Universitat Internacional de Catalunya
General Pathological Anatomy
Other languages of instruction: Spanish
Teaching staff
Whenever students need it be requested via email to arrange meeting day and time.
COORDINATOR OF THE SUBJECT
María Teresa Fernández Figueras: mfernandezf@uic.es
TEACHERS
Francesc Alameda: 11669faq@gmail.com / falameda@uic.es
Analia Elguezabal: aelguezabal@uic.es
Isabel Trias: isabel.trias@hospitalplato.com / itrias@uic.es
Noelia Pérez: noelia.perez@quironsalud.es / nperez@uic.es
Noelia de la Torre: NDeLaTorre@cst.cat / ndelatorre@uic.es
Napoleón de la Ossa: napoleon.delaossa@gmail.com / ndelaossa@uic.es
Natalia Papaleo nfpapaleo@tauli.cat
Maria Teresa Fernández Figueras: mfernandezf@uic.es
Introduction
Anatomic pathology is the science that studies the causes and consequences of the disease, by analyzing the structural, functional, genetic and molecular changes in cells, tissues and organs, in correlation with the clinical presentation. Anatomic pathology provides the basis to understand the pathogenesis, clinical presentation, evolution and treatment of diseases and it is the discipline responsible of most of the diagnosis in tumor pathology and also in many non-neoplastic diseases.
The terms “Histopathology” or “Pathology” are often used as a synonym of anatomic pathology and the specialists in this area are denominated “Pathologists” or “Anatomopathologists”. Pathologists are much more than morphologists. Pathologist need to have a deep knowledge of the disease to be able to correlate morphomolecular findings with clinical information and radiology.
The subject of Anatomic Pathology includes General Pathology and Systemic Pathology. While General Pathology is focused in the study of basic cellular and tissue reactions in front of the disease (including neoplasia), Systemic Pathology analyzes the alterations specific of different cells, tissues and organs in front of the disease .
Pre-course requirements
Knowledge of cellular and molecular biology, anatomy and histology to recognize pathological changes in tissues and pathophysiology.
Objectives
- To recognise the histopathological changes (structural, histochemicals, immunohistochemistry and molecular) that allow to identify the different diseases and understand the structural and molecular processes that lead to the disease
- To know the correct management of the tissue samples taken for their anatomopathological study and the need to provide clinical information to study them
- To learn how to correlate clinical data and morfomolecular alterations, with practical cases that highlight its importance
- To learn the correct handling of the virtual microscope
- To get used to the Internet resources of Anatomic pathology.
Competences/Learning outcomes of the degree programme
- 06 - Develop professional practice with other health professionals, acquiring teamwork skills.
- 07 - Understand and recognise normal structure and function of the human body at the molecular, cellular, tissue, and organ and systemetic levels, at different stages of life and in both sexes.
- 09 - Understand and recognize the effects, mechanisms and manifestations of disease on the structure and function of the human body.
- 11 - Understand and recognize the effects of growth, development and aging on the individual and their social environment.
- 15 - Ability to formulate an initial diagnosis and establish a rationalised diagnostic strategy.
- 17 - Establish the diagnosis, prognosis and treatment, applying principles based on the best information possible and safe clinical practice..
- 27 - Recognize role in multidisciplinary teams, assuming leadership when appropriate, for the delivery of health care, such as interventions for health promotion.
- 31 - Understand, critically evaluate and know how to use sources of clinical and biomedical information to obtain, organize, interpret and communicate scientific and health care information.
- 32 - Know how to use information and communication technology in clinical, therapeutic, preventive health care and research.
- 36 - Be able to formulate hypotheses, collect and critically evaluate information for problem solving using the scientific method.
Learning outcomes of the subject
After completing the course the student should be able to:
- Identify key morphological changes associated with inflammatory diseases
- Identify key morphological changes associated with infectious diseases
- Identify key morphological changes associated with autoimmune diseases
- Identify key morphological changes associated with neoplastic diseases
- Using the virtual microscope and properly
- Interprete macroscopical and microscopical correlating them with the clinical settings of the patient
- Find and use relevant information in Internet Pathology.
