Essentials of Rubin's Pathology

Cover\n......Page 1
Half-Title Page\n......Page 3
Title Page\n......Page 5
Copyright\n......Page 6
DEDICATION\n......Page 7
CONTRIBUTORS\n......Page 8
PREFACE\n......Page 11
ACKNOWLEDGMENTS\n......Page 12
TABLE OF CONTENTS\n......Page 13
Reactions to Persistent Stress and Cell Injury\n......Page 15
ATROPHY IS AN ACTIVE RESPONSE TO AN ALTERED ENVIRONMENT THAT RESULTS IN REDUCED FUNCTION OR SIZE OF CELLS OR ORGANS\n......Page 16
POSTMITOTIC CELLS MAY TURN OVER......Page 17
HYPERPLASIA IS AN INCREASE IN THE NUMBER OF CELLS IN AN ORGAN OR TISSUE......Page 19
METAPLASIA IS CONVERSION OF ONE DIFFERENTIATED CELL TYPE TO ANOTHER......Page 20
Mechanisms and Morphology of Cell Injury......Page 21
SUBCELLULAR CHANGES OCCUR IN REVERSIBLY INJURED CELLS......Page 22
OXIDATIVE STRESS LEADS TO CELL INJURY IN MANY ORGANS......Page 23
INTRACELLULAR STORAGE IS RETENTION OF MATERIALS WITHIN THE CELL......Page 25
How Exogenous Agents Injure Cells......Page 27
CHEMICALS INJURE CELLS DIRECTLY AND INDIRECTLY......Page 28
NECROTIC CELL DEATH RESULTS FROM EXOGENOUS CELL INJURY AND IS REFLECTED IN GEOGRAPHIC AREAS OF CELL DEATH......Page 29
APOPTOSIS, OR PROGRAMMED CELL DEATH, IS A SIGNALING MECHANISM BY WHICH CELLS COMMIT SUICIDE......Page 31
RECEPTOR–LIGAND INTERACTIONS AT THE CELL MEMBRANE TRIGGER EXTRINSIC APOPTOSIS......Page 32
RELEASE OF CA2+ FROM THE ENDOPLASMIC RETICULUM MAY TRIGGER APOPTOSIS......Page 34
Biologic Aging......Page 35
THE CELLULAR BASIS OF AGING......Page 36
SUMMARY HYPOTHESIS OF AGING......Page 38
Overview of Inflammation\n......Page 39
Acute Inflammation: Vascular Events\n......Page 40
HAGEMAN FACTOR IS A KEY SOURCE OF VASOACTIVE MEDIATORS......Page 42
COMPLEMENT IS ACTIVATED THROUGH THREE PATHWAYS TO FORM THE MEMBRANE ATTACK COMPLEX......Page 43
ARACHIDONIC ACID AND PLATELET-ACTIVATING FACTOR ARE DERIVED FROM MEMBRANE PHOSPHOLIPIDS......Page 45
PROSTANOIDS, LEUKOTRIENES AND LIPOXINS ARE BIOLOGICALLY ACTIVE METABOLITES OF ARACHIDONIC ACID......Page 46
CYTOKINES ARE CELL-DERIVED INFLAMMATORY HORMONES......Page 47
REACTIVE OXYGEN SPECIES ARE SIGNAL-TRANSDUCING, BACTERICIDAL AND CYTOTOXIC MOLECULES......Page 48
ENDOTHELIAL CELLS LINE BLOOD VESSELS......Page 49
MAST CELLS AND BASOPHILS ARE IMPORTANT IN ALLERGIC HYPERSENSITIVITY REACTIONS......Page 50
PLATELETS PLAY A ROLE IN NORMAL HEMOSTASIS......Page 51
LEUKOCYTE ADHESION TO ENDOTHELIUM RESULTS FROM THE INTERACTION OF COMPLEMENTARY ADHESION MOLECULES......Page 52
LEUKOCYTES PHAGOCYTOSE MICROORGANISMS AND TISSUE DEBRIS......Page 54
NEUTROPHIL ENZYMES ARE REQUIRED FOR ANTIMICROBIAL DEFENSE AND DEBRIDEMENT......Page 55
INFLAMMATORY CELLS HAVE OXIDATIVE AND NONOXIDATIVE BACTERICIDAL ACTIVITY......Page 56
TUMOR NECROSIS FACTOR RECEPTOR PATHWAYS......Page 57
CHRONIC INFLAMMATION......Page 58
CELLS FROM BOTH THE CIRCULATION AND AFFECTED TISSUES PLAY A ROLE IN CHRONIC INFLAMMATION......Page 59
Systemic Manifestations of Inflammation......Page 60
SHOCK IS CHARACTERIZED BY CARDIAC DECOMPENSATION......Page 61
MIGRATION OF CELLS INITIATES REPAIR......Page 63
EXTRACELLULAR MATRIX SUSTAINS THE REPAIR PROCESS\n......Page 65
STROMAL REMODELING IS CRITICAL TO REPAIR......Page 68
WOUND HEALING EXHIBITS A DEFINED SEQUENCE......Page 70
CELLS CAN BE CLASSIFIED BY THEIR PROLIFERATIVE POTENTIAL\n......Page 78
SPECIFIC SITES EXHIBIT DIFFERENT REPAIR PATTERNS......Page 79
WOUND REPAIR IS OFTEN SUBOPTIMAL......Page 82
THE CELLS THAT COMPRISE THE IMMUNE SYSTEM DERIVE FROM HEMATOPOIETIC STEM CELLS\n......Page 85
THE MAJOR HISTOCOMPATIBILITY COMPLEX COORDINATES INTERACTIONS AMONG IMMUNE CELLS\n......Page 91
TYPE I OR IMMEDIATE HYPERSENSITIVITY REACTIONS ARE TRIGGERED BY IgE BOUND TO MAST CELLS\n......Page 92
TYPE II HYPERSENSITIVITY REACTIONS ARE MEDIATED BY ANTIBODIES AGAINST FIXED CELLULAR OR EXTRACELLULAR ANTIGENS\n......Page 94
IN TYPE III HYPERSENSITIVITY REACTIONS IMMUNE COMPLEX DEPOSITION OR FORMATION IN SITU LEADS TO COMPLEMENT FIXATION AND INFLAMMATION\n......Page 95
TYPE IV, OR CELL-MEDIATED, HYPERSENSITIVITY REACTIONS ARE CELLULAR IMMUNE RESPONSES THAT DO NOT INVOLVE ANTIBODIES\n......Page 96
