Pathologist: From 1 Different Sources
A doctor that specialises in the interpretation of changes in tissues.
The study of disease – its causes, mechanisms, and effects on the body. Pathologists conduct autopsies to determine causes of death and to determine the effects that a disease or a treatment has had.... pathology
Gram’s Method is a staining procedure that separates bacteria into those that stain (positive) and those that don’t (negative). Gram-positive bugs cause such lovely things as scarlet fever, tetanus, and anthrax, while some of the gram negs can give you cholera, plague, and the clap. This is significant to the microbiologist and the pathologist; otherwise I wouldn’t worry. Still, knowing the specifics (toss in anaerobes and aerobes as well), you can impress real medical professionals with your knowledge of the secret, arcane language of medicine.... gram-positive/negative
The study of the minute structure of the tissues using special staining processes which are combined with electron and light microscopy. The specialty is sta?ed by medically quali?ed pathologists (histologists) and scienti?cally quali?ed technicians.... histology
A malignant tumour of the LYMPH NODES divided histologically and clinically into two types: Hodgkin’s disease, and non-Hodgkin’s lymphoma. Hodgkin’s disease or lymphadenoma was named after Thomas Hodgkin (1798–1866), a Guy’s Hospital pathologist, who ?rst described the condition.
Hodgkin’s disease The incidence is around four new cases per 100,000 population annually, with slightly more men than women contracting it. The ?rst incidence peak is in age group 20–35 and the second in age group 50–
70. The cause of Hodgkin’s is not known, although it is more common in patients from small families and well-educated backgrounds. The disease is three times more likely to occur in people who have had glandular fever (see MONONUCLEOSIS) but no link with the EPSTEIN BARR VIRUS has been established (see Burkitt’s lymphoma, below)
The disease is characterised histologically by the presence of large malignant lymphoid cells (Reed-Sternberg cells) in the lymph glands.
Clinically the lymph glands are enlarged, rubbery but painless; usually those in the neck or just above the CLAVICLE are affected. Spread is to adjacent lymph glands and in young people a mass of enlarged glands may develop in the MEDIASTINUM. The SPLEEN is affected in about one-third of patients with the disorder. Treatment is either with RADIOTHERAPY, CHEMOTHERAPY or both, depending on when the disease is diagnosed and the nature of the abnormal lymph cells. Cure rates are good, especially if the lymphoma is diagnosed early.
Non-Hodgkin’s lymphoma (NHL) This varies in its malignancy depending on the nature and activity of the abnormal lymph cells. The disease is hard to classify histologically, so various classi?cation systems have been evolved. High- and low-grade categories are recognised according to the rate of proliferation of abnormal lymph cells. No single causative factor has been identi?ed, although viral and bacterial infections have been linked to NHL, and genetic and immunological factors may be implicated. The incidence is higher than that of Hodgkin’s disease, at 12 new cases per 100,000 population a year, and the median age of diagnosis is 65–70 years. Suppression of the immune system that ocurs in people with HIV infection has been linked with a marked rise in the incidence of non-Hodgkin’s lymphoma and Hodgkin’s disease.
Most patients have painless swelling of one or more groups of lymph nodes in the neck or groin, and the liver and spleen may enlarge. As other organs can also be affected, patients may present with a wide range of symptoms, including fever, itching and weight loss. If NHL occurs in a single group of lymph nodes, radiotherapy is the treatment of choice; more extensive in?ltration of glands will require chemotherapy – and sometimes both types of treatment will be necessary. If these treatments fail, BONE MARROW TRANSPLANT may be carried out. Prognosis is good for low-grade NHL (75 per cent of patients survive ?ve years or more); in more severe types the survival rate is 40–50 per cent for two years.
