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Contents
xi
Section I: GENERAL PATHOLOGY
Chapter 1: Introduction to Pathology 1 � Study of Pathology, 1: Health and Disease, 1; Common Terms in Pathology, 1 � Evolution of Pathology, 2: Prehistoric Times to Medieval Period, 2; Human Anatomy and Era of Gross Pathology, 3; Era of Technology Development and Cellular Pathology, 4; Modern Pathology, 6; Telepathology and Virtual Microscopy, 7
Chapter 2: Cell Injury, Cellular Adaptations and Cellular Ageing 9 � Cell Injury, 9: Etiology of Cell Injury, 9; Pathogenesis of Cell Injury, 10; Morphology of Reversible Cell Injury, 17; Intracellular Accumulations, 19; Pigments, 22; Morphology of Irreversible Cell Injury (Cell Death), 26; Changes after Cell Death, 32
� Adaptive Disorders, 37: Atrophy, 37; Hypertrophy, 38; Hyperplasia, 39; Metaplasia, 39; Dysplasia, 41 � Ageing, 42: Theories of Ageing, 42; Organ Changes in Ageing, 43
Chapter 3: Immunopathology Including Amyloidosis 44 � The Immune System, 44: Organs and Cells of Immune System, 44; Cytokines, 48; HLA System and Major Histocompatibility Complex, 48; Transplant Rejection, 49
� Amyloidosis, 66: Physical and Chemical Nature of Amyloid, 67; Pathogenesis of Amyloidosis, 69; Classification of Amyloidosis, 70; Staining Characteristics of Amyloid, 72; Diagnosis of Amyloidosis, 73; Morphologic Features of Amyloidosis of Organs, 73; Prognosis of Amyloidosis, 75
Chapter 4: Derangements of Homeostasis and Haemodynamics 78 � Homeostasis, 78: Normal Water and Electrolyte Balance (Gibbs-Donnan Equilibrium), 79; Acid-Base Balance, 79; Pressure Gradients and Fluid Exchanges, 79
� Disturbances of Body Water, 80: Oedema, 80; Dehydration, 87; Overhydration, 87 � Disturbances of Electrolytes and pH of Blood, 88: Acid Base Imbalance, 89 � Haemodynamic Derangements, 89: Disturbances in the Volume of Circulating Blood, 90; Circulatory Disturbances of Obstructive Nature, 99
Chapter 5: Inflammation and Healing 116 � Acute Inflammation, 116: Acute Inflammatory Response, 116; Mediators of Inflammation, 122; Regulation of Inflammation, 127; The Inflammatory Cells, 128; Acute Inflammation—Factors, Morphology, Effects, Fate, 131
xii � Diseases Caused by Parasites, 178: Amoebiasis, 178; Malaria, 179; Filariasis, 180; Cysticercosis, 181 � Torch Complex, 182:
Chapter 7: Neoplasia 184 � Nomenclature and Classification, 184 � Characteristics of Tumours, 186 I. Rate of Growth, 186; II. Cancer Phenotype and Stem Cells, 188; III. Clinical and Gross Features, 188; IV. Microscopic Features, 188; V. Spread of Tumours, 192; Grading and Staging of Cancer, 197
� Epidemiology and Molecular Pathogenesis of Cancer, 197: Epidemiologic Factors, 198; Molecular Basis of Cancer, 201
� Carcinogens and Carcinogenesis, 209: A. Chemical Carcinogenesis, 210; B. Physical Carcinogenesis, 214; C. Biologic Carcinogenesis, 216
� Clinical Aspects of Neoplasia, 222: Host Response against Tumour (Tumour Immunology), 222; Effect of Tumour on Host, 224; Pathologic Diagnosis of Cancer, 226
Chapter 8: Environmental and Nutritional Diseases 231 � Environmental Diseases, 231: Environmental Pollution, 231; Chemical and Drug Injury, 233; Injury by Physical Agents, 237
� Nutritional Diseases, 238: Obesity, 238; Starvation, 240; Protein-Energy Malnutrition, 240; Metals and Trace Elements, 240; Disorders of Vitamins, 241; Diet and Cancer, 249
� Other Paediatric Diseases, 258: Tumours of Infancy and Childhood, 259
Section II: HAEMATOLOGY AND LYMPHORETICULAR TISSUES
Chapter 10: Introduction to Haematopoietic System and Disorders of Erythroid Series 261
� Bone Marrow and Haematopoiesis, 261: Haematopoietic Organs, 261; Haematopoietic Stem Cells, 262; Bone Marrow Examination, 262
� Erythropoiesis, 264: Erythropoietin, 264; Erythroid Series, 265; The Red Cell, 265; Nutritional Requirements for Erythro poiesis, 266
� Anaemia—General Considerations, 268: General Clinical Features, 268; General Scheme of Investigations of Anaemia, 269; Classification of Anaemias, 271
� Hypochromic Anaemias, 272: Iron Deficiency Anaemia, 272; Sideroblastic Anaemia, 277; Anaemia of Chronic Disorders, 278
