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SEQ CHAPTER \h \r 1Contents 1 Fundamentals of Pathology Pathology . . . 2 Methods Disease . . . 5 Etiology Causal Pathogenesis Formal Pathogenesis Clinical Course Signs of Death . . . 5 Statistics . . . 5 Autopsy . . . 5 2 Cellular Pathology Nuclear Lesions . . . 6 Forms of Nuclei Chromosomes DNA Repair Defects . . . 6 Xeroderma Pigmentosum Chromosome Abnormalities . . . 6 Change in the Size of the Nucleus . . . 8 Relation of Nucleus to Cytoplasm Nuclear Euploidy Nuclear Polyploidy Nuclear Aneuploidy Chromatin Change . . . 8 Heterochromatin Condensation Dyskaryosis Hyperchromatosis of the Nuclear Membrane Karyolysis Inclusions . . . 8 Cytoplasmic Inclusions Paraplasmic Inclusions Change in the Number of Nuclei . . . 10 Polynuclear Cells Anuclear Cells Antinuclear Autoantibodies . . . 10 Nucleolar Change . . . 10 Inflammatory Nucleoli Tumor Nucleoli Giant Nucleoli Lesions of the Rough Endoplasmic Reticulum . . . 12 Quantitative Change . . . 12 Increase in the Number of Cisterns Decrease in the Number of Cisterns Morphologic Change . . . 12 Fragmentation of the Rough Endoplasmic Reticulum Formation of Vacuoles in the Rough Endoplasmic Reticulum Swelling of the Rough Endoplasmic Reticulum Rough Endoplasmic Reticulum Cistern Collapse Inclusions . . . 12 Amorphous Inclusions Crystalline Inclusions Particulate Inclusions Oncofetal Lesion . . . 12 Ribosome-Layer Complexes Annular Layers Mitochondria-Layer Complexes Lesions of the Smooth Endoplasmic Reticulum . . . 14 Quantitative Change . . . 14 Proliferation of Smooth Endoplasmic Reticulum Atrophy of the Smooth Endoplasmic Reticulum Morphologic Change . . . 14 Formation of Vesicles in the Smooth Endoplasmic Reticulum Cytoplasmic Secondary Nuclei Inclusions . . . 14 Golgi Apparatus Lesions . . . 16 Atrophy of the Golgi Apparatus . . . 16 Hypertrophy of the Golgi Apparatus . . . 16 Disorders Associated with the Golgi Apparatus . . . 16 Cholestasia Fatty Liver Chondrodystrophia Fetalis Alveolar Proteinosis Mitochondrial Lesions . . . 18 Quantitative Change . . . 18 Mitochondrial Proliferation Mitochondrial Depletion Morphologic Change . . . 18 Megamitochondria Mitochondrial Swelling Structural Change in Mitochondrial DNA . . . 20 Mitochondrial DNA Mutations . . . 20 Congenital Forms Acquired Forms Changes in the Mitochondrial Cristae . . . 20 Membrane Proliferation Membrane Loss Inclusions . . . 20 Matrix Inclusions Crista Inclusions Grana Inclusions Mitochondrial Disorders . . . 22 Mitochondrial Myopathies . . . 22 Hypoxia . . . 22 Hypoxemic Hypoxia Ischemic Hypoxia Hyperglycemic Hypoxia Histotoxic Hypoxia Mitochondrial Autoantibodies . . . 22 Peroxisomal Lesions . . . 24 Peroxisomal Diseases . . . 24 Acatalasemia Refsum Disease Cerebrohepatorenal Syndrome Adrenoleukodystrophy Systemic Carnitine Deficiency Lysosomal Lesions . . . 26 Prelysosomal Phase . . . 26 Lysosomal Phase . . . 28 Postlysosomal Phase . . . 28 Lysosomal Disorders . . . 30 Cytomembrane Lesions . . . 32 Apical Cell Edema Disrupted Communication Receptor Lesions . . . 32 Cytoskeletal Lesions . . . 34 Microtubular Lesions . . . 34 Polymerization Block Microfilament Lesions Intermediate Filament Lesions . . . 34 Actin Bodies Mallory Bodies 3 Connective Tissue Lesions Collagen Lesions . . . 36 Types of Collagen . . . 36 Biosynthesis Disorders . . . 