PRIMARY T-CELL IMMUNODEFICIENCY DISEASES TYPICALLY RESULT IN RECURRENT OR PROTRACTED VIRAL AND FUNGAL INFECTIONS\n......Page 98
AUTOIMMUNE DISEASES INVOLVE AN IMMUNE RESPONSE AGAINST SELF-ANTIGENS\n......Page 99
SYSTEMIC LUPUS ERYTHEMATOSUS IS A PROTOTYPICAL SYSTEMIC IMMUNE COMPLEX DISEASE\n......Page 100
SCLERODERMA (PROGRESSIVE SYSTEMIC SCLEROSIS) IS AN AUTOIMMUNE DISEASE OF CONNECTIVE TISSUE\n......Page 102
MIXED CONNECTIVE TISSUE DISEASE COMBINES FEATURES OF SLE, SCLERODERMA AND DERMATOMYOSITIS\n......Page 103
CHRONIC REJECTION APPEARS MONTHS TO YEARS AFTER TRANSPLANTATION\n......Page 104
HIV and AIDS......Page 105
IMMUNOLOGY OF AIDS......Page 106
ESSENTIALS 5: Neoplasia\n......Page 107
MALIGNANT TUMORS ARE MOSTLY CARCINOMAS OR SARCOMAS......Page 108
IMMUNOHISTOCHEMICAL TUMOR MARKERS ARE ANTIGENS THAT POINT TO THE ORIGIN OF NEOPLASMS......Page 110
Invasion and Metastasis......Page 111
DIRECT EXTENSION DAMAGES THE INVOLVED ORGAN AND ADJACENT TISSUES......Page 113
METASTATIC SPREAD IS THE MOST COMMON CAUSE OF CANCER DEATH......Page 114
INVASION AND METASTASIS ARE MULTISTEP EVENTS......Page 115
CANCER STAGING REFERS TO THE EXTENT OF SPREAD......Page 117
MOST TUMORS ARE HETEROGENEOUS IN THEIR APPEARANCE AND CELLULAR COMPOSITION......Page 118
TUMOR ANGIOGENESIS REFERS TO THE SPROUTING OF NEW CAPILLARIES......Page 119
The Molecular Genetics of Cancer......Page 121
FAILURE OF DNA REPAIR AND GENOMIC INSTABILITY CONTRIBUTE TO CANCER DEVELOPMENT......Page 122
ONCOGENES ARE COUNTERPARTS OF NORMAL GENES......Page 123
TUMOR SUPPRESSOR GENES NEGATIVELY REGULATE CELL GROWTH......Page 126
EPIGENETIC MECHANISMS MAY BOTH IMPEDE AND FOSTER TUMOR DEVELOPMENT......Page 128
DISTURBANCES IN PROGRAMMED CELL DEATH PLAY KEY ROLES IN ONCOGENESIS......Page 129
DNA VIRUSES ENCODE PROTEINS THAT BIND REGULATORY PROTEINS......Page 130
CHEMICAL CARCINOGENESIS IS A MULTISTEP PROCESS......Page 131
UV RADIATION CAUSES SKIN CANCERS......Page 132
Systemic Effects of Cancer on The Host......Page 133
Epidemiology of Cancer......Page 134
GEOGRAPHIC AND ETHNIC DIFFERENCES INFLUENCE CANCER INCIDENCE......Page 135
STUDIES OF MIGRANT POPULATIONS GIVE CLUES TO CANCER DEVELOPMENT......Page 136
Magnitude of the Problem......Page 137
Errors of Morphogenesis......Page 138
Clinically Important Malformations......Page 139
FETAL ALCOHOL SYNDROME DEMONSTRATES THE TERATOGENIC POTENTIAL OF COMMON CHEMICALS......Page 140
Chromosomal Abnormalities......Page 141
STRUCTURAL CHROMOSOMAL ABNORMALITIES MAY ARISE DURING SOMATIC CELL DIVISION (MITOSIS) OR DURING GAMETOGENESIS (MEIOSIS)......Page 142
THE CAUSES OF ABNORMAL CHROMOSOME NUMBERS ARE LARGELY UNKNOWN......Page 143
NUMERICAL AUTOSOMAL ABERRATIONS IN LIVEBORN INFANTS ARE VIRTUALLY ALL TRISOMIES......Page 144
ADDITIONAL SEX CHROMOSOMES PRODUCE LESS SEVERE DISEASE THAN DO EXTRA AUTOSOMES......Page 146
AUTOSOMAL DOMINANT DISORDERS ARE EXPRESSED IN HETEROZYGOTES......Page 148
HERITABLE DISEASES OF CONNECTIVE TISSUE ARE HETEROGENEOUS AND OFTEN INHERITED AS AUTOSOMAL DOMINANT TRAITS......Page 149
NEUROFIBROMATOSIS INCLUDES TWO DISTINCT AUTOSOMAL DOMINANT DISORDERS THAT FEATURE BENIGN TUMORS OF PERIPHERAL NERVES......Page 150
AUTOSOMAL RECESSIVE DISORDERS CAUSE SYMPTOMS IN HOMOZYGOUS PEOPLE......Page 151
CYSTIC FIBROSIS IS A CHANNELOPATHY THAT IS THE MOST COMMON LETHAL AUTOSOMAL RECESSIVE DISEASE IN WHITES......Page 152
LYSOSOMAL STORAGE DISEASES ARE CHARACTERIZED BY THE ACCUMULATION OF UNMETABOLIZED NORMAL SUBSTRATES......Page 154
INBORN ERRORS OF AMINO ACID METABOLISM MANIFEST WITH VARIABLY SEVERE SYMPTOMATOLOGY......Page 157
AN X-LINKED DISORDER FEATURES AN ABNORMAL GENE ON THE X CHROMOSOME......Page 158
SOME DISEASES ARE ASSOCIATED WITH NON-MENDELIAN PATTERNS OF INHERITANCE......Page 160
CLEFT LIP AND CLEFT PALATE EXEMPLIFY MULTIFACTORIAL INHERITANCE......Page 161
NEONATAL RESPIRATORY DISTRESS SYNDROME IS DUE TO DEFICIENCY OF SURFACTANT......Page 162
BIRTH INJURY SPANS THE SPECTRUM FROM MECHANICAL TRAUMA TO ANOXIC DAMAGE......Page 164
BENIGN TUMORS AND TUMOR-LIKE CONDITIONS ENCOMPASS A WIDE RANGE OF ABNORMALITIES......Page 166
