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
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
It is essential that the student has completed or be enrrolled in the following subjects:
- Biochemistry
- S&F of the Locomotor System
- Introduction to Medical Genetics
- S&F of the Nervous and Endocrine Integration Systems
- S&F Skin and Sense Organs
- Molecular Biology
- Cell Biology
- S&F Cardiovascular, Respiratory and Renal Systems
- S&F Blood and Immune System EiF: Digestive System
- S&F Digestive System and Metabolism
- S&F Reproductive System
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
THEORETICAL CLASSES
SESSION 1
1. Introduction to Pathological Anatomy.
What is Pathological Anatomy? What does a pathologist do? (Surgical, necropsy, cytopathology, digital pathology) What is an anatomopathological report like and how is it interpreted? Historical background. Study methods in human pathology: Surgical pathology (biopsies, surgical specimens, intraoperative biopsies), Cytopathology (smear, fluids, aspiration, thin-layer cytology), Autopsy pathology, Immunohistochemistry, Molecular pathology. Role of anatomical pathologyin current medicine.
2. Cell adaptation and differentiation.
Mechanisms of cellular homeostasis. Cellular adaptations of growth and differentiation. Physiological and pathological hyperplasia. Physiological and pathological hyperplasia. Physiological and pathological aplasia. Metaplasia.
SESSION 2
3. Cell injury and death: Necrosis and apoptosis.
Causes and mechanisms of cell injury. Lesion morphology and cell necrosis. Injury due to ischemia and hypoxia. Mechanisms of cell injury. Examples of cell injury and necrosis. Apoptosis: Causes, morphological and molecular changes of apoptosis (programmed cell death)
4. Intracellular deposits. Cell Aging
Lipid deposits: Fatty change (fat degeneration or metamorphosis). Alcohol cell injury. Intracellular protein deposits. Glycogen stores. Pigments. Dystrophic and metastatic calcification. Cellular aging.
SESSION 3
5. Cell repair: Cell and tissue regeneration.
Tissue repair overview. Control of cell proliferation. Proliferative capacity of tissues. Stem cells. Role of the extracellular matrix in repair. Tissue repair. Formation of a scar: Angiogenesis, fibroblast activation and connective tissue deposition. Connective tissue repair. Wound healing on the skin. Regeneration of different tissues
6. Hemodynamic, thromboembolic and shock disorders
Hyperemia and congestion. Etiopathogenesis and morphology of edema. Hemorrhage. Thrombosis. Morphology and the evolution of thrombi. Disseminated intravascular coagulation. Definition, types and consequences of embolism. Definition, causes, types, morphology and evolution of infarction. Crash. Stages of the clash.
SESSION 4
7. Inflammation I: Concept and general characteristics. Acute inflammation.
Concept of inflammation. Acute inflammation. Causes. Vascular and cellular changes. Chemotaxis. Main chemotactic agents. Phagocytosis. Lesions caused by leukocytes. Defects in leukocyte function. Morphological patterns of acute inflammation: Serous, fibrinous, and suppurative inflammation. Abscess and ulcer. Mediators of inflammation.
8. Inflammation II: Chronic and granulomatous inflammation
Evolution of acute inflammation: Resolution and chronification. Chronic inflammation: Causes and inflammatory cells. Granulomatous inflammation: The types of cells that make up granulomas. Types of granulomas.
SESSION 5
9. Infectious diseases: generalities and bacterial diseases.
Types of infectious agents. Transmission of infectious microorganisms. Patterns of inflammatory response to infection. Infectious vasculitis. Examples of bacterial infections: Pneumococcus, Mycobacteria, Treponema pallidus, and Helicobacter pylori.
10. Diseases 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, Mucormycosis and Pneumocystis jirovecii. Examples of protozoan infections: Leishmania, Trichomona, and Giardia.
SESSION 6
11. Hypertensive vascular disease and arteriosclerosis.
Hypertensive vascular disease: Arteriolosclerosis. Calcifying sclerosis of the stocking. Atherosclerosis: Epidemiology, morphology and complications.
12. Vascular and cardiac pathology.
Ischemic heart disease. Hypertensive heart disease. Valvular heart disease. Cardiomyopathies. Myocarditis. Pericardial disease. Benign and malignant vascular tumors.