38 Ehlers-Danlos Syndrome Scurvy Osteogenesis Imperfecta Fibrosis . . . 40 Sequelae of Fibrosis . . . 40 Pulmonary Fibrosis Cirrhosis of the Liver Collagenolysis Disorders . . . 44 "ð1-Antitrypsin Deficiency Fibrinoid Necrosis Collagen Hyalinization Collagen Diseases . . . 46 Microfibril Lesions . . . 48 Marfan Syndrome Amyloidosis . . . 48 General Definitions . . . 48 Structure of Amyloid . . . 50 Types of Amyloid . . . 50 Classification of Amyloidoses . . . 52 Elastin Lesions . . . 54 Biosynthesis Disorders . . . 54 Restrictive Dermopathy Senile Elastosis Trichopoliodystrophy Type V Ehlers-Danlos Syndrome Elastosis . . . 56 Actinic Elastosis Pseudoxanthoma Elasticum Fibroelastosis . . . 56 Sequelae of Fibroelastosis . . . 56 Intimal Fibroelastosis Endocardial Fibroelastosis Elastin Lysis Deficiencies . . . 58 Sequelae of Elastin Lysis Deficiencies . . . 58 Polyarteritis Nodosa Temporal Arteritis Syphilitic Aortitis Proteoglycan Lesions . . . 60 Proteoglycan Complexing Disorders . . . 60 Mucoid Degeneration . . . 60 Sequelae of Mucoid Degeneration . . . 60 Mucoid Meniscus Pathology Ganglion Cystic Vascular Degeneration Mitral Valve Prolapse Syndrome Dissecting Aneurysm Proteoglycan Secretion Disorders . . . 64 Cystic Fibrosis . . . 64 Sequelae of Cystic Fibrosis . . . 64 Bronchial Ectasia Cystic Fibrosis of the Pancreas Meconium Ileus Liver Cirrhosis Proteoglycan Lysis Deficiencies . . . 66 Mucopolysaccharidoses . . . 66 HurlerÆs Syndrome Hunter's Syndrome Mucolipidoses . . . 66 4 Metabolic Disorders Caused by Inorganic Agents Oxygen . . . 68 Acute Generalized Hypoxia . . . 68 Acute Local Hypoxia . . . 69 Chronic Hypoxia . . . 69 Fatty Degeneration Organ Atrophy Interstitial Fibrosis Calcium . . . 70 Hypocalcemia . . . 70 Hypercalcemia . . . 70 Iron . . . 72 Iron Deficiency . . . 72 Iron Overload . . . 72 Hemochromatosis Secondary Siderosis Copper . . . 74 Copper Deficiency . . . 74 Chronic Copper Deficiency Trichopoliodystrophy Copper Overload . . . 74 Wilson's Disease 5 Metabolic Disorders Caused by Organic Agents Carbohydrates . . . 76 Glycogenoses . . . 76 Carbohydrate Malabsorption . . . 78 Lactose Intolerance Saccharose-Isomaltose Intolerance Glucose Synthesis Disorders . . . 78 Fructose-1,6-Diphosphatase Deficiency Hereditary Fructose Intolerance Deficient Carbohydrate Metabolism . . . 78 Diabetes Mellitus . . . 78 Sequelae . . . 80 Diabetic Macroangiopathy Diabetic Microangiopathy Diabetic Cataract Diabetic Liver Diabetic Neuropathy Susceptibility to Infection Diabetic Embryopathy Galactosemia . . . 80 Lipids . . . 82 Fat Absorption Disorders . . . 82 Malabsorption Syndromes . . . 82 Disorders Associated with Malabsorption . . . 82 Gluten Enteropathy Whipple Disease Fatty Degeneration . . . 84 Dietary Steatosis Fat Transport Steatosis Absorptive Steatosis Retention Steatosis Disorders of Fat Catabolism . . . 84 Starvation Obesity Ketonemia Phytanic Acid Storage Disease Propionic Acidemia Methylmalonic Aciduria Hypolipoproteinemia Disorders . . . 86 Abetalipoproteinemia Analphalipoproteinemia Hyperlipoproteinemia Disorders . . . 88 Type I-IV Hyperlipoproteinemia Familial LCAT Deficiency Sequelae of Hyperlipoproteinemia . . . 90 Atherosclerosis Xanthoma Sphingolipidoses . . . 92 Gaucher Disease Sphingomyelin Lipidosis Krabbe Disease Metachromatic Leukodystrophy Fabry Disease Type I GM2 Gangliosidosis GM1 Gangliosidosis Proteins . . . 96 Serum Protein Deficiencies . . . 