MALIGNANCIES IN THE PEDIATRIC AGE GROUP ARE UNCOMMON......Page 167
HYPEREMIA IS AN EXCESS OF BLOOD IN AN ORGAN......Page 169
HEMORRHAGE IS A DISCHARGE OF BLOOD OUT OF THE VASCULAR COMPARTMENT......Page 170
THROMBOSIS IN THE ARTERIAL SYSTEM IS USUALLY DUE TO ATHEROSCLEROSIS......Page 171
THROMBOSIS IN THE HEART DEVELOPS ON THE ENDOCARDIUM......Page 172
PULMONARY ARTERIAL EMBOLISM IS COMMON AND IS POTENTIALLY FATAL......Page 173
SYSTEMIC ARTERIAL EMBOLISM OFTEN CAUSES INFARCTS......Page 174
Infarction......Page 176
THE MECHANISMS OF EDEMA FORMATION ALTER THE EQUILIBRIUM OF FLUID BETWEEN THE VASCULATURE AND INTERSTITIUM......Page 177
PULMONARY EDEMA FEATURES INCREASED FLUID IN THE ALVEOLAR SPACES AND INTERSTITIUM OF THE LUNG......Page 178
THE NEPHROTIC SYNDROME REFLECTS MASSIVE PROTEINURIA......Page 180
Shock......Page 181
SYSTEMIC INFLAMMATORY RESPONSE SYNDROME CHARACTERIZES SEPTIC SHOCK......Page 182
MULTIPLE ORGAN DYSFUNCTION SYNDROME IS THE END RESULT OF SHOCK......Page 184
CARDIOVASCULAR DISEASE IS A MAJOR COMPLICATION OF SMOKING......Page 187
CANCER OF THE LUNG IS LARGELY A DISEASE OF CIGARETTE SMOKERS......Page 188
ENVIRONMENTAL TOBACCO SMOKE MAY PRODUCE A VARIETY OF DISEASES IN NONSMOKERS......Page 189
ALCOHOL INGESTION AFFECTS ORGANS AND TISSUES......Page 190
ILLICIT DRUGS ARE RESPONSIBLE FOR MANY PATHOLOGIC SYNDROMES......Page 191
Hormonal Contraceptives......Page 192
TOXIC EFFECTS DIFFER FROM HYPERSENSITIVITY RESPONSES......Page 193
HYPERTHERMIA MEANS AN INCREASE IN BODY TEMPERATURE......Page 198
Radiation......Page 200
WHOLE-BODY IRRADIATION INJURES MANY ORGANS......Page 201
LOCALIZED RADIATION INJURY COMPLICATES RADIATION THERAPY FOR TUMORS......Page 202
PROTEIN-CALORIE MALNUTRITION REFLECTS STARVATION OR SPECIFIC DEFICIENCIES......Page 203
VITAMINS ARE ORGANIC CATALYSTS THAT ARE BOTH REQUIRED FOR NORMAL METABOLISM AND AVAILABLE ONLY FROM DIETARY SOURCES......Page 204
ESSENTIAL TRACE MINERALS ARE MOSTLY COMPONENTS OF ENZYMES AND COFACTORS......Page 208
ESSENTIALS 9: Infectious and Parasitic Diseases\n......Page 209
Host Defense Mechanisms......Page 210
Viral Infections......Page 211
INFLUENZA VIRUS IS A HIGHLY CONTAGIOUS EPIDEMIC DISEASE......Page 212
MEASLES (RUBEOLA) IS A HIGHLY CONTAGIOUS VIRUS THAT MAY CAUSE FATAL INFECTION......Page 213
Viral Hemorrhagic Fevers......Page 214
WEST NILE VIRUS (WNV) IS SPREAD BY MOSQUITO VECTORS AND BIRDS......Page 215
HIV IS TRANSMITTED BY CONTACT WITH BLOOD AND CERTAIN BODY FLUIDS......Page 216
OPPORTUNISTIC INFECTIONS, PARTICULARLY POLYMICROBIAL INFECTIONS, ARE COMMON IN PATIENTS WITH AIDS......Page 217
HERPES VIRUSES......Page 219
EPSTEIN-BARR VIRUS (EBV) IS THE CAUSE OF INFECTIOUS MONONUCLEOSIS\n......Page 221
Human Papillomavirus (HPV)......Page 223
PYOGENIC GRAM-POSITIVE COCCI......Page 224
DIPHTHERIA IS A NECROTIZING UPPER RESPIRATORY TRACT INFECTION......Page 227
NEISSERIA MENINGITIDIS CAUSES PYOGENIC MENINGITIS AND OVERWHELMING SHOCK......Page 228
ESCHERICHIA COLI IS A COMMON CAUSE OF DIARRHEA AND URINARY TRACT INFECTIONS......Page 229
CHOLERA IS AN EPIDEMIC ENTERITIS USUALLY ACQUIRED FROM CONTAMINATED WATER......Page 231
CAMPYLOBACTER JEJUNI IS THE MOST COMMON CAUSE OF BACTERIAL DIARRHEA IN THE DEVELOPED WORLD......Page 232
BOTULISM IS A PARALYZING DISEASE DUE TO C. BOTULINUM NEUROTOXIN......Page 233
YERSINIA PESTIS CAUSES BUBONIC PLAGUE, THE MEDIEVAL “BLACK DEATH”......Page 235
LISTERIOSIS IS A SYSTEMIC MULTIORGAN INFECTION THAT CARRIES A HIGH MORTALITY......Page 236
Spirochetal Infections......Page 237
SYPHILIS......Page 238
CHLAMYDIA TRACHOMATIS INFECTION......Page 240
Rickettsial Infections......Page 241
Mycoplasmal Infections: Mycoplasma Pneumonia......Page 242
TUBERCULOSIS......Page 243
PNEUMOCYSTIS JIROVECI PNEUMONIA......Page 246
CRYPTOCOCCOSIS......Page 248
COCCIDIOIDOMYCOSIS......Page 250
BLASTOMYCOSIS......Page 251
MALARIA......Page 252
TOXOPLASMOSIS......Page 254
CRYPTOSPORIDIOSIS......Page 255
LEISHMANIASIS......Page 257
AFRICAN TRYPANOSOMIASIS......Page 259
FILARIAL NEMATODES......Page 260
INTESTINAL NEMATODES......Page 261