Syllabus
THEORICAL AND PRACTICAL CLASSES
Introduction to Pathological Anatomy.
What is anatomic pathology? What do you do to a pathologist? (Surgical pathology, Necropsies, cytopathology, digital pathology) How is an anatomic pathology report prepared and how is it interpreted? History. Methods of study in human pathology: Surgical pathology (biopsies, surgical specimens, intraoperative biopsies), cytopathology (extensions, liquids, fine needle aspiration, thin layer cytology ), autopsic pathology , immunohistochemistry, molecular pathology. Role of anatomic pathology in today's medicine.
2. Cell adaptation and differentiation.
Mechanisms of cellular homeostasis. Cell adaptation to growth and differentiation. Physiological and pathological hyperplasia. Physiological and pathological hypertrophy. Physiological and pathological atrophy. Metaplasia.
3. Cell injury: necrosis and apoptosis.
Causes and mechanisms of cell injury. Morphology of cell lesions and necrosis. Injury from ischemia and hypoxia. Cellular injury mechanisms. Examples of cell injuries and necrosis. Apoptosis: Causes, morphological and molecular changes in apoptosis (programmed cell death)
4. Intracellular deposits. Cellular aging
Lipid deposits: Lipid change (fat degeneration). Cell injury due to alcohol. Intracellular protein deposits. Glycogen deposits. Pigments. Dystophic and metastatic calcification. Cellular aging.
5. Cell repair: Cell and tissue regeneration.
General aspects of tissue repair. Cell proliferation control. Proliferative capacity of tissues. Stem cells. The role of the extracellular matrix in repair. Tissue repair. The formation of a scar: Angiogenesis, activation of fibroblasts. Connective tissue repair. Scarring of wounds on the skin. Regeneration of different tissues
6. Hemodynamic disorders, thromboembolism and shock
Hyperemia and congestion. Etiotogenesis and edema: morphology. Bleeding. Thrombosis. Thrombi: Morphology and Evolution. Disseminated intravascular coagulation. Definition, types and consequences of embolism. Definition, causes, type, morphology and evolution of the infarction. Shock: types and stages.
7. Inflammation I: general concept and characteristics. Acute inflammation.
Concept of inflammation. Acute inflammation. Causes. Vascular and cellular changes. Chemotaxis. Main chemotactic agents. Phagocytosis. Injuries caused by leukocytes. Defects in the function of leukocytes. Morphological patterns of acute inflammation: Serous, fibrinous and suppurative inflammation. Abscess and ulcer. Inflammatory mediators.
8. Inflammation II: chronic and granulomatous inflammation
Evolution of acute inflammation: resolution and chronification. Chronic inflammation: Causes and types of inflammatory cells. Granulomatous inflammation: Types of cells that form granulomas. Types of granulomas.
9. Infectious diseases generalities and bacterial diseases.
Types of infectious agents. Transmission of infectious microorganisms. Inflammatory response patterns in infection. Infectious vasculitis. Examples of bacterial infections: pneumococcus, mycoobacteria, Treponema and Helicobacter pylori.
10. Infections caused by viruses, fungi, protozoa and helminths
Examples of viral infections: herpes simplex. Cytomegalovirus. Human papillomavirus. Epstein Barr Virus. Examples of fungal infections: Candida, Aspergillus, Mucor and Pneumocystis jirovecii. Examples of protozoal infections: Leishmania, Trichomona and Giardia.
11. Hypertensive vascular disease and arteriosclerosis.
Hypertensive vascular disease: arteriolosclerosis. Atherosclerosis: Epidemiology, morphology and complications.
12. Vascular cardiac pathology.
Ischemic disease. Hypertensive cardiopathy. Valvopathy. Cardiomyopathies. Myocarditis. Pericardial disease. Vascular tumors.