Another variety of lymphoma is found in children in Africa, sometimes called after Burkitt, the Irish surgeon who ?rst identi?ed it. Burkitt’s lymphoma is a rapidly growing malignant tumour occurring in varying sites, and the Epstein Barr virus has a role in its origin and growth. A non-African variety of Burkitt’s lymphoma is now also recognised. CYTOTOXIC drug therapy is e?ective.... lymphoma
These form an agreed UK thesaurus of health-care terminology named after the general practitioner who devised them initially in the 1970s. The coding system provides a basis for computerised clinical records that can be shared across professional and administrative boundaries. Such records have essential safeguards for security and con?dentiality. The codes accommodate the di?erent views of specialists, but use simple terms without any loss of the ?ne detail necessary in specialist terminology. The Read Codes are being merged with the world’s other leading coding and classi?cation system: the College of American Pathologists’ Systemised Nomenclature of Medicine (SNOMED-RT).... read codes
a congenital disorder in which there is distortion of the base of the skull with protrusion of the lower brainstem and parts of the cerebellum through the opening for the spinal cord at the base of the skull (see banana and lemon signs). It is associated commonly with *neural tube defects, *hydrocephalus, and a *syringomyelia. [J. Arnold (1835–1915) and H. Chiari (1851–1916), German pathologists]... arnold–chiari malformation
a disorder in which enlargement and overactivity of the spleen occurs as a result of increased pressure within the splenic vein (see hypersplenism; splenomegaly). It arises primarily in children and occurs with *cirrhosis of the liver. [G. Banti (1852–1925), Italian pathologist]... banti’s syndrome
the distance (in millimetres) between the surface and the deepest extent of a malignant *melanoma. The measurement is the best prognostic indicator in melanoma; tumours that are less than 0.76 mm thick have a 5-year survival in well over 90% of patients. [A. Breslow (1928–80), US pathologist]... breslow thickness
a rare condition that follows occlusion of the hepatic veins by thrombosis or nonthrombotic processes. In the majority of cases the cause is unknown but hypercoagulable states, local or disseminated malignancy, and infection are possible causes. It is characterized by abdominal pain, abdominal distension due to ascites, and jaundice. Clinical examination may reveal hepatomegaly, and *hepatic encephalopathy. [G. Budd (1808–82), British physician; H. Chiari (1851–1916), German pathologist]... budd–chiari syndrome
(eosinophilic granulomatosis with polyangiitis) a systemic autoimmune *vasculitis comprising severe asthma, allergic rhinitis, and sinusitis associated with an increased *eosinophil count in the peripheral blood and eosinophilic deposits in the small vessels of the lungs. It usually responds to oral corticosteroids. [J. Churg (1910–2005) and L. Strauss (1913–85), US pathologists]... churg–strauss syndrome
a widely accepted histological classification of the extent of tumours of the colon and rectum, which is useful for prognosis. There have been modifications to the original classification. [Sir C. Dukes (1890–1977), British pathologist]... dukes’ staging
(EB virus, EBV, human herpesvirus 4, HHV-4) the virus, belonging to the *herpesvirus group, that is the causative agent of *glandular fever. It attacks B *lymphocytes. EB virus is also implicated in hepatitis and in certain cancers (e.g. *Burkitt’s lymphoma and *Hodgkin’s disease). [Sir M. A. Epstein (1921– ) and Y. M. Barr (1932– ), British pathologists]... epstein–barr virus
a malignant tumour of bone occurring in children and young adults. Distinguished from *osteosarcoma by J. Ewing in 1921, it commonly arises in the femur but is liable to spread to other bones and to the lung. It usually presents with pain, often associated with fever and *leucocytosis. The tumour is sensitive to radiotherapy, and systemic therapy with *cytotoxic drugs has greatly improved its prognosis. [J. Ewing (1866–1943), US pathologist]... ewing’s sarcoma
the lesion produced in the lung of a previously uninfected person by tubercle bacilli. It is a small focus of granulomatous inflammation, which may become visible on a chest X-ray if it grows large enough or if it calcifies. A Ghon focus usually heals without further trouble, but in some patients tuberculosis spreads from it via the lymphatics, the air spaces, or the bloodstream. [A. Ghon (1866–1936), Czech pathologist]... ghon’s focus
The second most common cancer in women. The alarming aspect of national health is the almost epidemic increase of cervical malignancy in younger women due to frequency of coitus, promiscuity, early coitus and contact with the herpes virus. All are mostly squamous cell carcinoma. Research studies have demonstrated a link between cigarette smoking and cancer of the cervix. (Dr Dan Hellberg)
Symptoms. Low backache, bleeding after intercourse, between periods or after ‘the change’. Abdominal swelling after 40 years of age. Sixty per cent of patients have no symptoms. Malodorous vaginal discharge. A positive cervical “pap” smear or cone-shaped biopsy examined by a pathologist confirms. Vaginal bleeding occurs in the later stages.
A letter in the New England Journal of Medicine suggests a strong link between increased risk of cervical cancer and cigarette smoking, nicotine being detected in the cervical fluids of cigarette smokers. This form of cancer is almost unknown in virgins living in closed communities such as those of the Church.
Conventional treatment is usually hysterectomy. Whatever treatment is adopted little ground is lost by supportive cleansing herbal teas. Mullein for pain.