TISSUE NEMATODES: TRICHINELLOSIS......Page 263
TREMATODES (FLUKES)......Page 264
CESTODES: INTESTINAL TAPEWORMS......Page 266
BLOOD COAGULATION OCCURS WHEN FIBRINOGEN IS CONVERTED TO FIBRIN......Page 269
PLATELET ADHESION AND AGGREGATION OCCUR AFTER INJURY TO A BLOOD VESSEL......Page 270
ENDOTHELIAL FACTORS REGULATE BOTH ANTICOAGULANT AND PROCOAGULANT PROCESSES......Page 271
THE PATHOGENESIS OF ATHEROSCLEROSIS IS BASED ON A UNIFYING HYPOTHESIS......Page 272
LIPID METABOLISM IS THE MAJOR FACTOR IN ATHEROSCLEROSIS......Page 278
SEVERAL HERITABLE DYSLIPOPROTEINEMIAS ARE NOW RECOGNIZED......Page 279
Hypertensive Vascular Disease......Page 280
ACQUIRED CAUSES OF HYPERTENSION......Page 283
Vasculitis......Page 284
LARGE-VESSEL VASCULITIS IS ASSOCIATED WITH GRANULOMATOUS INFLAMMATION......Page 285
MEDIUM-SIZED VESSEL VASCULITIS IS CHARACTERIZED BY NECROTIZING VASCULITIS......Page 286
SMALL-VESSEL VASCULITIS IS ASSOCIATED WITH EITHER IMMUNE COMPLEXES OR IS “PAUCI-IMMUNE”......Page 287
Aneurysms......Page 288
ANEURYSMS OF CEREBRAL ARTERIES LEAD TO SUBARACHNOID HEMORRHAGE......Page 289
DISSECTING ANEURYSM IS A HEMATOMA OF THE AORTIC WALL......Page 290
VARICOSE VEINS OF THE LEGS INVOLVE THE SUPERFICIAL SAPHENOUS SYSTEM......Page 291
HEMANGIOMAS ARE COMMON BENIGN TUMORS OF VASCULAR CHANNELS......Page 292
Malignant Tumors of Blood Vessels......Page 293
KAPOSI SARCOMA IS A COMPLICATION OF ACQUIRED IMMUNODEFICIENCY SYNDROME......Page 294
Coronary Arteries Supply Blood to the Heart......Page 295
Myocardial Hypertrophy and Heart Failure......Page 297
EARLY LEFT-TO-RIGHT SHUNT REFLECTS HIGHER PRESSURE ON THE LEFT SIDE OF THE HEART......Page 300
TETRALOGY OF FALLOT (DOMINANT RIGHT-TO-LEFT SHUNT) IS THE MOST COMMON CYANOTIC CHD......Page 303
CONGENITAL HEART DISEASES WITHOUT SHUNTS INVOLVE VARIOUS CARDIOVASCULAR SITES......Page 304
Ischemic Heart Disease......Page 306
MYOCARDIAL INFARCTS MAY BE MAINLY SUBENDOCARDIAL OR TRANSMURAL......Page 308
COMPLICATIONS OF MYOCARDIAL INFARCTION INFLUENCE THE CLINICAL COURSE......Page 311
THERAPEUTIC INTERVENTIONS LIMIT INFARCT SIZE......Page 312
EFFECTS OF HYPERTENSION ON THE HEART......Page 313
RHEUMATIC HEART DISEASE ENCOMPASSES ACUTE MYOCARDITIS AND RESIDUAL VALVULAR DEFORMITIES......Page 314
BACTERIAL ENDOCARDITIS REFERS TO INFECTION OF THE CARDIAC VALVES......Page 318
CALCIFIC AORTIC STENOSIS REFLECTS CHRONIC DAMAGE TO THE VALVE......Page 319
MITRAL VALVE PROLAPSE (MVP) IS THE MOST COMMON INDICATION FOR VALVE REPLACEMENT......Page 320
VIRAL MYOCARDITIS MAY BE DIFFICULT TO DEMONSTRATE......Page 321
Cardiomyopathy......Page 322
SECONDARY DILATED CARDIOMYOPATHY HAS MANY CAUSES......Page 323
ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY (ARVC) IS A DISEASE OF THE DESMOSOME WITH A HIGH RISK OF SUDDEN DEATH......Page 324
RESTRICTIVE CARDIOMYOPATHY IMPAIRS DIASTOLIC FUNCTION......Page 325
METASTATIC TUMORS TO THE HEART MAY MANIFEST AS RESTRICTIVE CARDIOMYOPATHY......Page 327
ACUTE PERICARDITIS MAY FOLLOW VIRAL INFECTIONS......Page 328
CONSTRICTIVE PERICARDITIS MAY MIMIC RIGHT HEART FAILURE......Page 329
CONGENITAL ANOMALIES......Page 331
DISEASES OF THE BRONCHI AND BRONCHIOLES......Page 332
BACTERIAL INFECTIONS......Page 335
DIFFUSE ALVEOLAR DAMAGE (ACUTE RESPIRATORY DISTRESS SYNDROME [ARDS])......Page 340
CHRONIC OBSTRUCTIVE PULMONARY DISEASES......Page 342
PNEUMOCONIOSES......Page 348
INTERSTITIAL LUNG DISEASE......Page 352
PULMONARY HYPERTENSION......Page 356
CARCINOMA OF THE LUNG......Page 358
PNEUMOTHORAX......Page 362
PLEURAL EFFUSION......Page 363
TUMORS OF THE PLEURA: MALIGNANT MESOTHELIOMA......Page 364
CONGENITAL DISORDERS......Page 365
MOTOR DISORDERS......Page 366
HIATAL HERNIA......Page 367
ESOPHAGITIS......Page 368
NEOPLASMS......Page 370
CONGENITAL DISORDERS: CONGENITAL PYLORIC STENOSIS......Page 371
GASTRITIS......Page 372
PEPTIC ULCER DISEASE......Page 374
MALIGNANT TUMORS......Page 378
CONGENITAL DISORDERS......Page 380
VASCULAR DISEASES OF THE SMALL INTESTINE......Page 381
MALABSORPTION......Page 382
NEOPLASMS......Page 386
CONGENITAL DISORDERS......Page 388