13. Hypersensitivity, autoimmune (I) and auto-inflammatory diseases.
Non-infectious vasculitis and arteritis. Hypersensitivity. Autoimmune and autoinflammatory
14. Autoimmune diseases (II). Rejection of transplants.
Disease related to IgG4. Rejection of transplantation. Graft versus host reaction.
15. Congenital and acquired immunodeficiency
Overview. Etiopatogenesis. AIDS-associated lesions. Neoplasms and associated infections.
16. Amyloidosis.
Amyloidosis: Pathogenesis and classification. Morphological injuries.
17. Neoplasms: Definitions and terminology. Epidemiology of cancer.
Neoplasms terminology. Characteristics of benign and malignancies. Epidemiology. Influence of the environment. Incidence. Geographical and environmental factors. Age. Hereditary cancer syndromes, family cancers, defects in DNA repair. Acquired preneoplastic diseases.
18. Molecular basis cancer (I).
Differentiation and Anaplasia. Growth rate. Local invasion. Metastasis. Diffusion routes. The multiple pathways of carcinogenesis. Oncogenes. Tumoral suppressors genes. Apoptosis and Cancer. Telomeres and Cancer. DNA repair. Karyotypic changes in tumors. Tumor cell kinetics.
19. Molecular basis cancer (II).
Differentiation and anaplasia. Growth rate. Local invasion. Metastasis. Diffusion routes. The multiple pathways of carcinogenesis. Oncogenes. Tumor suppressor genes. Apoptosis and cancer. Telomeres and cancer. DNA repair. Karynotypic changes in tumors. Tumor cell kinetics.
20. Molecular basis cancer (III): Biology of tumor growth.
Tumor angiogenesis. Progress and heterogeneity. Mechanisms of invasion and metastasis: Invasion of the extracellular matrix, vascular dissemination and molecular genetics. Fromhost's fensa against the tumor. Tumor antigens. Anti-tumor effector mechanisms.
21. Physical chemical and microbiological carcinogenesis.
Chemical carcinogenesis: initiation and promotion; Carcinogenic products. Radiation carcinogenesis: ultraviolet rays and ionizing radiation. Viral carcinogenesis: Oncogenic DNA and RNA of the oncogenic virus. Helicobacter pylori.
22. Diagnosis and prognosis of neoplasms.
Cancer Lab Diagnosis: histology, cytology, immunohistochemistry, electron microscopy, molecular biology, flow cytometry, tumor markers. Tumor grade and stage.
23. Endocrine pathology.
Overview of neoplastic and non-neoplastic endocrine disease
24. Pathology of the head and neck
Thyroid, parathyroid, salivary glands, synonasal and oropharingeal pathology
25. Chronic restrictive and obstructive lung pathology.
Type and morphology of chronic bronchitis, peripheral airway disease, emphysema, asthma and bronchiectasis. Infectious diseases. Pulmonary interstitial pathology.
26. Pulmonary and pleural neoplasms.
Incidence, classification, risk factors, morphology and prognosis of bronchopulmonary and pleural neoplasms.
27. Lymphoid pathology
General aspects of neoplastic and non-neoplastic lymphoid pathology
28. Renal pathology and urinary tract
Kidney tumors. Urothelial neoplasms. Prostate: Benign hyperplasia and carcinoma. Testicular neoplasms. Neoplasia of the penis.
29. Gynecological lesions and neoplasms (uterus and ovaries)
Uterine body: Endometriosis and adenomyosis, endometrial hyperplasia and endometrial carcinoma. Endometrial polyps. Smooth muscle tumors. Fallopiant break: Inflammation and neoplasm. Ovary: Ovarian cysts and neoplasms. Placenta diseases: inflammatory processes and trophoblastic disease
30. Gynecological lesions and neoplasms (cervix and vulva)
Vulva: lichen sclerosus, condyloma , carcinoma, extramamary Paget disease. Vulvar and vaginal cysts. Malignant vaginal neoplasia. Cervical neoplasia.
31. Proliferative lesions and benign breast tumors.
Benign breast pathology. Benign tumors: Fibroadenoma and intraductal papilloma. Phyllodes Tumor. Gynecomastia.
