Contents
Section I |
GENERAL PATHOLOGY |
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AND BASIC TECHNIQUES |
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CHAPTER 1 |
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Introduction to Pathology |
01 |
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Study of Diseases, 1
Evolution of Pathology, 1
Subdivisions of Pathology, 7
CHAPTER 2
Techniques for the Study of Pathology 09
Autopsy Pathology, 9
Surgical Pathology, 9
Special Stains (Histochemistry), 11
Enzyme Histochemistry, 13
Basic Microscopy, 13
Immunofluorescence, 14
Electron Microscopy, 14
Immunohistochemistry, 15
Cytogenetics, 16
Diagnostic Molecular Pathology, 17
Other Modern Aids in Diagnostic Pathology, 18
CHAPTER 3 |
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Cell Injury and Cellular Adaptations |
21 |
The Normal Cell, 21 |
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Etiology of Cell Injury, 27 |
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Pathogenesis of Cell Injury, 28 |
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Morphology of Cell Injury, 34 |
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Intracellular Accumulations, 37 |
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Pigments, 40 |
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Morphology of Irreversible Cell Injury |
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(Cell Death), 44 |
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Cellular Adaptations, 53 |
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Cellular Aging, 59 |
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CHAPTER 4 |
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Immunopathology Including |
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Amyloidosis |
61 |
Introduction, 61
Structure of Immune System, 61
HLA System and Major Histocompatibility
Complex, 64
Transplant Rejection, 65
Diseases of Immunity, 66
Immunodeficiency Diseases, 67
Acquired Immunodeficiency Syndrome (AIDS), 67
Hypersensitivity Reactions (Immunologic
Tissue Injury), 73
Autoimmune Diseases, 77
Types and Examples of Autoimmune Diseases, 78
Amyloidosis, 82
CHAPTER 5 |
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Derangements of Homeostasis and |
93 |
Haemodynamics |
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Homeostasis, 93
Disturbances of Body Fluids, 96
Oedema, 96
Dehydration, 102
Overhydration, 102
Disturbances of Electrolytes, 103
Acid-base Imbalance (Abnormalities in pH
of Blood), 103
Haemodynamic Derangements, 104
Disturbances in the Volume of Circulating Blood, 105
Haemorrhage, 107
Shock, 108
Circulatory Disturbances of Obstructive Nature, 113
Thrombosis, 113
Embolism, 119
Ischaemia, 124
Infarction, 126
CHAPTER 6 |
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Inflammation and Healing |
130 |
Inflammation, 130
Introduction, 130
Acute Inflammation, 130
Chemical Mediators of Inflammation, 136
The Inflammatory Cells, 141
Morphology of Acute Inflammation, 144
Chronic Inflammation, 147
General Features of Chronic Inflammation, 147
Systemic Effects of Chronic Inflammation, 147
Types of Chronic Inflammation, 147
Granulomatous Inflammation, 148
Examples of Granulomatous Inflammation, 149
Tuberculosis, 149
Leprosy, 157
Syphilis, 161
Actinomycosis, 163
Sarcoidosis (Boeck’s Sarcoid), 164
Healing, 165
Regeneration, 165
Repair, 166
Wound Healing, 167
Healing in Specialised Tissues, 171
CHAPTER 7 |
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Infectious and Parasitic Diseases |
174 |
Introduction, 174
Diseases Caused by Bacteria, Spirochaetes and Mycobacteria, 175
Diseases Caused by Fungi, 181 Diseases Caused by Viruses, 183 Diseases Caused by Parasites, 187 Torch Complex, 190
xi Contents
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Pathology of Textbook
CHAPTER 8 |
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Neoplasia |
192 |
Nomenclature and Classification, 192 Characteristics of Tumours, 194
Rate of Growth, 194
Cancer Phenotype and Stem Cells, 196 Clinical and Gross Features, 196 Microscopic Features, 196
Local Invasion (Direct Spread), 200 Metastasis (Distant Spread), 200 Grading and Staging of Cancer, 204
Epidemiology and Predisposition to Neoplasia, 205
Cancer Incidence, 205 Epidemiologic Factors, 205
Carcinogenesis: Etiology and Pathogenesis of Cancer, 208
Molecular Pathogenesis of Cancer (Genetic Mechanism of Cancer), 208
Chemical Carcinogenesis, 216
Physical Carcinogenesis, 220
Biologic Carcinogenesis, 222
Viruses and Human Cancer: A Summary, 228
Clinical Aspects of Neoplasia, 228
Tumour-host Inter-relationship, 228
Pathologic Diagnosis of Cancer, 232