96 Disorders of Amino Acid Metabolism . . . 96 Phenylketonuria Albinism Alkaptonuria Maple Syrup Urine Disease Primary Hyperoxaluria Type I Homocystinuria Cystinuria Cystinosis Urea Synthesis Disorders . . . 100 Nucleotides . . . 102 Hyperuricemia . . . 102 Primary Gout Secondary Gout 6 Pigment Lesions Exogenous Pigments . . . 104 Cosmetic Pigments . . . 104 Occupational Toxin Pigments . . . 104 Anthracosis Plumbism Chalcosis Iatrogenic Pigments . . . 104 Argyria Amalgam Disease Tetracycline Carotene Disease Endogenous Pigments . . . 106 Hematogenous Pigments . . . 106 Porphyria . . . 106 Congenital Erythropoietic Porphyria Hemoglobin Breakdown Pigments . . . 106 Hyperbilirubinemia . . . 108 Tyrosine Derivative Pigments . . . 112 Cutaneous Melanin . . . 112 Vitiligo Albinism Hemochromatosis Addison Disease Phenylketonuria Melasma Neuromelanin . . . 114 Parkinson Disease Non-Melanin Pigments . . . 114 Brown Colon Alkaptonuria Lipogenic Pigments . . . 114 7 Sublethal Cell Damage Hypertrophy . . . 116 Diseases Associated with Hypertrophy . . . 116 Hypertrophic Cardiomyopathy Congenital Hypertrophic Pyloric Stenosis Hyperplasia . . . 118 Diseases Associated with Hyperplasia . . . 118 Endometrial Hyperplasia Prostatic Hyperplasia Endocrine Hyperplasia . . . 120 Thyroid Hyperplasia Parathyroid Hyperplasia Hyperplasia of the Adrenal Cortex . . . 122 Adrenal Cortex Hyperfunction Syndrome . . . 122 Hyperaldosteronism Hypercortisolism Adrenogenital Syndrome Atrophy . . . 124 Disorders Associated with Generalized Atrophy . . . 124 Senile Atrophy Atrophy Due to Inanition (Cachexia) Disorders Associated with Organ Atrophy . . . 126 Osteoporosis Alzheimer Disease Pick Disease 8 Lethal Cell Injury Apoptosis . . . 128 Accidental Cell Death . . . 130 Necrosis . . . 130 Focal Cytoplasmic Necrosis . . . 130 Coagulative Necrosis . . . 130 Liquefactive Necrosis . . . 132 Shrinking Necrosis . . . 132 Autolysis . . . 132 9 Calcification and Stone Disorders Calcification . . . 134 Dystrophic Calcification . . . 134 Degenerative Calcification . . . 134 Disorders Associated with Degenerative Calcification . . . 134 Calcinosis Cutis Myositis Ossificans Valvular Calcific Degeneration Mönckeberg Arteriosclerosis Necrotic Calcification . . . 136 Metastatic Calcification . . . 136 Disorders Associated with Metastatic Calcification . . . 136 Pulmonary Calcinosis Renal Calcinosis Gastric Calcinosis Myocardial Calcinosis Stone Disorders . . . 138 Urolithiasis Cholelithiasis 10 Chemical Cell Injury Drug-Induced Disorders . . . 140 Drug-Induced Damage to Blood Cell Disease . . . 140 Drug-Induced Skin Disease . . . 140 Drug-Induced Liver Disease . . . 141 Drug-Induced Kidney Disease . . . 141 Drug-Induced Lung Disease . . . 141 Drug-Induced Neurologic Disorders . . . 141 Diseases from Environmental Toxins . . . 142 Carbon Monoxide Poisoning . . . 142 Sequelae . . . 142 Lead Poisoning . . . 142 Sequelae . . . 142 Metaphyseal Lead Lines Acquired Porphyria Anemia Erythrocyte Disease Lead Nephropathy Saturnine Encephalopathy Polyneuropathy Asbestosis . . . 142 Sequelae . . . 142 Pneumoconiosis Pleural Plaques Malignant Mesotheliomas Disease from Alimentary Toxins . . . 144 "ð-Amanitine Poisoning Alcoholism Sequelae of Alcoholism . . . 144 Alcoholic Fatty Degeneration of the Liver Alcoholic Hepatitis Alcoholic Liver Cirrhosis Megaloblastic Anemia Wernicke-Korsakoff Syndrome Cardiomyopathy 11 Physical Cell Injury Thermal Injury . . . 