SESSION 7
13. Autoimmune (I) and autoinflammatory hypersensitivity diseases.
Noninfectious vasculitis and arteritis. Hypersensitivity. Mechanisms and diseases. Autoimmune diseases. Autoinflammatory diseases.
14 Autoimmune diseases (II). Transplant rejection.
IgG4-related disease. Transplant rejection. Transplant reaction against the host.
SESSION 8
15. Congenital and acquired immunodeficiencies.
Types and general characteristics. Pathogenesis. Morphology of AIDS-associated lesions. Neoplasms and associated infections.
16. Amyloidosis.
Amyloidosis: Pathogenesis and classification. Morphology of lesions.
SESSION 9
17. Neoplasms: Definitions and terminology. Epidemiology of cancer.
Neoplasm terminology. Characteristics of benign and malignant neoplasms. Epidemiology. Influence of the environment. Incidence. Geographical and environmental factors. Age. Heredity: Hereditary cancer syndromes, familial cancers, DNA repair defects. Acquired preneoplastic diseases.
18. Molecular basis of cancer (I).
Differentiation and anaplasia. Growth rate. Local invasion. Metastasis. Routes of dissemination. The multiple pathways of carcinogenesis. Oncogenes. Nothing tumor suppressants. Apoptosis and cancer. Telomeres and cancer. DNA repair. Karyotypic changes in tumors. Tumor cell kinetics.
SESSION 10
19. Molecular basis of cancer (II).
Differentiation and anaplasia. Growth rate. Local invasion. Metastasis. Routes of dissemination. The multiple pathways of carcinogenesis. Oncogenes. Tumor suppressor genes. Apoptosis and cancer. Telomeres and cancer. DNA repair. Karyotypic changes in tumors. Tumor cell kinetics.
20. Molecular basis of cancer (III): Biology of tumor growth.
Tumor angiogenesis. Progression and heterogeneity. Mechanisms of invasion and metastasis: Invasion of the extracellular matrix, vascular dissemination, and molecular genetics. Graft-versus-host reaction. Tumor antigens. Antitumor effector mechanisms. Effects of the tumor on the host.
SESSION 11
21. Chemical, physical and microbial carcinogenesis.
Chemical carcinogenesis: initiation and promotion; carcinogens. Carcinogenesis by radiation: Ultraviolet rays and ionizing radiation. Viral carcinogenesis: DNA oncogenic viruses and RNA oncogenic viruses. Helicobacter pylori.
22. Diagnosis and prognosis of neoplasms
Cancer laboratory diagnosis: histology, cytology, immunohistochemistry, electron microscopy, molecular biology, flow cytometry, tumor markers. Grade and stage of tumors.
SESSION 12
23. Endocrine organ pathology
Overview of endocrine and non-neoplastic pathology
24. Head and neck pathology
Thyroid, parathyroid, salivary glands, sinonasal and oropharyngeal pathology
SESSION 13
Extraordinary Masterclass: Pediatric Pathology (2 hours)
Childhood diseases and tumors. Childhood diseases: perinatal infections, respiratory distress syndrome of the newborn, necrotizing enterocolitis, sudden infant death syndrome. Most common childhood tumors.
SESSION 14
25. Chronic and restrictive obstructive pulmonary disease.
Types and morphology of chronic bronchitis, peripheral airway disease, emphysema, asthma and bronchiectasis. Infectious diseases. Introduction to pulmonary interstitial pathology.
26. Pulmonary and pleural neoplasms.
Incidence, classification, risk factors, general morphological characteristics and prognosis of bronchopulmonary and pleural neoplasms.
SESSION 15
27. Lymphoid pathology
Overview of Neoplastic and Non-Neoplastic Lymphoid Pathology
28. Renal and urinary tract pathology
Renal tumors. Urothelial neoplasms. Prostate: Benign hyperplasia and carcinoma. Testicular neoplasms. Penile neoplasms.
SESSION 16
29. Gynecological lesions and neoplasms (uterine and ovaries)
Body of the uterus: Endometriosis and adenomyosis, Endometrial hyperplasia and endometrial carcinoma. Endometrial polyps. Smooth muscle tumors. Fallopian tube: Inflammation and neoplasms. Ovary: Ovarian cysts and neoplasms. Diseases of the placenta: Inflammatory processes and Trophoblastic disease
30. Gynecological lesions and neoplasms (cervix and vulva)
Vulva: Lichen sclerosus, Condylomas, carcinoma and extramammary paget's disease. Vulvar and vaginal cysts. Vaginal malignancies. Neoplasm of the cervix.