CHAPTER 9 |
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Environmental and |
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Nutritional Diseases |
236 |
Introduction, 236 |
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Environmental Pollution, 236 |
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Air Pollution, 236 |
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Tobacco Smoking, 237 |
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Chemical and Drug Injury, 238 |
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Therapeutic (Iatrogenic) Drug Injury, 238 |
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Non-therapeutic Toxic Agents, 238 |
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Environmental Chemicals, 242 |
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Injury by Physical Agents, 242 |
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Thermal and Electrical Injury, 242 |
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Injury by Radiation, 242 |
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Nutritional Diseases, 243 |
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Obesity, 243 |
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Starvation, 245 |
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Protein-energy Malnutrition, 245 |
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Disorders of Vitamins, 246 |
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Metals and Trace Elements, 254 |
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Diet and Cancer, 254 |
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CHAPTER 10 |
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Genetic and Paediatric Diseases |
256 |
Developmental Defects, 256
Cytogenetic (Karyotypic) Abnormalities, 257
Single-gene Defects (Mendelian Disorders), 259
Storage Diseases (Inborn Errors of
Metabolism), 260
Multifactorial Inheritance, 263
Other Paediatric Diseases, 263
CHAPTER 11 |
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Basic Diagnostic Cytology |
266 |
Introduction, 266 Exfoliative Cytology, 267
Female Genital Tract, 267 Respiratory Tract, 272 Gastrointestinal Tract, 273 Urinary Tract, 273
Body Fluids, 273
Buccal Smears for Sex Chromatin Bodies, 274 Techniques in Exfoliative Cytology, 275
Interventional Cytology, 277
Fine Needle Aspiration Cytology, 277 Imprint Cytology, 283
Crush Smear Cytology, 283 Biopsy Sediment Cytology, 283
Section II |
HAEMATOLOGY AND |
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LYMPHORETICULAR TISSUES |
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CHAPTER 12
Introduction to Haematopoietic System
and Disorders of Erythroid Series |
284 |
Bone Marrow, 284 |
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Haematopoiesis, 284 |
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Haematopoietic Stem Cells, 285 |
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Bone Marrow Examination, 285 |
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Red Blood Cells, 287 |
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Erythropoiesis, 287 |
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Anaemia—General Considerations, 291 |
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Anaemia of Blood Loss, 294 |
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Hypochromic Anaemia, 295 |
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Megaloblastic Anaemia, 303 |
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Pernicious Anaemia, 309 |
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Haemolytic Anaemias, 310 |
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Acquired (Extracorpuscular) Haemolytic |
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Anaemias, 311 |
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Hereditary (Intracorpuscular) Haemolytic |
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Anaemia, 314 |
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Aplastic Anaemia and Other Primary Bone |
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Marrow Disorders, 324 |
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CHAPTER 13 |
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Disorders of Platelets, Bleeding |
327 |
Disorders and Basic Transfusion |
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Medicine |
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Thrombopoiesis, 327
Bleeding Disorders (Haemorrhagic Diathesis), 328
Investigations of Haemostatic Function, 328 Haemorrhagic Diatheses Due to Vascular
Disorders, 331
Haemorrhagic Diatheses Due to Platelet Disorders, 331
Coagulation Disorders, 335