146 Heat-Induced Injuries . . . 146 Heat Stroke Burns Cold-Induced Injuries . . . 148 Hypothermia Frostbite Sequelae of Cold Injuries . . . 148 Endangiitis Obliterans Raynaud Syndrome Electrical Injuries . . . 150 Radiation Injury . . . 150 Microwaves and Infrared Radiation . . . 150 Visible Light and Ultraviolet Radiation . . . 150 Sequelae of Light Radiation . . . 150 Laser Radiation . . . 150 Ionizing Radiation . . . 152 Sequelae of Radiation . . . 152 Radiation Vasculitis Radiation Dermatitis Radiation Enteritis Radiation Bone Necrosis Radiation-Induced Leukocyte Disease Radiation Therapy . . . 154 12 Immune Pathology Antigen . . . 156 Antigen Neutralization . . . 156 Immune Organs . . . 157 Central Immune Organs . . . 157 Thymus Bursa of Fabricius and Bone Marrow Peripheral Immune Organs . . . 157 Lymph Nodes Spleen MALT SALT Cell-Mediated Immunity . . . 158 Humoral Immunity . . . 160 Immune Regulating Antigens . . . 164 HLA Antigens . . . 164 HLA-Associated Disorders . . . 164 Pathogenic Immune Reactions . . . 166 Hypersensitivity Reactions . . . 166 Type I Hypersensitivity Reactions . . . 166 Local Anaphylaxis Systemic Anaphylaxis Atopic Reaction Disorders Associated with Type I Hypersensitivity Reaction . . . 168 Bronchial Asthma Allergic Rhinitis Type II Hypersensitivity Reactions . . . 170 Type III Hypersensitivity Reactions . . . 170 Serum Disease - Immune Complex Vasculitis - Immune Complex Nephritis Local Immune Complex Disease - Extrinsic Allergic Alveolitis Type IV Hypersensitivity Reaction . . . 174 Cutaneous Basophilic Hypersensitivity Reaction Contact Allergy Tuberculin Reaction Granulomatous Hypersensitivity Reaction Transplantation Pathology . . . 178 Transplant Allergy Graft-Versus-Host Disease Autoimmune Disorders . . . 180 Systemic Autoimmune Disorders . . . 180 Systemic Lupus Erythematosus Scleroderma Dermatomyositis Goodpasture Syndrome Wegener Granulomatosis Rheumatoid Arthritis Sjögren Syndrome Autoimmune Disorders of Specific Organs . . . 186 Hashimoto Thyroiditis Autoimmune Adrenalitis Type I Diabetes Mellitus Myasthenia Gravis Autoimmune Gastritis Multiple Sclerosis Immunodeficiency Disorders . . . 188 Primary Immunodeficiency Disorders: B-Cell Defects. . . 188 X-Linked Agammaglobulinemia Transient Hypogammaglobulinemia Heavy-Chain Defect 6ð Chain Defect IgG Subclass Defect Hyper IgM Syndrome Isolated IgA Deficiency Common Variable Immunodeficiency Primary Immunodeficiency Syndromes: T-Cell Defects . . . 189 DiGeorge Syndrome Nezelof Syndrome Chronic Myocutaneous Candidiasis Primary Immunodeficiency Syndromes: B-Cell and T-Cell Defects . . . 190 Severe Combined Immunodeficiency (SCID) Adenosine Deaminase Deficiency Ataxia Telangiectasia Wiskott-Aldrich Syndrome Secondary Immunodeficiency Syndromes . . . 190 Monoclonal Gammopathy Acquired Immunodeficiency Syndrome (AIDS) Sequelae of AIDS . . . 192 HIV Lymphadenopathy Kaposi Sarcoma HIV-Associated Pneumopathy HIV Encephalitis 13 Pathology of Inflammation Definition of Inflammation . . . 194 Exudative Inflammatory Reaction . . . 196 Changes in Microcirculation . . . 196 Increased Permeability . . . 198 Leukocyte Transmigration . . . 200 Inflammatory Cells . . . 200 Inflammation Mediators . . . 202 Cell-Derived Mediators Plasma-Derived Mediators Necrosis-Derived Mediators Acute Exudative Inflammations . . . 