Babish first studied cervical cytopathology in 1927.
- Papaniocole’s method is recognized as the origin of the pap smear. Normal Uterine Cervix (Macroscopic Image): The cervix is taken from a hysterectomy sample. Normal Cervical Squamous Epithelium (Microscopic Image): Shows squamous cells maturing from the basal layer to the surface Cervical Squamous Dysplasia (Pap Smear Image A): Displays dysplastic cells with smaller size darker nuclei, and a abnormal nuclear-to-cytoplasm ratio. Cervical Carcinoma (Pap Smear Image B): Shows pleomorphic, larger, darker, cells with more irregular nuclei. Additionally, the background shows inflammation and hemorrhage, with infiltration of polymorphonuclear leukocytes indicative of an aggressive lesion.
Distinguishing Exfoliative From Interventional Cytology
- Exfoliative cytology collects cells shed spontaneously or removed mechanically from body surfaces.
- Interventional cytology involves aspirating cells from lesions or masses.
Introduction to Forensic Pathology
- Forensic pathology examines corpses, human remains, or lesions from crimes.
- Surgical pathology focuses on tissues; cytopathology focuses on cells.
- Forensic pathology is an application of medical jurisprudence.
- It varies by country and state.
- Forensic pathology was recognized by American Board of Pathology in 1959.
- Canada formally recognized it in 2003.
Autopsy Types
- Autopsy is a standardized examination of a corpse to answer medical and legal questions.
- Clinical autopsy investigates natural deaths (advanced age or disease).
- Goals are establishing diagnosis, confirming pre-existing diagnosis, and research.
- The family or patient can authorize autopsy.
- Forensic autopsy investigates deaths with no natural cause or suspicion.
- Examples are accidents, suicides, and homicides.
- It is the context in which a young healthy person is found dead.
- Goals are to establish identity and manner of death.
Goals of Forensic Autopsy
- Establish identity, time, place, and manner of death.
- The process is done by physiology, pathology, toxicology, and pharmacology.
- Physics (ballistics), geology (soil analysis), and entomology are also relevant.
- Forensic aims to reconstruct the crime or accident.
- It gathers evidence for legal prosecution.
- Judicial entities authorize forensic autopsies.
- Homicides are rare compared to suicides and accidents.
Historical Forensic Pathology
- Dr. Miklos Nissly was a prisoner forced to perform autopsies for Nazi experiments.
- COVID-19 autopsies were clinical and forensic.
- The autopsies were for research and because of a public threat.
- Lung specimen images show infected (red) versus normal (blue) cells.
- Degradation post-mortem was observed.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