Haemorrhagic Diathesis Due to Fibrinolytic Defects, 337
Disseminated Intravascular Coagulation (DIC), 337
Blood Groups and Blood Transfusion, 339
CHAPTER 14 |
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Disorders of Leucocytes and |
342 |
Lymphoreticular Tissues |
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Lymph Nodes: Normal and Reactive, 342
Normal Structure, 342
Reactive Lymphadenitis, 343
White Blood Cells: Normal and Reactive, 345
Granulopoiesis, 345
Lymphopoiesis, 346
Infectious Mononucleosis, 350
Leukaemoid Reactions, 352
Haematologic Neoplasms
(Leukaemias-lymphomas): General, 353
Classification: Current Concepts, 353
Myeloid Neoplasms, 356
Myeloproliferative Diseases, 356
Myelodysplastic Syndromes, 361
Acute Myeloid Leukaemia, 362
Lymphoid Neoplasms, 365
General Comments on Lymphoid Malignancies, 368
Hodgkin’s Disease, 369
Precursor (Immature) B- and T-cell Leukaemia/
Lymphoma (Synonym: Acute Lymphoblastic
Leukaemia), 373
Peripheral (Mature) B-cell Malignancies, 374
Peripheral (Mature) T-cell Malignancies, 379
Plasma Cell Disorders, 380
Lymph Node Metastatic Tumours, 385
Histiocytic Neoplasms:
Langerhans’ Cell Histiocytosis, 385
Spleen, 386
Thymus, 388
Section III SYSTEMIC PATHOLOGY
CHAPTER 15 |
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The Blood Vessels and Lymphatics |
390 |
Arteries, 390 |
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Normal Structure, 390 |
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Arteriosclerosis, 391 |
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Arteritis, 400 |
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Aneurysms, 405 |
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Fibromuscular Dysplasia, 409 |
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Veins, 409 |
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Lymphatics, 410 |
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Tumours and Tumour-like Lesions, 411 |
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CHAPTER 16 |
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The Heart |
417 |
Normal Structure, 417
Patterns and Classification of Heart
Diseases, 418
Heart Failure, 419
Congenital Heart Disease, 422
Malpositions of the Heart, 423
Shunts (Cyanotic Congenital Heart Disease), 423
Obstructions (Obstructive Congenital Heart
Disease), 426
Ischaemic Heart Disease, 427
Etiopathogenesis, 427
Effects of Myocardial Ischaemia, 428
Angina Pectoris, 429
Acute Myocardial Infarction, 429
Chronic Ischaemic Heart Disease, 436
Sudden Cardiac Death, 436
Hypertensive Heart Disease, 437
Cor Pulmonale, 437
Rheumatic Fever and Rheumatic Heart
Disease, 438
Non-rheumatic Endocarditis, 444
Valvular Diseases and Deformities, 449
Myocardial Disease, 452
Myocarditis, 452
Cardiomyopathy, 454
Pericardial Disease, 456
Pericardial Fluid Accumulations, 456
Pericarditis, 457
Tumours of the Heart, 459
Pathology of Cardiovascular Interventions, 459
CHAPTER 17 |
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The Respiratory System |
461 |
Lungs, 461
Normal Structure, 461 Paediatric Lung Disease, 462
Pulmonary Vascular Disease, 465 Pulmonary Infections, 467
Pneumonias, 467
Lung Abscess, 475
Fungal Infections of Lung, 476
Pulmonary Tuberculosis, 477
Chronic Obstructive Pulmonary Disease, 477 Chronic Bronchitis, 477
Emphysema, 478 Bronchial Asthma, 483 Bronchiectasis, 484
Chronic Restrictive Pulmonary Disease, 486 Pneumoconioses, 487
ILD Associated with Immunologic Lung Diseases, 493
ILD Associated with Connective Tissue Diseases, 495
Idiopathic Pulmonary Fibrosis, 495 ILD Associated with Smoking, 496
Tumours of Lungs, 496
Pleura, 504
CHAPTER 18 |
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The Eye, ENT and Neck |
507 |
Eye, 507
Ear, 513
Nose And Paranasal Sinuses, 515
Pharynx, 517
Larynx, 519
Neck, 520
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Contents
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Pathology of Textbook
CHAPTER 19 |
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The Oral Cavity and Salivary Glands |
522 |
Oral Soft Tissues, 522 |
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Normal Structure, 522 |
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Developmental Anomalies, 522 |
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Mucocutaneous Lesions, 522 |
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Inflammatory Diseases, 522 |
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Pigmentary Lesions, 523 |
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Tumours and Tumour-like Lesions, 523 |
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Teeth and Periodontal Tissues, 527 |