32. Malignant breast tumors
Carcinoma Epidemiology. Risk factors. Pathogenesis. Carcinoma in situ. Invasive carcinomas.
33. Skin pathology.
General aspects of neoplastic and inflammatory skin pathology.
34. Soft tissues, joints and bone lesions and tumors.
Overview of soft tissues and bone tumors. Non-neoplastic osteoarticular pathology.
35. Non-neoplasic neural pathology
Overview of non-neoplastic neuronal pathology
36. Neoplasms of the nervous system.
CNS neoplasms: gliomas. Neural tumors. Embrionary neoplasms. Meningiomas. Metastases. Tumors of the peripheral nervous system.
Master class: Pediatric Pathology. (2 hours)
Childhood diseases and tumors. Childhood diseases: perinatal infections, respiratory distress syndrome, neonatal enterocolitis, necrotizing enterocolitis, sudden infant death syndrome. Pediatric tumors.
PRACTICAL CLASSES
LG: How does a department of anatomic pathology work? visit to the Pathology Department of the Hospital Universitario General de Cataluña. Grupo Quironsalud
ABP1. Inflammation
ABP2. Lymphoid pathology
PBL3. Urology
ABP4 Gynecology and breast pathology
ABP5 Skin pathology
MC1. Integrated pathological anatomy (I). Study cases for students: Introduction and guidance of cases
MC2. Integrated pathological anatomy (II). Study cases for students. New information and follow-up. New information and follow-up. Work methodologies
MC3. Integrated pathological anatomy (III). Study cases for students. New information and follow-up. Microscopic aspects of infectious diseases.
MC4. Integrated pathological anatomy (IV). Study cases for students. Review of results
PL1 Microscopy. Cellular and vascular pathology
PL2. Microscopy. Pathology of acute and chronic inflammation
PL3. Microscopy. Tumor pathology I (macroscopy and tumor microscopy)
PL4. Microscopy. Tumor pathology II (integrated diagnosis of tumors)
PL5. Digestive pathology
PL6. Integrated pathological anatomy (V): Presentation of cases
Teaching and learning activities
In person
They will be performed:
On line synchronous through collaborate
In person- 36 hours of theoretical classes and a master class of 2 hours
- 2 hours of Laboratory skills consisting in the visit to the pathological anatomy service of the Hospital Universitari General de Catalunya
- 12 hours of laboratory practices
- 10 hours of learning based on problems
- 8 hours of Case Method
Microscopy PracticesPractices are performed with computers and it would be advisable to bring your own labtop
Evaluation systems and criteria
In person
Partial exam: 3 points. Subjects 1 to 18 (aproximately 40 theoretical and practical test questions). It does not exonerate the evaluation of this topics in the final exam.
Final exam: 7 points Subjects 1 to 36 (aproximately 80 theoretical and practical test questions).
To pass the subject, you must obtain at least 5 points between the partial and final exam.
Continuous evaluation: It can allow to increase the final qualifications up to 1 point for the students that passed the exam. It will be evaluated with questions at the end of the classes by the students who are there and the cases of the Laboratory practice with mandatory presence of 80% to be evaluated.
- All exams will be done with a computer. Incorrect answers will have a negative score.
- The repeating students will have to do both exams.
"Second-chance" evaluation July:
The exam will consist of theoretical and practical test questions of the whole subject, with negative punctuation. It will be done with computer and to pass the subject you must obtain 5 points out of 10
Wrong questions: -0.33 points
Bibliography and resources
- Kumar, Abbas, Aster. Robbins Patología Humana (10ª edición). Elsevier, Barcelona, 2018. Recommended book.
- Kumar, Abbas, Aster. Robbins y Cotran Patología Estructural y Funcional (9ª edición). Elsevier, Barcelona, 2015.
- Edward F. Goljan. Rapid Review Pathology. V edition. Elsevier. 2018.
Evaluation period
- E1 20/01/2023 14:00h