Descriptive Pathology Flashcards
What factors contribute to coming to the wrong conclusion in a case?
- Limited experience or knowledge.
- Insufficient info to reach a conclusion.
- Error(s) in reasoning.
Steps of the diagnostic process.
- Detect any abnormalities/lesions.
- Objectively describe the morphological features of the lesions.
- Interpret the nature of the change. Consider the pathological process(es) could explain the appearance (differential diagnoses).
- Generate a preliminary diagnosis (morphologic diagnosis).
What do you include in descriptions of lesions?
- Location/site (organ, structure, anatomical region).
- Distribution and number/extent.
- Shape.
- Size.
- Colour.
- Texture.
- Other features e.g. contour, demarcation, content, odour, patency, weight of an organ.
- In terms of distribution, how would your describe a singular abnormality?
- What if there was more than one abnormality?
- What if the multiple abnormalities start to join together?
- What if there a single abnormality/lesion that spans a larger area?
- What if the abnormality or lesion spans the whole organ/defined site?
- What if the abnormality is spanning the whole organ/defined site and but there are normal parts of the organ in between abnormalities?
- What if talking about an organ like intestine?
- What about description in terms of pattern?
- What about with a pair of organs?
- Focal.
- Multifocal.
- Coalescing.
- Focally extensive (locally extensive).
- Diffuse.
- Generalised/widespread/disseminated.
- Segmental.
- Regular/irregular.
- Unilateral or bilateral (symmetrical/asymmetrical).
Providing info on number?
Focal = 1.
Multifocal = More than 1.
May be more helpful to provide a number.
If too many to count:
- Estimate.
- Tens of…
- Hundreds of…
- Innumerable.
Providing info on extent?
Sometimes helpful to indicate proportion of the organ/site affected.
- When would you be talking about an abnormality 3-dimentionally?
- When would you be talking about an abnormality 2-dimentionally?
- When looking at the abnormality on the organ or at the site as it is. (Spherical, ovoid/nodular, tubular, polypoid, pedunculated).
- When looking at the abnormality on the cut surface of the organ/structure. (Round, oval/irregular, circular, wedge-shaped/triangular, linear, branching).
- What does polypoid mean?
- What does pedunculated mean?
- Attached by a narrow stalk.
- Attached by an elongated stalk.
- Other shape-related features.
- What does demarcated mean?
- Raised, flat, depressed, smooth, irregular.
- The level definition/contrast between normal and abnormal. e.g. edges.
Providing info on size.
Measure or estimate dimensions.
use standard metric unit i.e. mm, cm etc.
Give size ranges for multiple lesions present.
Modifiers of colour.
Light, pale, dark, mottled, streaked, stippled.
Factors affecting the colour of tissues…
1. redness.
2. White.
3. yellow.
4. Green.
5. Black.
- Amount of blood present.
- High cellular density (neoplastic, inflam), connective tissue e.g. fibrosis/fat, mineralisation, reduced blood flow/ischaemia/ necrosis.
- Fat, bilirubin, fibrin (inflam), necrosis.
- Bile. necrosis, PM changes.
- Melanin, iron pigment (bruising), necrosis.
Providing info on texture.
Soft, firm, hard, spongy, flabby.
Tissues described as…
1. Soft.
2. Firm.
3. Hard.
4. Spongy/flabby.
5. Other descriptive words for texture?
- Skin, subcutis, fat, muscle, stomach, intestines, lungs.
- Liver, kidney.
- Bone, cartilage.
- Lung.
- Friable (crumbly), granular, gritty, viscous, mucoid, gelatinous, homogenous, crepitant (crackling sensation).
Liquid descriptive words.
Watery – clear or coloured e.g. serosanguineous.
Viscous – thick e.g. mucus or fibrin present.
Opaques – contains cells or lipid droplets.
Turbid – Cloudy/opaque and contains clumped suspended matter or material e.g. fibrin, cells.