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Normal Structure, 527 |
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Dental Caries, 528 |
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Periodontal Disease, 529 |
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Epithelial Cysts of the Jaw, 529 |
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Odontogenic Tumours, 531 |
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Salivary Glands, 533 |
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Normal Structure, 533 |
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Salivary Flow Disturbances, 533 |
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Sialadenitis, 533 |
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Tumours of Salivary Glands, 534 |
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CHAPTER 20 |
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The Gastrointestinal Tract |
538 |
Oesophagus, 538
Normal Structure, 538
Congenital Anomalies, 538
Muscular Dysfunctions, 538
Haematemesis of Oesophageal Origin, 539
Inflammatory Lesions, 540
Tumours of Oesophagus, 541
Stomach, 543
Normal Structure, 543
Gastric Analysis, 544
Congenital Anomalies, 545
Miscellaneous Acquired Conditions, 546
Inflammatory Conditions, 546
Haematemesis and Melaena of Gastric Origin, 554
Tumours and Tumour-like Lesions, 554
Small Intestine, 560
Normal Structure, 560
Congenital Anomalies, 561
Intestinal Obstruction, 562
Ischaemic Bowel Disease
(Ischaemic Enterocolitis), 563
Inflammatory Bowel Disease
(Crohn’s Disease and Ulcerative Colitis), 565
Other Inflammatory Lesions of the Bowel, 569
Malabsorption Syndrome, 573
Small Intestinal Tumours, 576
Appendix, 577
Normal Structure, 577
Appendicitis, 578
Tumours of Appendix, 579
Large Intestine, 579
Normal Structure, 579
Congenital Malformations, 580
Colitis, 580
Miscellaneous Lesions, 581
Miscellaneous Inflammatory Conditions, 581
Large Intestinal Polyps and Tumours, 581
Causes of Gastrointestinal Bleeding, 590
Peritoneum, 590
CHAPTER 21 |
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The Liver, Biliary Tract and |
592 |
Exocrine Pancreas |
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Liver, 592
Normal Structure, 592
Liver Function Tests, 593
Jaundice—General, 596
Neonatal Jaundice, 600
Hepatic Failure, 602
Circulatory Disturbances, 603
Liver Cell Necrosis, 604
Viral Hepatitis, 605
Other Infections and Infestations, 614
Chemical and Drug Injury, 617
Cirrhosis, 618
Clinical Manifestations and Complications of
Cirrhosis, 630
Portal Hypertension, 630
Hepatic Tumours and Tumour-like Lesions, 632
Biliary System, 638
Normal Structure, 638
Congenital Anomalies, 638
Cholelithiasis (Gallstones), 638
Cholecystitis, 641
Tumours of Biliary System, 643
Exocrine Pancreas, 644
Normal Structure, 644
Developmental Anomalies, 645
Pancreatitis, 646
Tumours and Tumour-like Lesions, 647
CHAPTER 22
The Kidney and Lower Urinary Tract 649
Kidney, 649
Normal Structure, 649
Renal Function Tests, 652
Pathophysiology of Renal Disease:
Renal Failure, 653
Congenital Malformations, 656
Glomerular Diseases, 660
Pathogenesis of Glomerular Injury, 662
Specific Types of Glomerular Diseases, 665
Tubular and Tubulointerstitial Diseases, 678
Renal Vascular Diseases, 685
Obstructive Uropathy, 690
Tumours of Kidney, 693
Lower Urinary Tract, 698
Normal Structure, 698
Congenital Anomalies, 698
Inflammations, 698
Tumours, 700
CHAPTER 23
The Male Reproductive System and 703
Prostate
Testis and Epididymis, 703
Normal Structure, 703
Congenital Anomalies, 703
Inflammations, 705
Miscellaneous Lesions, 706
Testicular Tumours, 706
Penis, 714
Normal Structure, 714
Congenital Anomalies, 714
Inflammations, 714
Tumours, 714
Prostate, 716
Normal Structure, 716
Prostatitis, 716
Nodular Hyperplasia, 717
Carcinoma of Prostate, 718
CHAPTER 24 |
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The Female Genital Tract |
721 |
Vulva, 721
Normal Structure, 721
Bartholin’s Cyst and Abscess, 721
Non-neoplastic Epithelial Disorders, 721
Vulval Tumours, 722
Vagina , 723
Normal Structure, 723
Vaginitis and Vulvovaginitis, 723
Tumours and Tumour-like Conditions, 723
Cervix , 724
Normal Structure, 724
Cervicitis, 724
Tumours, 725
Myometrium and Endometrium , 730
Normal Structure, 730
Normal Cyclic Changes, 730
Effects of Hormones, 730
Dysfunctional Uterine Bleeding (DUB), 731
Endometritis and Myometritis, 732
Adenomyosis , 732
Endometriosis, 732
Endometrial Hyperplasias, 733
Tumours of Endometrium and Myometrium, 735
Fallopian Tubes, 738
Normal Structure, 738
Inflammations, 738
Ectopic Tubal Pregnancy, 739
Tumours and Tumour-like Lesions, 739
Ovaries, 739
