Part 1: general introduction, some basic
concepts in pathology
Watch PPT for pictures!!
1. Definition of pathology in the broad sense
Pathology = “ziekteleer” = looking at the cause of diseases and how a diseases
occurs, what the consequences are and what the course of the disease is
Process that may be the cause of disease
- Inflammatory processes: infections bacterial, viral, fungal, …
- Tumors
- Congenital, immunological, metabolic disorders
- Traumas and poisoning
- Degenerative processes
2. Definition of pathology as clinical speciality: pathological
anatomy or clinical pathology
Pathology = the clinical speciality that, by means of microscopic examination
(morphology) of (human) tissue, tries to give an insight about the pathological
processes which take place in the tissue
Basic medical discipline with an important input in diagnosis and treatment
plan in the individual patient
Based on histology!!
3. Work pathologist UZGent
- Active participation in the MOC = multidisciplinary oncological consults
- Active participation in expert pathology panels in Belgium and the
Netherlands
4. Biopsy
Different types of biopsies
- Needle biopsies
o Fine needle aspiration: mostly fluids, single cells
- Endoscopical biopsies
- Surgical biopsies
o Punch biopsy
Small cylinder biopsy
To diagnose, describe inflammatory proces
o Shave biopsy
Most cases larger
More superficial so no information of the subcutis and deep
dermal
For esthetical pleasure, not for suspicious skin
1
, o Excision biopsy
o Incision biopsy
- Surgical resection specimen
Rectoscopy and echo to visualise
Most important difference between malignant and benign lesions => benign
mostly well encapsulated
Benign tumor can not metastases but has more morbidity because it can grow
locally and give lots of problems => local aggressive!!
Malignant tumor can metastases and can kill you!!
Osteosarcoma
- Very malignant and very rare
- More then 95% cases diagnosed in children
- Aggressive chemotherapy that is only for children => destructing tumor
and normal tissue
- Revalidation + 6/8 months ageing chemotherapy
5. Department of pathology
Overview of the processing flow of the patient material: processing of a
biopsy/resection to a histological slide -> quite technical
5.1 Processing of the specimen
- Biopsy with labelling of the recipient and correctly completed application
form
o Application form: personal information of the patient -> check if it is
the same on the form and specimen
- Sending of the recipient and the application form to the department of
pathology
- Recipient in the biopsy room and correct numbering of the recipient
- Taking extra material for Biobank/other research before fixation
- Macroscopical processing of the specimen
- Automatically processing of the tissue
- Embedding of the tissue in paraffin
- Cutting of the paraffin slides and staining
- H&E slides and the application forma issued to the pathologist
- Additional testing
5.2 A complete and correct clinical information => MUST
- Correct patient identification
- Name of the clinical
- Correct date of procedure
- Correct name of procedure
- Topography of the lesion
- Complete clinical information
- Clinical differential diagnosis
Full responsibility of the clinical
- Relevant anamnestic information
2
concepts in pathology
Watch PPT for pictures!!
1. Definition of pathology in the broad sense
Pathology = “ziekteleer” = looking at the cause of diseases and how a diseases
occurs, what the consequences are and what the course of the disease is
Process that may be the cause of disease
- Inflammatory processes: infections bacterial, viral, fungal, …
- Tumors
- Congenital, immunological, metabolic disorders
- Traumas and poisoning
- Degenerative processes
2. Definition of pathology as clinical speciality: pathological
anatomy or clinical pathology
Pathology = the clinical speciality that, by means of microscopic examination
(morphology) of (human) tissue, tries to give an insight about the pathological
processes which take place in the tissue
Basic medical discipline with an important input in diagnosis and treatment
plan in the individual patient
Based on histology!!
3. Work pathologist UZGent
- Active participation in the MOC = multidisciplinary oncological consults
- Active participation in expert pathology panels in Belgium and the
Netherlands
4. Biopsy
Different types of biopsies
- Needle biopsies
o Fine needle aspiration: mostly fluids, single cells
- Endoscopical biopsies
- Surgical biopsies
o Punch biopsy
Small cylinder biopsy
To diagnose, describe inflammatory proces
o Shave biopsy
Most cases larger
More superficial so no information of the subcutis and deep
dermal
For esthetical pleasure, not for suspicious skin
1
, o Excision biopsy
o Incision biopsy
- Surgical resection specimen
Rectoscopy and echo to visualise
Most important difference between malignant and benign lesions => benign
mostly well encapsulated
Benign tumor can not metastases but has more morbidity because it can grow
locally and give lots of problems => local aggressive!!
Malignant tumor can metastases and can kill you!!
Osteosarcoma
- Very malignant and very rare
- More then 95% cases diagnosed in children
- Aggressive chemotherapy that is only for children => destructing tumor
and normal tissue
- Revalidation + 6/8 months ageing chemotherapy
5. Department of pathology
Overview of the processing flow of the patient material: processing of a
biopsy/resection to a histological slide -> quite technical
5.1 Processing of the specimen
- Biopsy with labelling of the recipient and correctly completed application
form
o Application form: personal information of the patient -> check if it is
the same on the form and specimen
- Sending of the recipient and the application form to the department of
pathology
- Recipient in the biopsy room and correct numbering of the recipient
- Taking extra material for Biobank/other research before fixation
- Macroscopical processing of the specimen
- Automatically processing of the tissue
- Embedding of the tissue in paraffin
- Cutting of the paraffin slides and staining
- H&E slides and the application forma issued to the pathologist
- Additional testing
5.2 A complete and correct clinical information => MUST
- Correct patient identification
- Name of the clinical
- Correct date of procedure
- Correct name of procedure
- Topography of the lesion
- Complete clinical information
- Clinical differential diagnosis
Full responsibility of the clinical
- Relevant anamnestic information
2
