PENGANTAR PRAKTIKUMPATOLOGI ANATOMI

PATHOLOGY• : study (logos); suffering (pathos)• The core of pathology : 1. Etiology (the cause) 2. Pathogenesis (the mechanisms of its

development) 3. Morphologic changes (the structural alterations induced in the cells&organs of the body

4. Clinical significance (the functional consequences of the morfologic changes). 1

CELLULAR PATHOLOGY

• Normal cell normal homeostasisby its genetic programs of metabolism, differentiation & specialization

• Physiologic stresses >> , or some pathologic stimuli physiologi&morphologic

cellular adaptations

When adaptation is not possible cell injury - reversible injury - irreversible injury

Adaptation

Normal

Reversible injury

Irreversible injury(cell death : necrosis, or apoptosis)

Point of no return

CELLULAR CHANGES :• Acute cell injury :

reversible injury

irreversible injury/ cell death : necrosis, apoptosis.• Subcellular alterations in sublethal&chronic injury• Cellular adaptations :

atrophy, hypertrophy, hyperplasia, metaplasia,

dysplasia• Intracellular accumulations :

proteins, lipids, carbohydrates• Pathologic calcification• Cell aging

CAUSES OF CELL INJURY

• Oxygen deprivation

• Pysical agents

• Chemical agents & drugs

• Infectious agents

• Immunologic reactions

• Genetic derangements

• Nutritional imbalances

Proses pertumbuhan sel, jaringan & alat tubuh dapat mengalami gangguan/ kondisi patologis, sehingga kita kenal berbagai keadaan sbb :

• APLASIA / AGENESIS• HIPOPLASIA• ATROFI• HIPERTROFI• HIPERPLASIA• METAPLASIA• DISPLASIA• ANAPLASIA

Approach to Endocrine Pathology

• Some Definitions

• Some Anatomy & Histology (Morphology)

• Some Biochemistry (Chemical Measurements)

• Some Physiology (Regulation)

• The Pathology (Morphology)

• The Laboratory Diagnosis

Classification of Endocrine Diseases

Hyperfunction (Excess) Hypofunction

– Impaired synthesis or release (deficiency)– Abnormal target tissue interaction (resistance)– Abnormal target tissue response (resistance)

Mass Lesions (Neoplasia)– Non-functioning (No hormone)– Functioning (Hormone)

Etiology of Endocrine Deficiency & Resistance Syndromes

Hormone Deficiency

1. Autoimmune

Hypothyroidism (Hashimoto’s)

Type I Diabetes Mellitus

2. Post Surgical

Hypoparathyroidism

Hypothyroidism

Hormone Deficiency

3. Inflammation, Neoplasia

Granulomatous

Non-Functioning Adenoma

Receptor Defect/Resistance

• Type II Diabetes Mellitus

PRAKTIKUM PATOLOGI ANATOMI

• Perubahan struktur&morfologi pada tingkat :

- jaringan/ organ MAKROSKOPIS

(anatomi)

- sel, subsel MIKROSKOPIS

(histologi,fisiologi, biokimia, biomol)

Untuk membuat diagnosis histopatologi.

MAKROSKOPIS

• Ukuran, berat.• Bentuk : solid/ padat, kistik, noduler.• Permukaan : rata, berbenjol-benjol,licin• Kapsul : ada/ tidak, utuh/tidak utuh,invasi tumor• Warna• Konsistensi : keras, kenyal, lunak, rapuh.• Jika kistik : dinding tebal, papiler isi : serous, mucin, koloid, darah,dll. lokus : multilokuler, unilokuler

MIKROSKOPIS

• Jaringan diproses untuk diwarnai dengan pewarnaan rutin atau khusus.

• Diamati dengan mikroskop• Dievaluasi sel dan jaringannya :• Bentuk, diferensiasi, N/C ratio, sitoplasma,

lapisan/ jumlah sel, pola pertumbuhan, inti(nukleus), aktivitas mitosis, ekspresi protein& reseptor, dll.

• Vaskularisasi, invasi vaskular, angiogenesis.• Perubahan neoplastik : jinak, ganas, in situ.