Sponges loaded with powdered Goldenseal held against the cervix with a contraceptive cap can give encouraging results. Replace after three days. Vitamin A supplements are valuable to protect against the disease. The vitamin may also be applied topically in creams.
This form of cancer resists chemical treatment, but has been slowed down and halted by Periwinkle (Vinchristine) without damaging normal cells.
G.B. Ibotson, MD, reported disappearance of cancer of the cervix by infusions of Violet leaves by mouth and by vaginal injection. (Lancet 1917, i, 224)
In a study group of cervical cancer patients it was found that women with carcinoma in situ (CIS) were more likely to have a total Vitamin A intake below the pooled median (3450iu). Vitamin A supplementation is indicated together with zinc. (Bio-availability of Vitamin A is linked with zinc levels.) Vitamin A and zinc may be applied topically in creams and ointments.
Orthodox treatment: radiotherapy, chemotherapy, hysterectomy. As oestrogen can stimulate dormant cells the surgeon may wish to remove ovaries also. Whatever the decision, herbal supportive treatment may be beneficial. J.T Kent, MD, recommends Thuja and Shepherd’s Purse. Agents commonly indicated: Echinacea, Wild Indigo, Thuja, Mistletoe, Wild Yam. Herbal teas may be taken with profit. Dr Alfred Vogel advises Mistletoe from the oak (loranthus europaeus).
Other alternatives:– Teas. Red Clover, Violet, Mistletoe, Plantain, Clivers. 1-2 teaspoons to each cup boiling water. Infuse 15 minutes. 1 cup freely.
Decoctions. White Pond Lily. Thuja. Echinacea. Wild Yam. Any one.
Tablets/capsules. Echinacea. Goldenseal. Wild Yam. Thuja.
Formula No. 1. Red Clover 2; Echinacea 1; Shepherd’s Purse 1; Thuja quarter. Mix. Dose: Powders: 750mg (three 00 capsules or half a teaspoon). Liquid extracts: 1-2 teaspoons. Tinctures: 1-3 teaspoons. Formula No. 2. Equal parts: Poke root, Goldenseal, Mistletoe. Mix. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons.
Diet. Women who eat large quantities of meat and fatty foods are up to four times the risk of those eating mainly fruit and vegetables.
Vaginal injection. 1. Strong infusion Red Clover to which 10-15 drops Tincture Goldenseal is added. Follow with tampon smeared with Goldenseal Salve.
2. Strong decoction Yellow Dock to which 10-15 drops Tincture Goldenseal is added. Follow with tampon smeared with Goldenseal salve.
If bleeding is severe douche with neat distilled extract of Witch Hazel.
Chinese Herbalism. See – CANCER: CHINESE PRESCRIPTION. Also: Decoction of ssu-hsieh-lu (Galium gracile) 2-4 liang.
Advice. One-yearly smear test for all women over 40.
Diet. See: DIET – CANCER.
Treatment by a general medical practitioner or hospital oncologist. ... cancer – womb
the grade (from one to five) given to an area of prostate cancer, reflecting the level of differentiation of the tumour. The tumour pattern is assessed by examining the gland at low magnification. Higher grades indicate poorer differentiation. [D. F. Gleason (1920–2008), US pathologist]... gleason grade
a rare autoimmune illness with production of antibodies directed against the glomerular basement membrane (anti-GBM antibodies). Classically patients present with lung haemorrhage and a rapidly progressive glomerulonephritis. Most cases will respond to aggressive treatment with plasma exchange and immunosuppression. [E. W. Goodpasture (1886–1960), US pathologist]... goodpasture’s disease
a genetic condition characterized by disorders of the skin, bones, and nervous system, with a markedly increased risk of developing multiple *basal cell carcinomas. [R. J. Gorlin (1923– ), US pathologist]... gorlin’s syndrome
see renal cell carcinoma. [P. A. Grawitz (1850–1932), German pathologist]... grawitz tumour
see achalasia. [E. Heller (1877–1964), Austrian pathologist]... heller’s operation
a test for the presence of protein (albumin) in the urine. A quantity of urine is carefully poured onto the same quantity of pure nitric acid in a test tube. A white ring forms at the junction of the liquids if albumin is present. However, a similar result may be obtained if the urine contains certain drugs or is very concentrated. A dark brown ring indicates the presence of an abnormally high level of potassium indoxyl sulphate in the urine (see indicanuria). [J. F. Heller (1813–71), Austrian pathologist]... heller’s test
a mixture of potassium dichromate, sodium sulphate, mercuric chloride, formaldehyde, and distilled water, used in the preservation of bone marrow. [K. Helly (20th century), Swiss pathologist]... helly’s fluid