INFECTIONS OF THE LARGE INTESTINE......Page 389
DIVERTICULAR DISEASE......Page 390
INFLAMMATORY BOWEL DISEASE......Page 391
POLYPS OF THE COLON AND RECTUM......Page 396
MALIGNANT TUMORS......Page 401
NEOPLASMS OF THE APPENDIX......Page 403
NEOPLASMS OF THE PERITONEUM......Page 404
ESSENTIALS 14: The Liver and Biliary System\n......Page 405
BILIRUBIN IS THE END PRODUCT OF HEME CATABOLISM......Page 406
DECREASED TRANSPORT OF CONJUGATED BILIRUBIN OFTEN INVOLVES MUTATIONS IN THE MULTIDRUG RESISTANCE PROTEIN FAMILY......Page 407
IMPAIRED CANALICULAR BILE FLOW ACCOMPANIED BY VISIBLE BILIARY PIGMENT (CHOLESTASIS) REFLECTS EITHER EXTRAHEPATIC OR INTRAHEPATIC BILIARY OBSTRUCTION......Page 409
Cirrhosis......Page 410
HEPATIC ENCEPHALOPATHY REFERS TO NEUROLOGIC SIGNS AND SYMPTOMS OF LIVER FAILURE......Page 412
Portal Hypertension......Page 413
SINUSOIDAL OR INTRAHEPATIC PORTAL HYPERTENSION IS USUALLY CAUSED BY CIRRHOSIS......Page 414
PORTAL HYPERTENSION LEADS TO SYSTEMIC COMPLICATIONS......Page 415
Viral Hepatitis......Page 416
HEPATITIS B VIRUS IS A MAJOR CAUSE OF ACUTE AND CHRONIC LIVER DISEASE......Page 417
HEPATITIS D VIRUS IS A DEFECTIVE RNA VIRUS......Page 418
HEPATITIS E VIRUS IS A MAJOR CAUSE OF EPIDEMICS OF HEPATITIS IN UNDERDEVELOPED COUNTRIES......Page 420
ACUTE HEPATITIS IS MORPHOLOGICALLY SIMILAR IN ALL FORMS OF VIRAL HEPATITIS......Page 421
CHRONIC HEPATITIS IS A COMPLICATION OF HEPATITIS B AND C AND OF A NUMBER OF METABOLIC AND IMMUNE DISORDERS......Page 423
FATTY LIVER IS FOUND IN VIRTUALLY ALL CHRONIC ALCOHOLICS......Page 424
ALCOHOLIC CIRRHOSIS IS A RESULT OF REPEATED LIVER INJURY, FIBROSIS AND REGENERATION......Page 425
Primary Biliary Cirrhosis......Page 426
HEREDITARY HEMOCHROMATOSIS IS A COMMON DISORDER OF IRON METABOLISM......Page 428
SECONDARY IRON-OVERLOAD SYNDROMES OCCUR IN PERSONS WHO DO NOT CARRY THE GENE FOR HH......Page 429
α1 -ANTITRYPSIN DEFICIENCY LEADS TO CIRRHOSIS......Page 430
Drug-Induced Liver Injury......Page 431
HISTOLOGIC PATTERNS OF DRUG-INDUCED LIVER DISEASE ARE EXCEEDINGLY DIVERSE......Page 432
SHOCK RESULTS IN DECREASED PERFUSION OF THE LIVER......Page 433
BILIARY ATRESIA REFERS TO THE LACK OF A LUMEN IN THE BILIARY TREE......Page 434
HEPATIC ADENOMAS ARE BENIGN TUMORS OF HEPATOCYTES THAT OCCUR PRINCIPALLY IN WOMEN......Page 435
HEPATOCELLULAR CARCINOMA IS A MALIGNANT TUMOR THAT DERIVES FROM HEPATOCYTES OR THEIR PRECURSORS......Page 436
Cholelithiasis......Page 438
CHOLESTEROL STONES ARE THE MOST COMMON GALLSTONES......Page 439
Acute Cholecystitis......Page 440
CARCINOMA OF THE BILE DUCT AND THE AMPULLA OF VATER PRESENT AS OBSTRUCTIVE JAUNDICE......Page 441
Acute Pancreatitis......Page 443
Chronic Pancreatitis......Page 444
MOST (~85%) PANCREATIC TUMORS IN ADULTS ARE INFILTRATING DUCTAL ADENOCARCINOMAS......Page 447
THE ISLETS OF LANGERHANS FORM THE ENDOCRINE PANCREAS......Page 449
PANCREATIC NEUROENDOCRINE TUMORS (PanNETs) COMPRISE ABOUT 5% OF PANCREATIC NEOPLASMS......Page 451
ESSENTIALS 16: The Kidney\n......Page 453
RENAL ECTOPIA IS A NORMAL KIDNEY IN AN ABNORMAL LOCATION......Page 454
AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE (ADPKD) FEATURES ENLARGED MULTICYSTIC KIDNEYS......Page 455
AUTOSOMAL RECESSIVE POLYCYSTIC KIDNEY DISEASE (ARPKD) OCCURS IN INFANTS......Page 456
Glomerular Diseases......Page 457
NEPHROTIC SYNDROME FEATURES SEVERE PROTEINURIA......Page 458
GLOMERULAR INFLAMMATION IS MOST FREQUENTLY MEDIATED BY IMMUNE MECHANISMS......Page 459
MINIMAL-CHANGE GLOMERULOPATHY CAUSES NEPHROTIC SYNDROME......Page 461
FOCAL SEGMENTAL GLOMERULOSCLEROSIS (FSGS) IS A FEATURE OF MULTIPLE DISEASE PROCESSES......Page 462
MEMBRANOUS GLOMERULOPATHY IS AN IMMUNE COMPLEX DISEASE......Page 463
AMYLOIDOSIS CAUSES NEPHROTIC SYNDROME AND RENAL FAILURE......Page 465
ACUTE POSTINFECTIOUS GLOMERULONEPHRITIS IS AN IMMUNE COMPLEX DISEASE OF CHILDHOOD......Page 466
TYPE I MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS (MPGN) IS A CHRONIC IMMUNE COMPLEX DISEASE......Page 467
TYPE II MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS (DENSE DEPOSIT DISEASE) FEATURES COMPLEMENT DEPOSITION......Page 468