204 Serous Inflammation . . . 204 Seromucous Inflammation . . . 204 Acute Rhinitis Fibrinous Inflammation . . . 206 Fibrinous Parenchymal Inflammation . . . 206 Fibrinous Serosal Inflammation . . . 206 Fibrinous Pleuritis Fibrinous Pericarditis Fibrinous Peritonitis Fibrinous Mucosal Inflammation . . . 208 Pseudomembranous Croupous Form Pseudomembranous Necrotizing Form Fibrinous Suppurative Inflammation . . . 210 Lobar Pneumonia Suppurative Inflammation . . . 212 Mucopurulent Inflammation . . . 212 Empyema . . . 212 Acute Cellulitis . . . 212 Abscess-Forming Inflammation . . . 212 Appendicitis Acute Bacterial Pyelonephritis Acute Bacterial Meningitis Hemorrhagic Inflammation . . . 216 Scarlet Fever Waterhouse-Friderichsen Syndrome Plague Influenzal Pneumonia Disorders Associated with Enterohemorrhagic E. Coli Hemorrhagic Viral Bladder Infection Anthrax Viral Hemorrhagic Fever Acute Pancreatitis Necrotizing Inflammation . . . 218 Ulcerous Necrotizing Inflammation . . . 218 Acute Necrotizing Ulcerous Gingivitis Peptic Gastroduodenal Ulcer Ulcerous Colitis Diffuse Necrotizing Inflammation Nonreactive Necrotizing Inflammation Gangrenous Inflammation Lymphocytic and Plasmocytic Inflammation . . . 220 Fetal Inflammation . . . 220 Clinical Courses of Acute Inflammation . . . 222 Chronic Inflammation . . . 224 Chronic Nonsuppurative Inflammation . . . 224 Chronic Bronchitis Chronic Suppurative Inflammation . . . 224 Chronic Mucopurulent Inflammation . . . 224 Granulating Inflammations . . . 226 Demarcation of Necrosis Chronic Abscess Chronic Fistula Chronic Ulcer Granulomatous Inflammations . . . 228 Granuloma Cells . . . 228 Histogenesis of Granulomas . . . 228 Morphology of Granulomas . . . 229 Sarcoidal Granuloma Tuberculous Granuloma Pseudotuberculous Granuloma Rheumatic Granuloma Rheumatoid Granuloma Foreign-Body Granuloma 14 Viral Infection Unenveloped Single-Stranded RNA Viruses . . . 238 Picornaviridae . . . 238 Poliomyelitis Virus Hepatitis A Virus (HAV) Rhinoviruses Unenveloped Double-Stranded RNA Viruses . . . 240 Reoviridae . . . 240 Rotaviruses Enveloped Single-Strand RNA Viruses . . . 240 Togaviridae . . . 240 Alphaviruses and Flaviviruses Rubiviruses Orthomyxoviridae . . . 242 Influenza Viruses Paramyxoviridae . . . 242 Parainfluenza Viruses Mumps Virus Respiratory Syncytial Virus Measles Virus Arenaviridae . . . 242 Rhabdoviridae . . . 244 Rabies Virus Retroviridae . . . 244 Oncornaviruses Human Immunodeficiency Virus (HIV) Enveloped Double-Stranded RNA Viruses . . . 246 Poxviridae . . . 246 Variola Virus Molluscum Contagiosum Virus Herpesviridae . . . 246 Herpes Simplex Virus (HSV) Varicella Zoster Virus Cytomegalovirus (CMV) Epstein-Barr Virus (EBV) Hepadnaviridae . . . 248 Hepatitis B Virus (HBV) Unenveloped Double-Stranded DNA Viruses . . . 250 Adenoviridae . . . 250 Papovaviridae . . . 250 Papillomaviruses Miopapovaviridae . . . 250 Unenveloped Single-Stranded DNA Viruses . . . 250 Parvoviridae . . . 250 Parvovirus B19 Prion Diseases . . . 252 Creutzfeldt-Jakob Disease Gerstmann-Sträussler-Scheinker Syndrome Kuru Scrapie Bovine Spongiform Encephalopathy 15 Bacterial Infection Gram-Positive Cocci . . . 254 Staphylococci . . . 254 Staphylococcus Epidermidis Staphylococcus Aureus Streptococci . . . 254 Streptococcus Pyogenes Gram-Negative Cocci . . . 256 Neisseriaceae . . . 256 Neisseriaceae Gonorrhoeae Neisseriaceae Meningitidis Gram-Positive Rods . . . 