OBJECTIVE 1. เพื่อให้นักศึกษาทราบขอบข่ายของ วิชาพยาธิวิทยา 2. เพื่อให้นักศึกษาทราบศัพท์ที่ใช้ บ่อยในวิชาพยาธิวิทยา 3. เพื่อให้นักศึกษาทราบชนิดสิ่งส่ง ตรวจต่างๆทางพยาธิ - วิทยา

Introduction to Pathology Pathology ( พยาธิวิทยา ) Pathos + logos The Study of Disease Pathologist ( พยาธิแพทย์ )

Definition The branch of medicine that deals with the nature of disease and its pathogenesis; specifically, the structural and functional changes produced by injury to cells, tissue, organs or the entire organism.

Disease ( โรค ) A departure from health or absence of comfort; specifically, a particular destructive process with a cause and pathogenesis (known or unknown), usually involving tissue changes and characteristic symptoms, signs and course.

Injury ( ภยันตราย ) A stimulus which damages cells, tissues, or organs; many different types. Physical – chemical - biological agents Bigger, smaller, proliferate, or die

Lesion ( รอยโรค ) An abnormality in an organ or tissue; the result of an injury or damage; may result in impairment or loss of function Morphological changes

Etiology ( สมุฏฐานวิทยา ) Etiology ( สมุฏฐานวิทยา ) ( วิชาว่า ด้วยสาเหตุของโรค ) The cause of a disease; can be genetic or acquire

Pathogenesis ( พยาธิ กำเนิด ) The process or series of steps by which a cause produces a disease; mechanism disease

Symptom ( อาการ ) A subjective indication of disease; what a patient feels or notices

Sign ( อาการแสดง ) An objective indication or symptom of disease; what an observer sees or can measure

Complication ( อาการแทรก ซ้อน ) A second disease or abnormal condition occurring during the course of primary disease

Cause of Death The name of a disease, abnormality, trauma or poisoning leading directly or indirectly to death

Manner of Death NASHU- natural, accident, suicide, homicide, undetermined. The way in which death is caused.

Diagnosis ( การ วินิจฉัยโรค ) Dia = between, gnosis = to know The act or process of deciding the nature of a disease condition by a careful examination of the symptoms and signs; also, the decision or opinion based on that examination

Differential diagnosis ( การพิเคราะห์แยกโรค ) A list of possible diagnoses

Prognosis ( การพยากรณ์ โรค ) A forecast, a prediction of probable course of a disease and a chance of recovery.

Type of Pathology 1.General Pathology deals with types and mechanisms of diseases 2.Systemic Pathology deals with organ and system pathology 3.Anatomical Pathology: cytopathology, surgical pathology, autopsy pathology

Type of Pathology (cont.) 4. Clinical Pathology blood bank, chemistry, coagulation and hematopathology etc 5. Forensic Pathology medicolegal pathology (investigations, inspections, autopsy, toxicology)

SPECIMENS IN PATHOLOGY 1.Surgical specimen - Organs (whole or part of ) - Tissue from biopsy - Excisional biopsy - Incisional biopsy

Fixation Fixatives 1. 10% buffered formalin 2. Alcohol 3. Zenker’s solution 4. Bouin ‘s solution etc.

STAINING Hematoxylin and Eosin (H&E) Basophilic and Acidophilic

HANDLING OF TISSUE - Tissue transfer - Fresh - Fixed - Avoid crushing, cauterization - Better avoid using gauze - Small tissue - fix immediately

HANDLING OF TISSUE (cont.) - Glass, plastic, metal containers, plastic bag plastic bag - Delayed - refrigerator at 4 C - Fresh tissue for frozen section

SPECIMENS IN PATHOLOGY (cont. ) 2. Cytological specimen - Exfoliative cytology (cervico-vaginal smear or pap smear, fluid from cavity) (cervico-vaginal smear or pap smear, fluid from cavity) - Fine needle aspiration (FNA)

SPECIMENS IN PATHOLOGY (cont. ) 3. Autopsy specimen - Whole body - Organs or tissue

SPECIAL TECHNIQUES IN SURGICAL PATHOLOGY 1. Special stains 2. Enzyme histochemistry 3. Tissue culture 4. Histometry 5. X-ray microanalysis 6. Electron microscopy 7. Immunohistochemistry - immunoperoxidase

SURGICAL PATHOLOGY AND PATHOLOGIST - Clinical correlation - Time and change - PATHOLOGIST - rich background in clinical medicine

ROLE OF PATHOLOGIST - Benign or malignant - Extent of diseases - Adequacy of excision - Comment, therapy - Prognosis - Conferences