LUPUS GLOMERULONEPHRITIS INCLUDES DIVERSE PATTERNS OF IMMUNE COMPLEX DEPOSITION......Page 469
ANTI-GLOMERULAR BASEMENT MEMBRANE GLOMERULONEPHRITIS IS OFTEN ASSOCIATED WITH PULMONARY HEMORRHAGE......Page 470
RENAL VASCULITIS MAY AFFECT VESSELS OF ALL SIZES......Page 472
HYPERTENSIVE NEPHROSCLEROSIS (BENIGN NEPHROSCLEROSIS) OBLITERATES GLOMERULI......Page 473
MALIGNANT HYPERTENSIVE NEPHROPATHY IS POTENTIALLY FATAL......Page 474
THROMBOTIC MICROANGIOPATHIES CAUSE HEMOLYTIC ANEMIA AND RENAL FAILURE......Page 475
ACUTE TUBULAR NECROSIS (ATN) CAUSES ACUTE RENAL FAILURE......Page 476
PYELONEPHRITIS REFERS TO BACTERIAL INFECTION OF THE KIDNEY......Page 478
ANALGESIC NEPHROPATHY RESULTS FROM CHRONIC OVERCONSUMPTION OF ANALGESICS......Page 480
LIGHT-CHAIN CAST NEPHROPATHY MAY COMPLICATE MULTIPLE MYELOMA......Page 481
Obstructive Uropathy and Hydronephrosis......Page 482
WILMS TUMOR (NEPHROBLASTOMA) IS COMPOSED OF EMBRYONAL ELEMENTS......Page 483
RENAL CELL CARCINOMA (RCC) IS THE MOSTCOMMON PRIMARY CANCER OF THE KIDNEY......Page 484
TRANSITIONAL CELL CARCINOMA......Page 485
Congenital Disorders......Page 487
Cystitis......Page 488
Benign Proliferative and Metaplastic Urothelial Lesions......Page 490
Tumors of the Urinary Bladder......Page 491
UROTHELIAL (TRANSITIONAL CELL) PAPILLOMA IS A BENIGN LESION......Page 492
UROTHELIAL CARCINOMAS VARY FROM SUPERFICIAL PAPILLARY TUMORS TO DEEPLY INVASIVE ONES......Page 493
Scrotal Masses......Page 495
Inflammatory Disorders......Page 496
Cancer of the Penis......Page 497
Cryptorchidism......Page 498
Tumors of the Testis......Page 499
SEMINOMA CONTAINS MONOMORPHOUS CELLS THAT RESEMBLE SPERMATOGONIA......Page 501
NONSEMINOMATOUS GERM CELL TUMORS (NSGCTs) ARE DERIVED FROM EMBRYONAL CELLS......Page 502
Prostatitis......Page 503
Nodular Hyperplasia of the Prostate......Page 504
Adenocarcinoma and Precursor Lesions......Page 505
ESSENTIALS 18: The Female Reproductive System\n......Page 511
SEXUALLY TRANSMITTED GENITAL INFECTIONS......Page 512
VULVAR INTRAEPITHELIAL NEOPLASIA (VIN) IS A PRECURSOR OF INVASIVE CANCER......Page 515
PAGET DISEASE OF THE VULVA APPEARS SIMILAR TO THAT OF THE NIPPLE......Page 516
CERVICAL INTRAEPITHELIAL NEOPLASIA (CIN) IS THE PRECURSOR OF INVASIVE CANCER......Page 517
MICROINVASIVE SQUAMOUS CELL CARCINOMA IS THE EARLIEST STAGE OF INVASIVE CERVICAL CANCER......Page 519
INVASIVE SQUAMOUS CELL CARCINOMA (SCC) IS STILL COMMON WORLDWIDE......Page 520
ENDOCERVICAL ADENOCARCINOMA ACCOUNTS FOR ONE FIFTH OF CERVICAL CANCERS......Page 521
The Menstrual Cycle......Page 522
Endometriosis......Page 523
ENDOMETRIAL POLYPS ARE BENIGN STROMAL NEOPLASMS......Page 524
BENIGN ENDOMETRIAL HYPERPLASIA IS CAUSED BY EXCESSIVE ESTROGENIC STIMULATION......Page 525
ENDOMETRIAL INTRAEPITHELIALNEOPLASIA (EIN) IS A PRECURSOR TO ADENOCARCINOMA......Page 526
LEIOMYOMA IS THE MOST COMMON TUMOR OF THE FEMALE GENITAL TRACT......Page 529
Salpingitis......Page 530
Polycystic Ovary Syndrome......Page 531
EPITHELIAL TUMORS ACCOUNT FOR MORETHAN 60% OF OVARIAN CANCERS......Page 532
GERM CELL TUMORS TEND TO BE BENIGN IN ADULTS AND MALIGNANT IN CHILDREN......Page 537
SEX CORD/STROMAL TUMORS ARE CLINICALLY FUNCTIONAL......Page 538
TUMORS METASTATIC TO THE OVARY MAY MIMIC A PRIMARY TUMOR......Page 539
Preeclampsia and Eclampsia......Page 540
COMPLETE HYDATIDIFORM MOLE DOES \nNOT CONTAIN AN EMBRYO......Page 541
GESTATIONAL CHORIOCARCINOMA IS A MALIGNANT TUMOR DERIVED FROM FETAL \nTROPHOBLAST......Page 543
PROLIFERATIVE BREAST DISEASE INCREASES THE RISK OF INVASIVE \nCARCINOMA......Page 545
PROLIFERATIVE DISEASE WITH ATYPIA IS A HIGH-\nRISK PRECURSOR TO CARCINOMA......Page 547
FIBROADENOMA IS A BENIGN TUMOR WITH EPITHELIAL AND STROMAL COMPONENTS......Page 548
Carcinoma of the Breast......Page 549
CARCINOMA IN SITU IS A PRECURSOR OF \nINVASIVE CARCINOMA......Page 550
INVASIVE BREAST CARCINOMA......Page 552
PROGNOSTIC FACTORS IN BREAST CANCER  REMAIN TO BE DEFINED CLEARLY......Page 554
CARCINOMA OF THE MALE BREAST IS \nDISTINCTLY UNCOMMON......Page 555
ANEMIA......Page 557
HEMOSTATIC DISORDERS......Page 570