� Haemolytic Anaemias and Anaemia due to Blood Loss, 286: General Aspects, 287; I. Acquired Haemolytic Anaemias, 288; II. Hereditary Haemolytic Anaemias, 291; Anaemia of Blood Loss, 301
� Aplastic Anaemia and Other Primary Bone Marrow Disorders, 301: Aplastic Anaemia, 301; Myelophthisic Anaemia, 303; Pure Red Cell Aplasia, 303
Chapter 11: Disorders of Platelets, Bleeding Disorders and Basic Transfusion Medicine 305
� Disorders of Platelets, 305: Investigations of Haemostatic Function, 306 � Bleeding Disorders (Haemorrhagic Diathesis), 309: Haemorrhagic Diatheses due to Vascular Disorders, 309; Haemorrhagic Diatheses due to Platelet Disorders, 310; Coagulation Disorders, 313; Other Bleeding and Coagulation Disorders, 315
� Blood Groups and Blood Transfusion, 317: Blood Transfusion, 318; Haemolytic Disease of Newborn, 319
Contents
xiiiChapter 12: Disorders of Leucocytes and Lymphoreticular Tissues 321 � Lymph Nodes: Normal and Reactive, 321: Reactive Lymphadenitis, 322 � White Blood Cells: Normal and Reactive, 324: Granulopoiesis, 324; Lymphopoiesis, 326; Mature Leucocytes in Health and Reactive Proliferation in Disease, 326; Infectious Mononucleosis, 329; Leukaemoid Reactions, 331
� Lymphohaematopoietic Malignancies (Leukaemias-Lymphomas): General, 333: Etiology of Lymphohaematopoietic Malignancies, 334; Pathogenesis, 334
� Lymphoid Neoplasms: General, 344: Common to ALL Lymphoid Malignancies, 347 � Hodgkin’s Disease, 348 � Non-Hodgkin’s Lymphomas-Leukaemias, 352: Precursor (Immature) B- and T-Cell Leukaemia/Lymphoma, 353; Peripheral (Mature) B-Cell Malignancies, 355; Peripheral (Mature) T-Cell Malignancies, 359; Staging of NHL, 360; Lymph Node Metastatic Tumours, 360
� Plasma Cell Disorders, 360 � Histiocytic Neoplasms: Langerhans Cell Histiocytosis, 365 � Spleen, 366: Splenic Enlargement and Effects on Function, 367 � Thymus, 368: Structural and Functional Changes in Thymus, 369
Section III: SYSTEMIC PATHOLOGY
Chapter 13: The Blood Vessels and Lymphatics 370 � Normal Structure, 370 � Arteriosclerosis, 371: Senile Arteriosclerosis, 371; Hypertensive Arteriolosclerosis, 371; Mönckeberg’s Arteriosclerosis (Medial Calcific Sclerosis), 372; Atherosclerosis, 373
� Vasculitis, 381: I. Infectious Arteritis, 381; II. Non-Infectious Arteritis, 382 � Aneurysms, 386 � Common Diseases of Veins, 389 � Diseases of Lymphatics, 390 � Tumours and Tumour-like Lesions, 391: A. Benign Tumours and Hamartomas, 391; B. Intermediate Grade Tumours, 394; C. Malignant Tumours, 394
Chapter 14: The Heart 397 � Normal Structure and Classification, 397 � Heart Failure, 399: Etiology, 399; Types of Heart Failure, 399; Compensatory Mechanisms: Cardiac Hypertrophy and Dilatation, 400
� Congenital Heart Disease, 402: I. Malpositions of the Heart, 403; II. Shunts (Cyanotic Congenital Heart Disease), 403; III. Obstructions (Obstructive Congenital Heart Disease), 406
Chapter 16: The Eye, ENT and Neck 488 � Eye, 488: Congenital Lesions, 488; Inflammatory Conditions, 489; Vascular Lesions, 489; Miscellaneous Conditions, 491; Tumours and Tumour-like Lesions, 492
� Ear, 495: Inflammatory and Miscellaneous Lesions, 495; Tumours and Tumour-Like Lesions, 495 � Nose and Paranasal Sinuses, 496: Inflammatory Conditions, 496; Tumours, 498 � Pharynx, 499: Inflammatory Conditions, 499; Tumours, 499 � Larynx, 500: Inflammatory Conditions, 500; Tumours, 500 � Neck, 501: Cysts of Neck, 502; Tumours, 502
Chapter 17: The Oral Cavity and Salivary Glands 504 � Oral Soft Tissues, 504: Developmental Anomalies, 504; Mucocutaneous Lesions, 504; Inflammatory and Pigmentary Diseases, 504; Tumours and Tumour-like Lesions, 505
� Teeth and Periodontal Tissues, 509: Inflammatory Diseases, 510; Epithelial Cysts of the Jaw, 511; Odontogenic Tumours, 513
� Salivary Glands, 515: Inflammatory and Salivary Flow Diseases, 515; Tumours of Salivary Glands, 516
Chapter 18: The Gastrointestinal Tract 521 � Oesophagus, 521: Congenital Anomalies, 521; Muscular Dysfunctions, 521; Haematemesis of Oesophageal Origin, 522; Inflammatory Lesions, 523; Tumours of Oesophagus, 524