256 Corynebacterium Diphtheriae Listeria Monocytogenes Actinomyces Israeli Bacillus Anthracis Clostridia . . . 258 Disorders Associated with Clostridia . . . 258 Clostridial Gas Gangrene Tetanus Botulism Antibiotic Enterocolitis Gram-Negative Rods . . . 260 Enterobacteriaceae . . . 260 Disorders Associated with Enterobacteriaceae . . . 260 Typhoid Fever Salmonella Enteritis Short Curved Gram-Negative Rods . . . 262 Vibrio Cholerae Campylobacter Jejuni and Campylobacter Coli Helicobacter Pylori Flexible Spiral Gram-Negative Bacteria . . . 262 Borrelia Burgdorferi Treponema Pallidum Mycobacteria . . . 264 Tuberculosis Bacteria Mycobacterium Leprae Obligatory Intracellular Bacteria . . . 266 Rickettsia Prowazekii Calymmatobacterium Granulomatis Chlamydia Mycoplasmas . . . 266 Mycoplasma Pneumoniae 16 Mycotic Infection Skin Mycoses . . . 268 Dermatophytoses . . . 268 Subcutaneous and Mucosal Mycoses . . . 268 Organ and Systemic Mycoses . . . 268 Yeasts . . . 270 Candida Albicans Cryptococcus Neoformans Molds . . . 272 Aspergillus Fungi Mucor (Zygomycetes) Dimorphic Fungi . . . 272 Histoplasma Capsulatum Coccidioides Immitis Rhinosporidium Seeberi . . . 272 17 Protozoan Infection Zoomastigophora . . . 274 Trypanosoma Cruzi Leishmania Trichomonas Vaginalis Giardia Lamblia Lobosea . . . 276 Entamoeba Histolytica Sporozoa . . . 276 Toxoplasma Gondii Plasmodia Mycoid Parasites . . . 278 Pneumocystis Carinii 18 Helminthic Infection Trematodes . . . 280 Schistosomes Cestodes . . . 280 Taenia Saginata Taenia Solium Echinococcus Granulosus Echinococcus Multilocularis Nematodes . . . 284 Enterobius Vermicularis Wuchereria Bancrofti Trichinella Spiralis 19 Hereditary Disorders Chromosomal Disorders . . . 287 Autosomal Aberrations . . . 287 Numeric Autosomal Aberrations . . . 288 Triploidy Trisomy 21 (Down Syndrome) Trisomy 18 (Edwards Syndrome) Trisomy 13 (Patau Syndrome) Structural Autosomal Aberrations . . . 288 Deletion Syndrome Microdeletion Syndromes Sex Chromosome Aberrations . . . 290 Klinefelter Syndrome XYY Syndrome Turner Syndrome Chromosome Breakage Syndromes . . . 290 Single-Gene Disorders . . . 292 Multifactorial Hereditary Disorders . . . 293 Mitochondrial Hereditary Disorders . . . 293 20 Congenital Malformations Basic Teratologic Terminology . . . 294 General Etiology . . . 295 General Causal Pathogenesis . . . 295 Cell Proliferation . . . 295 Cell Determination and Differentiation . . . 296 Cell Migration . . . 296 Apoptosis (Cell Death) . . . 296 Blastogenetic Disorders . . . 298 Conjoined Twins . . . 298 Twin-Twin Transfusion Syndrome . . . 298 Embryopathies . . . 300 Morphogenetic Forms of Embryopathy . . . 300 Isolated Malformations . . . 300 Supernumerary Malformations Fusion Malformations Failures of Posterior Fusion (Dysraphia) Failures of Anterior Fusion Agenesis Aplasia Hypoplasia Atresia Stenosis Vestige Hamartia Chorista Cysts Atavism Multiple Malformations . . . 302 Field Defect Sequence Syndrome Congenital Disorder Etiologic Forms of Embryopathy . . . 302 Radiation Embryopathy Diabetic Embryopathy Thalidomide Embryopathy Congenital Rubella Syndrome Fetal Alcohol Syndrome Amniotic Band Syndrome Teratogenesis and Tumorigenesis Multifactorial Malformations Fetopathy . . . 306 Diabetic Fetopathy Cytomegalovirus Fetopathy Listerial Fetopathy Fetal Toxoplasmosis Congenital Syphilis 21 Tissue Repair Regulatory Mechanisms . . . 