(primitive knot) the rounded front end of the embryonic *primitive streak. [V. Hensen (1835–1924), German pathologist]... hensen’s node
(IPF) a serious interstitial lung disease, formerly called cryptogenic fibrosing alveolitis (see alveolitis). It is characterized by progressive fibrous scarring of the lung and increased numbers of inflammatory cells in the alveoli and surrounding tissues. The disease is usually diagnosed on clinical grounds on a basis of worsening breathlessness, inspiratory crackles at the lung bases on auscultation, clubbing of the fingers or toes, bilateral radiographic shadowing predominantly in the lower zones of the chest X-ray, subpleural *honeycomb change on CT scanning of the chest, and restrictive lung function on spirometry. It is also called usual interstitial pneumonia (UIP; see interstitial pneumonia), a term used by lung pathologists for the most common cellular pattern seen on biopsy. Treatment includes *pirfenidone, corticosteroids, and immunosuppressants.... idiopathic pulmonary fibrosis
(interstitial pneumonitis) an alternative name for *idiopathic pulmonary fibrosis used by lung pathologists to classify the different cellular types of the disease. The most common cellular pattern is usual interstitial pneumonia (UIP). A differing cellular pattern is seen in patients with nonspecific interstitial pneumonia (NSIP), who have a better prognosis than those with UIP. There are two variants of NSIP: cellular and fibrosing. The former has chronic inflammatory cells with minimal collagen deposition, while the latter consists of diffuse interstitial fibrosis with fewer inflammatory cells. It is believed that corticosteroid therapy can slow the progression of cellular to fibrosing NSIP.... interstitial pneumonia
(Kernohan’s syndrome) *hemiplegia that is *ipsilateral to the brain lesion that caused it, due to pressure of the lesion (which is often a haematoma) on surrounding structures in the brain. It is unusual because normally a lesion of the brain causes dysfunction in the *contralateral limbs. [J. W. K. Kernohan (20th century), US pathologist]... kernohan’s phenomenon
a vertical linear deposit of brown pigment on the inner surface of the cornea (corneal endothelium), appearing in cases of pigment dispersion syndrome. [F. E. Krukenberg (1871–1946), German pathologist]... krukenberg’s spindle
see haemangioblastoma. [A. Lindau (1892–1958), Swedish pathologist]... lindau’s tumour
large irregular masses abnormally located in the hepatocytes of the liver. They are found in patients with alcoholic hepatitis, alcoholic cirrhosis, Wilson’s disease, primary biliary cirrhosis, clinical obesity, and hepatoma. [F. B. Mallory (1862–1941), US pathologist]... mallory bodies
trauma of the mucosal lining at the junction of the oesophagus (gullet) and stomach following protracted vomiting and retching. It is associated with *haematemesis and rarely perforation of the oesophagus. [G. K. Mallory (1926– ), US pathologist; S. Weiss (1899–1942), US physician]... mallory–weiss syndrome
(Rokitansky–Küster–Hauser syndrome, Müllerian agenesis) congenital absence of the uterus and upper part of the vagina due to failure of development of the *Müllerian duct. It may be associated with skeletal, renal, and auditory abnormalities, but usually presents with amenorrhoea in a patient with otherwise normal secondary sexual characteristics. There is a multidisciplinary approach to treatment, with psychological support, counselling, discussion of creation of a ‘neovagina’ with gradual use of vaginal dilators, and/or surgical vaginal reconstruction. Surrogacy is the only option for childbearing, although oocyte donation from the mother to a surrogate can be discussed. [K. W. Mayer (1795–1868), German gynaecologist; K. von Rokitansky (1804–78), Austrian pathologist; H. Küster and G. A. Hauser (20th century), German gynaecologists]... mayer–rokitansky–küster–hauser syndrome
an inherited (autosomal *recessive) disorder of lipid metabolism due to a defect in the enzyme sphingomyelinase and resulting in accumulation of sphingomyelin (a sphingolipid) and other phospholipids in the bone marrow, brain, liver, and spleen. Patients present with neurological problems, learning disabilities, and enlargement of the liver and spleen at a young age. There are four known types of the disease. [A. Niemann (1880–1921), German paediatrician; L. Pick (1868–1944), German pathologist]... niemann–pick disease
a cytotoxin responsible for increased virulence of *Staphylococcus aureus (see leukocidin). It may cause fatal necrotizing pneumonia or, more commonly, deep skin abscesses that tend to recur frequently. [Sir P. N. Panton (1877–1950) and F. C. Valentine (20th century), British pathologists]... panton–valentine leukocidin