SESSION 17
31. Proliferative and benign tumor lesions of the breast.
Benign breast pathology. Benign tumors: Fibroadenoma and intraductal papilloma. Phyllodes tumor. Gynecomastia.
32. Malignant breast tumors
Epidemiology of carcinoma. Risk factors. Pathogenesis. Carcinoma in situ. Infiltrating carcinomas.
SESSION 18
33. Skin pathology.
General aspects of inflammatory and neoplastic skin pathology.
34. Soft tissue, joint and bone lesions and tumors.
Overview of soft tissue and bear tumors. non-neoplastic osteoarticular pathology.
SESSION 19
35. Non-neoplastic neural pathology
Overview of non-neoplastic neural pathology
36. Neoplasms of the nervous system
Nerve neoplasms: Gliomas. Neuronal tumors. Embryonic neoplasms. Meningiomas. Metastatic tumors. Peripheral nervous system tumors.
PRACTICAL CLASSES
Laboratories (LG)
- How is a Laboratory of anatomical pathology? Visit to the Anatomical pathology department at the Hospital General of Catalonia. Quirónsalud Group
Problem-Based Learning (ABP)
- ABP1. Inflammation
- ABP2. Infectious diseases
- ABP3. Urologic neoplasm
- ABP4 Lymphoid Pathology
- ABP5 Gynecology and Breast Pathology
- ABP6 Skin pathology
Case Method (MC)
- MC1. Integrated anatomical pathology(I). Clinicopathological cases: Introduction
- MC2. Integrated anatomical pathology (II). Clinicopathological cases: Group work of cases
- MC3. Integrated anatomical pathology (III). Clinicopathological cases: Exchange of knowledge (Presentation of results)
Laboratory practices (PL)
- 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 tumor diagnosis)
- PL5. Digestive pathology
- PL6. Integrated Anatomical pathology(V): Clinicopathological Cases: Work Methodologies in Pathological Anatomy
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
- 12 hours of learning based on problems
- 6 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
Midterm exam: 3.7 points. Topics 1 to 22 (approximately 80 theoretical-practical multiple-choice questions through the intranet). It does not exonerate to study these topics for the final exam.
Final exam: 6 points. The entire syllabus (approximately 80 theoretical-practical multiple-choice questions through the intranet)
Continuous evaluation in practical classes: Up to 0.3 points (0.1 points for each exam taken at the end of each of the sessions of the Method of the case)
To pass the subject it will be necessary:
- Obtain at least 5 points for the weighing between the midterm and final exam together with the continuous assessment of Method of the case
- Obtain at least 4.7 points out of 10 in the final exam.
INSTRUCTIONS
- IMPORTANT: In the exams, it is mandatory to identify yourself with the UIC card, DNI or passport ORIGINALS (NOT PHOTOCOPIES OR IN DIGITAL FORMAT)
- All exams will be done on a computer.
- Incorrect answers will have a negative score (0.33 points).
- Students repeating the subject can follow the subject normally or choose to take both exams, although the content of the methods of the case is included in the exam subject. For them, the final exam will weigh 7.4 points.
- Honors (MH) will be awarded to students with the best final grades. In the event that two students have the same grade and cannot be given both, the continuous assessment grade will be assessed.
Continuous assessment: it will allow students who have passed 5 out of 10 to improve the grade by up to 0.5 points. It will be evaluated with questions at the end of the classes by the students who are there and the cases of Laboratory practice with mandatory face-to-face attendance to at least two of them.
July retake exam: The exam will consist of theoretical and practical multiple-choice questions for the entire subject with a negative score. It will be done with a computer and to pass it will be necessary to get at least 5 out of 10
Bibliography and resources
- Kumar, Abbas, Aster. Robbins Patología Humana (11ª edición). Elsevier, Barcelona, 2024. Libro recomendado.
- Robbins Basic Pathology (10th Edition) Editors: Vinay Kumar, Abul K. Abbas, Jon C. Aster. 2017
- https://www.pathelective.com/
- https://webpath.med.utah.edu/
- https://www.pathologyoutlines.com/