309 Physiologic Regeneration . . . 309 Defect Repair . . . 310 Regeneration . . . 310 Fibrosis (Fibroplasia) . . . 310 Wound Healing . . . 310 Healing of a Skin Wound . . . 310 Fracture Healing . . . 314 Wound Healing in Internal Organs . . . 314 Wound Healing in the Central Nervous System . . . 316 Wound Healing in Peripheral Nerves . . . 316 Metaplasia . . . 318 Epithelial Metaplasia . . . 318 Mesenchymal Metaplasia . . . 318 Heteroplasia . . . 318 Heterotopia . . . 318 Tissue Dissemination . . . 318 22 Tumor Pathology General Definitions . . . 320 Causal Tumorigenesis . . . 321 Disturbed Cellular Communication . . . 321 Loss of Proliferation Inhibition . . . 321 Growth Factors Protooncogenes Tumor Suppressor Genes Tumor Immunology . . . 326 Tumor Antigens . . . 326 Oncofetal Antigens Differentiation Antigens Tumor Immunity . . . 326 Chemical Tumorigenesis . . . 328 Stages of Carcinogenesis . . . 328 Activation in Tissue . . . 330 Organ and Species Specificity . . . 330 Viral Tumorigenesis . . . 332 DNA Tumor Viruses . . . 332 Human Papillomaviruses Adenoviruses Epstein-Barr Virus Hepatitis B Virus RNA Tumor Viruses . . . 334 Physical Tumorigenesis . . . 334 Ionizing Radiation Ultraviolet Radiation Foreign Bodies Tumor Risk Factors . . . 336 Predisposition Hormonal Factors Age Nutritional Factors and Drug Use Environmental Factors Genetic Changes Formal Tumorigenesis . . . 340 Precursors and Early Stages . . . 340 Precancerous Conditions . . . 340 Carcinoma in Situ . . . 340 Early Invasive Carcinoma . . . 340 Cellular and Nuclear Changes . . . 342 Cellular Changes . . . 342 Nuclear Changes . . . 342 Tumor Perfusion . . . 344 Tumor Dissemination . . . 344 Metastasis . . . 346 Tumor Regression . . . 350 Tumor Complications . . . 352 Local Complications . . . 352 Stenosis Circulatory Disruption Tumor Necrosis Disruption of Organ Function Systemic Complications . . . 352 Tumor Metastases Cancer Cachexia Paraneoplastic Syndromes Tumor Classification . . . 355 Nonepithelial Tumors . . . 355 General Definitions . . . 355 Fibrous Tumors . . . 356 Fibroma Fibrosarcoma Muscle Tumors . . . 356 Leiomyomas Leiomyosarcoma Rhabdomyoma Rhabdosarcoma Tumors of Fatty Tissue . . . 356 Lipoma Liposarcoma Cartilage Tumors . . . 358 Chondroma Chondrosarcoma Bone Tumors . . . 358 Osteoma Osteosarcoma Leukemias . . . 358 Acute Myelogenous Leukemia Chronic Myelogenous Leukemia Acute Lymphoblastic Leukemia Chronic Lymphocytic Leukemia Malignant Lymphoma . . . 362 HodgkinÆs Lymphomas Non-HodgkinÆs Lymphomas Melanocytic Tumors . . . 366 Nevocellular Nevus Malignant Melanoma Brain Tumors . . . 366 Gliomas Nerve Sheath Tumors Meningiomas Benign Epithelial Tumors . . . 370 Papillomas . . . 370 Basal Cell Papilloma Mucosal Papilloma Papilloma of Glandular Excretory Ducts Urothelial Papilloma Adenomas . . . 370 Solid Adenoma Tubular Adenoma Villous Adenoma Cystadenoma Fibroadenoma Malignant Epithelial Tumors . . . 372 Squamous Cell Carcinoma . . . 372 Adenocarcinomas . . . 372 Urothelial Carcinoma . . . 372 Carcinomas of Specific Organs . . . 374 Carcinoma of the Prostate Carcinoma of the Breast Bronchogenic Carcinoma Colorectal Carcinoma Dysontogenetic Tumors . . . 382 Teratoma . . . 382 Immature Teratoma Mature Teratoma Embryonal Tumors . . . 382 Neuroblastoma Medulloblastoma Retinoblastoma Nephroblastoma Embryonal Tumors Arising from Vestigial Tissue . . . 