NONMALIGNANT DISORDERS......Page 577
LEUKEMIAS AND MYELODYSPLASTIC \nSYNDROMES......Page 578
BENIGN DISORDERS OF THE LYMPHOPOIETIC \nSYSTEM......Page 584
MALIGNANT LYMPHOMAS......Page 587
DISORDERS OF THE SPLEEN: SPLENOMEGALY\n......Page 601
HYPERPLASIA......Page 602
THYMOMA......Page 603
ESSENTIALS 21 The Endocrine System\n......Page 605
Hypopituitarism......Page 606
\nHYPERPROLACTINEMIA IS THE MOST COMMON ENDOCRINOPATHY CAUSED BY PITUITARY ADENOMAS......Page 607
CORTICOTROPH ADENOMAS PRODUCE \nADRENOCORTICOTROPIC HORMONE (ACTH)......Page 608
Nontoxic Goiter......Page 609
GOITROUS HYPOTHYROIDISM REFLECTS INADEQUATE SECRETION \nOF THYROID HORMONE......Page 611
GRAVES DISEASE IS THE MOST COMMON CAUSE OF HYPERTHYROIDISM IN \nYOUNG ADULTS......Page 612
CHRONIC AUTOIMMUNE THYROIDITIS (HASHIMOTO THYROIDITIS) IS THE MOST COMMON CAUSE OF GOITROUS HYPOTHYROIDISM IN THE UNITED STATES......Page 614
RIEDEL THYROIDITIS CAUSES FIBROSIS OF \nTHE THYROID......Page 615
Thyroid Cancer......Page 616
PAPILLARY THYROID CARCINOMA (PTC) IS THE MOST COMMON THYROID CANCER......Page 617
MEDULLARY THYROID CARCINOMA (MTC) \nIS DERIVED FROM C CELLS OF THE THYROID......Page 618
ANAPLASTIC (UNDIFFERENTIATED)  THYROID CARCINOMA IS USUALLY FATAL......Page 619
Primary Hyperparathyroidism......Page 620
CLINICAL FEATURES OF HYPERPARATHYROIDISM ARE \nHIGHLY VARIABLE......Page 621
21-Hydroxylase (P450C21) Deficiency \n......Page 622
PRIMARY CHRONIC ADRENAL INSUFFICIENCY (ADDISON DISEASE) OFTEN REFLECTS AN AUTOIMMUNE DESTRUCTION \nOF THE ADRENAL GLANDS......Page 623
ACTH-DEPENDENT ADRENAL HYPERFUNCTION IS OF PITUITARY OR \nECTOPIC ORIGIN......Page 624
ACTH-INDEPENDENT ADRENAL HYPERFUNCTION IS CAUSED BY \nADRENAL TUMORS......Page 625
CLINICAL FEATURES OF CUSHING SYNDROME ARE SEEN IN MANY ORGANS\n......Page 626
PRIMARY ALDOSTERONISM (CONN SYNDROME) INDUCES HYPERTENSION  AND HYPOKALEMIA......Page 627
Pheochromocytomas are Rare Catecholamine-secreting Tumors......Page 628
Neuroblastoma......Page 630
Neoplasms......Page 631
OBESITY IS RELATED TO BOTH GENETIC AND ENVIRONMENTAL FACTORS\n......Page 633
THE COMPLICATIONS OF OBESITY AFFECT \nMOST ORGAN SYSTEMS......Page 634
DIABETES MELLITUS......Page 635
Type 2 Diabetes Mellitus......Page 636
Type 1 Diabetes Mellitus......Page 638
Complications of Diabetes......Page 639
DIABETIC NEUROPATHY AFFECTS SENSORY \nAND AUTONOMIC INNERVATION......Page 640
BACTERIAL AND FUNGAL INFECTIONS OCCUR IN DIABETIC PATIENTS WHOSE \nHYPERGLYCEMIA IS POORLY CONTROLLED......Page 641
DIABETES OCCURRING DURING PREGNANCY MAY PUT THE MOTHER AND FETUS AT RISK\n......Page 642
Constituents of Amyloid......Page 643
Detection of Amyloid......Page 644
ACQUIRED AMYLOIDOSIS DERIVES FROM \nDIVERSE SOURCES......Page 646
Clinical Features of Amyloidoses......Page 648
Anatomy of the Skin......Page 651
ICHTHYOSES FEATURE EPIDERMAL THICKENING AND SCALES......Page 653
PSORIASIS IS A PROLIFERATIVE SKIN DISEASE CHARACTERIZED BY PERSISTENT EPIDERMAL HYPERPLASIA\n......Page 654
PEMPHIGUS VULGARIS IS A BLISTERING SKIN DISORDER CAUSED BY ANTIBODIES TO KERATINOCYTES\n......Page 656
EPIDERMOLYSIS BULLOSA FEATURES BLISTER FORMATION IN THE BASEMENT MEMBRANE ZONE\n......Page 657
BULLOUS PEMPHIGOID IS A SUBEPIDERMAL BLISTERING DISEASE CAUSED BY AUTOANTIBODIES AGAINST BASEMENT MEMBRANE PROTEINS\n......Page 659
DERMATITIS HERPETIFORMIS REFLECTS GLUTEN SENSITIVITY AND IMMUNE COMPLEX DEPOSITION\n......Page 660
SYSTEMIC LUPUS ERYTHEMATOSUS IS AN IMMUNE COMPLEX DISEASE CHARACTERIZED BY AUTOANTIBODIES AND OTHER IMMUNE ABNORMALITIES\n......Page 661
LICHEN PLANUS IS A HYPERSENSITIVITY REACTION WITH LYMPHOCYTIC INFILTRATES AT THE DERMAL–EPIDERMAL  JUNCTION\n......Page 662
URTICARIA AND ANGIOEDEMA ARE IGE-DEPENDENT HYPERSENSITIVITY \nREACTIONS......Page 663
ALLERGIC CONTACT DERMATITIS IS CELL-MEDIATED HYPERSENSITIVITY TO EXOGENOUS SENSITIZING AGENTS\n......Page 664
Primary Neoplasms of the Skin: Melanocytic Neoplasia......Page 665
DYSPLASTIC (ATYPICAL) NEVUS IS A RISK MARKER FOR MELANOMA......Page 667
THE PROGNOSIS OF MALIGNANT MELANOMA IS A FUNCTION OF THE DEPTH OF INVASION......Page 668