� Stomach, 526: Gastric Analysis, 527; Congenital and Miscellaneous Acquired Conditions, 529; Inflammatory Conditions, 529; Haematemesis and Melaena of Gastric Origin, 537; Tumours and Tumour-like Lesions, 537
� Small Intestine, 544: Congenital Anomalies and Intestinal Obstruction, 544; Ischaemic Bowel Disease (Ischaemic Enterocolitis), 546; Inflammatory Bowel Disease (Crohn’s Disease and Ulcerative Colitis), 548; Infective and Other Enterocolitis, 552; Malabsorption Syndrome, 556; Small Intestinal Tumours, 559
� Appendix, 561: Appendicitis, 561; Tumours of Appendix, 562 � Large Bowel, 563: Congenital and Other Miscellaneous Conditions, 563; Polyps and Tumours of Large Bowel, 566; Causes of Gastrointestinal Bleeding, 573
� Peritoneum, 574: Peritonitis, 574; Tumour-like Lesions and Tumours, 575
Chapter 19: The Liver, Biliary Tract and Exocrine Pancreas 577 � Liver, 577: Liver Function Tests, 578; Jaundice—General, 581; Neonatal Jaundice, 585; Hepatic Failure, 587; Circulatory Disturbances, 589; Viral Hepatitis, 590; Other Infections and Infestations, 599; Chemical and Drug Injury, 601; Cirrhosis, 603; Portal Hypertension, 615; Hepatic Tumours and Tumour-like Lesions, 617
xvChapter 21: The Male Reproductive System and Prostate 691 � Testis and Epididymis, 691: Developmental Disorders, 691; Inflammations, 692; Miscellaneous Lesions, 694; Testicular Tumours, 694
Chapter 23: The Breast 745 � Non-Neoplastic Conditions, 746: Inflammations, 746; Fibrocystic Change, 746; Gynaecomastia (Hypertrophy of Male Breast), 748
� Breast Tumours, 748: Fibroadenoma, 748; Phyllodes Tumour (Cystosarcoma Phyllodes), 749; Intraductal Papilloma, 749; Carcinoma of the Breast, 750
Chapter 24: The Skin 759 � Dermatoses, 760: I. Genetic Dermatoses, 760; II. Non-Infectious Inflammatory Dermatoses, 761; III. Infectious Dermatoses, 762; IV. Granulomatous Diseases, 765; V. Connective Tissue Dermatoses, 765; VI. Non-Infectious Bullous Dermatoses, 766; VII. Scaling Dermatoses, 768; VIII. Metabolic Diseases of Skin, 769
� Tumours and Tumour-like Lesions, 770: I. Tumours and Cysts of the Epidermis, 771; II. Adnexal (Appendageal) Tumours, 776; III. Melanocytic Tumours, 777; IV. Tumours of the Dermis, 779; V. Cellular Migrant Tumours, 780
Chapter 25: The Endocrine System 782 � Basic Concept of Endocrines, 782: Neuroendocrine System, 782; The Endocrine System, 782 � Pituitary Gland, 784: Hyperpituitarism, 784; Hypopituitarism, 785; Pituitary Tumours, 786 � Adrenal Gland, 787: Adrenocortical Hyperfunction (Hyperadrenalism), 788; Adrenocortical Insufficiency (Hypoadrenalism), 789; Tumours of Adrenal Glands, 790
Chapter 26: The Musculoskeletal System 821 � Skeletal System, 821: Infection, Necrosis, Fracture Healing, 822; Disorders of Bone Growth and Development, 825; Metabolic and Endocrine Bone Diseases, 826; Paget’s Disease of Bone (Osteitis Deformans), 828; Tumour-like Lesions of Bone, 829; Tumours of Bone and Cartilage, 831
Chapter 27: Soft Tissue Tumours 851 � General Features, 851 � Soft Tissue Tumours, 853: Tumours and Tumour-like Lesions of Fibrous Tissue, 853; Fibrohistiocytic Tumours, 855; Tumours of Adipose Tissue, 857; Skeletal Muscle Tumours, 859; Tumours of Uncertain Histogenesis, 861
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xvi Chapter 28: The Nervous System 863 � Central Nervous System, 863: Developmental Anomalies and Hydrocephalus, 865; Infections of CNS, 866; Cerebrovascular Diseases, 871; Miscellaneous Diseases, 875; Tumours of the CNS, 878
Appendix I: Basic Diagnostic Cytology 888 � Exfoliative Cytology, 889: I. Gynaecologic Exfoliative Cytology, 889; II. Non-Gynaecologic Exfoliative Cytology, 894; Techniques in Exfoliative Cytology, 897
� Interventional Cytology, 899: I. Fine Needle Aspiration Cytology, 899; II. Imprint Cytology, 905; III. Crush Smear Cytology, 905; IV. Biopsy Sediment Cytology, 905
Appendix II: Answers to Clinical Cases 906Preamble, 906
Appendix III: Normal Values 915 � Weights and Measurements of Normal Organs, 915 � Laboratory Values of Clinical Significance, 916