382 Ameloblastoma Craniopharyngioma Chordoma Mixed Mesodermal Tumor Non-Metastasizing Malignant Tumors . . . 384 Basal Cell Carcinoma Carcinoid Tumor of the Appendix Ameloblastoma Chordoma Craniopharyngioma 23 Generalized Cardiovascular Disorders Arterial Hypertension . . . 386 Essential Hypertension . . . 386 Renal Hypertension . . . 386 Renovascular Hypertension Hypertension in the Renal Parenchyma Endocrine Hypertension . . . 388 Cardiovascular Hypertension . . . 388 Neurologic Hypertension . . . 388 Sequelae of Arterial Hypertension . . . 388 Hypertensive Cardiac Hypertrophy Hypertensive Vascular Disease Pulmonary Hypertension . . . 390 Sequelae of Pulmonary Hypertension . . . 390 Chronic Cor Pulmonale Hypertensive Pulmonary Vascular Disease Portal Hypertension . . . 392 Sequelae of Portal Hypertension . . . 392 Development of Collateral Circulation Splenomegaly in Portal Hypertension Ascites Shock . . . 394 Pathogenetic Forms of Shock . . . 394 Cardiogenic Shock Hypovolemic Shock Septic Shock Anaphylactic Shock Endocrine Shock Neurogenic Shock Hemodynamic Forms of Shock . . . 394 Hyperdynamic Shock Syndrome Hypodynamic Shock Syndrome Sequelae of Shock . . . 396 Shock Lung Shock Kidney Shock Hepatopathy Shock Pancreatopathy Shock Endocarditis Shock Enteropathy Shock Encephalopathy Shock Endocrinopathy Hemorrhage . . . 398 Bleeding through Ruptures . . . 398 Diapedesis . . . 398 Hemorrhagic Diathesis . . . 400 Vascular Forms Thrombocytopenia Thrombasthenia Coagulation Disorders 24 Localized Cardiovascular Disorders Thrombosis . . . 404 Causal Pathogenesis . . . 404 Forms of Thrombi . . . 406 Laminated Thrombus Red Thrombus Mixed Thrombus Hyaline Thrombus Forms of Thrombosis . . . 408 Venous Thrombosis Arterial Thrombosis Cardiac Thrombosis Sequelae of Thrombosis . . . 408 Recurrent Thrombus Obliteration of the Vessel Postthrombotic Syndrome Puriform Thrombolysis Thrombus Calcification Thromboembolism Embolism . . . 410 Thromboembolism . . . 410 Venous Thromboembolism Arterial Thromboembolism Fat Embolism . . . 412 Traumatic Fat Embolism Fat Emboli Syndrome Air Embolism . . . 412 Cholesterol Embolism . . . 412 Amniotic Fluid Embolism . . . 412 Parasite Embolism . . . 412 Arterial Hemodynamic Disorders . . . 414 Absolute Persistent Ischemia . . . 414 Anemic Infarct Hemorrhagic Infarct Absolute Temporary Ischemia . . . 416 Relative Ischemia . . . 416 Acute Temporary Relative Ischemia Chronic Relative Ischemia Disorders Associated with Absolute Persistent Ischemia . . . 418 Myocardial Infarction Anemic Splenic Infarct Anemic Cerebral Infarction Anemic Renal Infarct Venous Hemodynamic Disorders . . . 422 Venous Stasis . . . 422 Associated Disorders . . . 422 Hepatic Congestion Hemorrhagic Infarct . . . 422 Associated Disorders . . . 422 Hemorrhagic Cerebral Infarction Mesenteric Infarction 25 Edema Hydrostatic Edemas . . . 424 Cardiac Edema Portal Edema Venous Edema Osmotic Edema Oncotic Edema . . . 426 Vascular Edema . . . 426 Lymphedema . . . 426 Sequelae of Edema . . . 426 Sclerosis Dermatopathy Recurrent Erysipelas Nodal Vascular Sinus Transformation Stewart-Treves Syndrome Cerebral Edema . . . 428 Vasogenic Cerebral Edema Cytotoxic Cerebral Edema Interstitial Cerebral Edema Hyposmotic Cerebral Edema Glossary . . . 430 Index . . . 449
Library of Congress Subject Headings for this publication: Pathology Atlases