particles that occur in the cells of skin rashes in patients with *cowpox or *smallpox; they are thought to be the virus particles. [E. Paschen (1860–1936), German pathologist]... paschen bodies
a congenital condition characterized by absence of kidneys, resulting in decreased amniotic fluid (see oligohydramnios) and compression of the fetus. Babies have poorly developed lungs, a characteristic wrinkled and flattened facial appearance, and leg deformities and do not usually survive. [E. L. Potter (20th century), US pathologist]... potter syndrome
a large binucleate cell that is characteristic of *Hodgkin’s disease. [D. Reed Mendenhall (1874–1964), US pathologist; C. Sternberg (1872–1935), Austrian pathologist]... reed–sternberg cell
protrusions of the pulpy inner material of an intervertebral disc into the vertebral body, generally found in the thoracic and lumbar spine. [C. G. Schmorl (1861–1932), German pathologist]... schmorl’s nodes
a condition in which *amenorrhoea and infertility follow a major haemorrhage in pregnancy. It is caused by necrosis (death) of the anterior lobe of the pituitary gland as a direct result of the haemorrhage reducing the blood supply to the gland. Compare Asherman syndrome. [H. L. Sheehan (20th century), British pathologist]... sheehan’s syndrome
n. the use of information technology in the diagnosis and treatment of patients. It includes telephone conversations between physicians or between physicians and patients; tele- or videoconferencing among members of a patient’s health-care team; and telepathology, in which (for example) digital pictures of microscope slides can be sent by the Internet to a pathologist for a second opinion. Using telemedicine, a paramedic can access a consultant in an A & E department for the appropriate emergency treatment in difficult cases.... telemedicine
see VIPoma. [J. V. Verner (1927– ), US physician; A. B. Morrison (1922– ), Irish pathologist]... verner–morrison syndrome
(perivascular spaces) fluid-filled spaces that form around blood vessels in the *pia mater as they penetrate deeper brain tissue. They may dilate, resulting in raised intracranial pressure. [R. Virchow (1821–1902), German pathologist]... virchow–robin spaces
an inherited syndrome in which *haemangioblastomas, particularly in the cerebellum, are associated with renal and pancreatic cysts, *angiomas in the retina (causing blindness), cancer of the kidney cells, and red birthmarks. [E. von Hippel (1867–1939), German ophthalmologist; A. Lindau (1892–1958), Swedish pathologist]... von hippel–lindau disease
1. a syndrome due to excessive secretion of *parathyroid hormone (hyperparathyroidism), characterized by loss of mineral from bones, which become weakened and fracture easily, and formation of kidney stones. Medical name: osteitis fibrosa. 2. see neurofibromatosis. [F. D. von Recklinghausen (1833–1910), German pathologist]... von recklinghausen’s disease
(adenolymphoma) a tumour of the parotid salivary glands, containing epithelial and lymphoid tissues with cystic spaces. [A. S. Warthin (1866–1931), US pathologist]... warthin’s tumour
see granulomatosis with polyangiitis. [F. Wegener (1907–90), German pathologist]... wegener’s granulomatosis
the relationship of the upper and lower parts of a two-part kidney with two ureters and their drainage into the bladder. It states that the upper ureter inserts lower and more medially into the bladder in contrast to the lower ureter, which inserts higher and more laterally into the bladder. [C. Weigert (1845–1904), German pathologist; R. Meyer (1864–1947), German physician]... weigart–meyer rule
see Clostridium. [W. H. Welch (1850–1934), US pathologist]... welch’s bacillus
a rare disease, occurring commonly (but not exclusively) in males, in which absorption of digested food in the intestine is reduced. As well as symptoms and signs of *malabsorption there is usually abdominal pain, skin pigmentation, and arthritis. Diagnosis is usually made by small-intestinal biopsy (duodenal or *jejunal biopsy) demonstrating the presence of PAS-positive (see periodic acid–Schiff reaction) macrophages containing the causative microorganism, Tropheryma whipplei. The disease usually responds to a prolonged course of antibiotics. [G. H. Whipple (1878–1976), US pathologist]... whipple’s disease
an acid-fast *carbol fuchsin stain used specifically for identifying the tubercle bacillus. [F. Ziehl (1857–1926), German bacteriologist; F. K. A. Neelsen (1854–94), German pathologist]... ziehl–neelsen stain
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