VERRUCAE ARE WARTS CAUSED BY HUMAN PAPILLOMAVIRUS......Page 672
KERATOSIS IS A BENIGN HORNY GROWTH COMPOSED OF KERATINOCYTES......Page 673
BASAL CELL CARCINOMA IS A LOCALLY INVASIVE EPIDERMAL NEOPLASM......Page 674
SQUAMOUS CELL CARCINOMA TYPICALLY RESEMBLES DIFFERENTIATED KERATINOCYTES......Page 675
ADNEXAL TUMORS DIFFERENTIATE TOWARD SKIN APPENDAGES......Page 676
FIBROHISTIOCYTIC TUMORS OF THE SKIN SHOW A VARIED SPECTRUM OF DIFFERENTIATION......Page 677
ORAL CAVITY......Page 679
VIRAL INFECTIONS PRESENT AS VESICULAR OR ULCERATIVE LESIONS......Page 680
Preneoplastic or Epithelial Precursor Lesions: Leukoplakia and Erythroplakia......Page 681
Dental Caries (Tooth Decay)......Page 682
Odontogenic Tumors: Ameloblastoma......Page 683
SINUSITIS IS A BACTERIAL INFECTION......Page 684
Malignant Neoplasms of the Nasal Cavity and Paranasal Sinuses......Page 685
NASOPHARYNGEAL ANGIOFIBROMA IS A TUMOR OF ADOLESCENT BOYS......Page 686
EXTRAMEDULLARY PLASMACYTOMAS OFTEN OCCUR IN THE HEAD AND NECK......Page 687
Neoplasms of the Larynx......Page 688
PLEOMORPHIC ADENOMA (MIXED TUMOR) IS THE MOST COMMON TUMOR OF SALIVARY GLANDS......Page 689
Malignant Salivary Gland Tumors......Page 690
ACINIC CELL ADENOCARCINOMA ARISES FROM EPITHELIAL SECRETORY CELLS......Page 691
OTITIS MEDIA OFTEN RESULTS FROM OBSTRUCTION OF THE EUSTACHIAN TUBE......Page 692
LABYRINTHINE TOXICITY IS A DRUG-INDUCED CAUSE OF DEAFNESS......Page 693
THE MOST COMMON TUMOR OF THE INNER EAR IS SCHWANNOMA......Page 694
ANATOMY OF BONE......Page 695
BONE FORMATION AND GROWTH......Page 698
DISORDERS OF THE GROWTH PLATE......Page 700
MODELING ABNORMALITIES: OSTEOPETROSIS......Page 701
DELAYED MATURATION OF BONE......Page 702
FRACTURE......Page 703
REACTIVE BONE FORMATION......Page 705
INFECTIONS......Page 706
OSTEOPOROSIS......Page 708
OSTEOMALACIA AND RICKETS......Page 711
PRIMARY HYPERPARATHYROIDISM......Page 714
PAGET DISEASE OF BONE......Page 715
FIBROUS DYSPLASIA......Page 718
BENIGN TUMORS OF BONE......Page 719
MALIGNANT TUMORS OF BONE......Page 720
OSTEOARTHRITIS......Page 724
RHEUMATOID ARTHRITIS (RA)......Page 727
LYME DISEASE......Page 731
GOUT......Page 732
TUMORS AND TUMOR-LIKE CONDITIONS OF FIBROUS ORIGIN......Page 734
RHABDOMYOSARCOMA......Page 736
SYNOVIAL SARCOMA......Page 737
General Pathologic Reactions......Page 739
DUCHENNE AND BECKER MUSCULAR DYSTROPHIES ARE INHERITED NONINFLAMMATORY MYOPATHIES......Page 740
LIMB-GIRDLE MUSCULAR DYSTROPHIES ARE CAUSED BY MUTATIONS IN DIVERSE PROTEINS......Page 742
OCULOPHARYNGEAL MUSCULAR DYSTROPHY USUALLY PRESENTS IN ADULTS......Page 743
Congenital Myopathies......Page 744
Inflammatory Myopathies\n......Page 745
Myasthenia Gravis......Page 747
MITOCHONDRIAL DISEASES REFLECT MUTATIONS IN NUCLEAR OR MITOCHONDRIAL DNA......Page 748
Denervation......Page 749
TYPE II FIBER ATROPHY RESEMBLES DENERVATION MYOPATHY......Page 751
CELLS OF THE NERVOUS SYSTEM......Page 753
DEVELOPMENTAL MALFORMATIONS......Page 755
INCREASED INTRACRANIAL PRESSURE AND HERNIATION OCCUR WITH SPACE-OCCUPYING LESIONS......Page 759
TRAUMA......Page 761
CEREBROVASCULAR DISORDERS......Page 764
INFECTIOUS DISORDERS......Page 769
DEMYELINATING DISEASES......Page 779
TOXIC AND METABOLIC DISORDERS......Page 782
NEURODEGENERATIVE DISORDERS......Page 784
CENTRAL NERVOUS SYSTEM NEOPLASIA......Page 792
REACTIONS TO INJURY......Page 800
PERIPHERAL NEUROPATHIES......Page 801
TUMORS......Page 804
CONJUNCTIVITIS MAY BE INFECTIOUS OR ALLERGIC......Page 807
NONINFLAMMATORY GENETIC CORNEAL DISORDERS ARE DIVERSE......Page 808
SARCOIDOSIS OFTEN AFFECTS THE EYE......Page 809
DIABETIC RETINOPATHY IS PRIMARILY A VASCULAR DISEASE......Page 810
RETINAL DETACHMENT SEPARATES THE SENSORY RETINA FROM THE PIGMENT EPITHELIUM......Page 813
RETINITIS PIGMENTOSA IS A HERITABLE CAUSE OF BLINDNESS......Page 814
Glaucoma......Page 815
ADULT-ONSET PRIMARY GLAUCOMA......Page 816
MALIGNANT MELANOMA ARISES FROM MELANOCYTES IN THE UVEA......Page 817
RETINOBLASTOMA ORIGINATES FROM IMMATURE NEURONS......Page 818
FIGURE ACKNOWLEDGMENTS\n......Page 821
INDEX......Page 823