Normal Structure, 739
Non-neoplastic Cysts, 740
Ovarian Tumours, 740
Placenta , 751
Normal Structure, 751
Hydatidiform Mole, 751
Choriocarcinoma, 753
CHAPTER 25 |
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The Breast |
754 |
Normal Structure, 754
Non-neoplastic Conditions, 755
Inflammations, 755
Fibrocystic Change, 755
Gynaecomastia (Hypertrophy of Male Breast), 757
Breast Tumours, 757
Fibroadenoma, 757
Phyllodes Tumour (Cystosarcoma Phyllodes), 758
Intraductal Papilloma, 759
Carcinoma of the Breast, 759
CHAPTER 26 |
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The Skin |
768 |
Normal Structure, 768
Histopathologic Terms, 769
Dermatoses, 769
Genetic Dermatoses, 769
Non-infectious Inflammatory Dermatoses, 770
Infectious Dermatoses, 771
Granulomatous Diseases, 774
Connective Tissue Diseases, 774
Non-infectious Bullous Dermatoses, 775
Scaling Dermatoses, 778
Metabolic Diseases of Skin, 778
Tumours and Tumour-like Lesions, 779
Tumours and Cysts of the Epidermis, 780
Adnexal (Appendageal) Tumours, 785
Melanocytic Tumours, 787
Tumours of the Dermis, 789
Cellular Migrant Tumours, 790
CHAPTER 27 |
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The Endocrine System |
791 |
Endocrines: The Basic Concept , 791
Pituitary Gland , 792
Normal Structure, 792
Hyperpituitarism, 793
Hypopituitarism, 794
Pituitary Tumours, 795
Adrenal Gland , 796
Normal Structure, 796
Adrenocortical Hyperfunction
(Hyperadrenalism), 797
Adrenocortical Insufficiency (Hypoadrenalism), 798
Tumours of Adrenal Glands, 799
Thyroid Gland , 801
Normal Structure, 801
Functional Disorders, 802
Thyroiditis, 804
Graves’ Disease (Diffuse Toxic Goitre), 806
Goitre, 807
Thyroid Tumours, 810
Parathyroid Glands, 815
Normal Structure, 815
Hyperparathyroidism, 816
Hypoparathyroidism, 817
Parathyroid Tumours, 817
Endocrine Pancreas, 818
Normal Structure, 818
Diabetes Mellitus, 818
Islet Cell Tumours, 828
Miscellaneous Endocrine Tumours, 829
Multiple Endocrine Neoplasia (MEN)
Syndromes, 829
Polyglandular Autoimmune (PGA) Syndromes, 829
CHAPTER 28 |
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The Musculoskeletal System |
830 |
Skeletal System, 830
Normal Structure of Bone, 830
Normal Structure of Cartilage, 831
Osteomyelitis, 831
xv
Contents
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Pathology of Textbook
Avascular Necrosis (Osteonecrosis) , 833
Fracture Healing, 834
Disorders of Bone Growth and Development
(Skeletal Dysplasias), 834
Metabolic and Endocrine Bone Diseases, 834
Paget’s Disease of Bone (Osteitis Deformans), 837
Tumour-like Lesions of Bone, 837
Bone Tumours, 839
Joints, 850
Normal Structure, 850
Osteoarthritis, 850
Rheumatoid Arthritis, 851
Suppurative Arthritis, 853
Tuberculous Arthritis, 853
Gout and Gouty Arthritis, 853
Pigmented Villonodular Synovitis and
Tenosynovial Giant Cell Tumour, 855
Cyst of Ganglion, 855
Bursitis, 856
Skeletal Muscles, 856
CHAPTER 30 |
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The Nervous System |
871 |
Central Nervous System, 871
Normal Structure, 871
Developmental Anomalies, 872
Hydrocephalus, 873
Infections, 874
Cerebrovascular Diseases, 879
Trauma to the CNS, 882
Demyelinating Diseases, 883
Miscellaneous Diseases, 884
Tumours of the CNS, 886
Peripheral Nervous System, 891
Normal Structure, 891
Pathologic Reactions to Injury, 891
Peripheral Neuropathy, 892
Nerve Sheath Tumours, 893
CHAPTER 29 |
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APPENDIX |
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Soft Tissue Tumours |
860 |
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General Features, 860 |
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APPENDIX |
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Tumours and Tumour-like Lesions of |
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Fibrous Tissue, 861 |
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Normal Values |
896 |
Fibrohistiocytic Tumours, 864 |
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Weights and Measurements of |
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Tumours of Adipose Tissue, 865 |
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Normal Organs, 896 |
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Skeletal Muscle Tumours, 867 |
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Laboratory Values of Clinical Significance, 897 |
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Tumours of Uncertain Histogenesis, 868 |
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Further Readings |
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904 |
Index |
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911 |