The anatomo-pathology , or pathological anatomy, is a medical Spécialité technical, human and veterinary, which is devoted to the study of the macroscopic and microscopic lesions of pathological fabrics taken on a subject alive or deceased. One owes the modern form of anatomo-pathology with the Italian Jean-Baptiste Morgagni or Giovanni Battista Morgagni.

The doctor or the veterinary surgeon specialized in anatomo-pathology is called anatomo-pathologist or commonly, but in abusive manner, Pathologiste.

Definitions

Pathology

The Pathologie is the study of the diseases. It integrates anatomo-pathology, the epidemiology, the Pathogénie, the Sémiologie etc the word " pathologie" is thus not a synonym of " maladie" , and must be used only in the singular.

Anatomo-pathology

Anatomo-pathology studies the macroscopic and microscopic lesions sick living beings. According to whether it is interested in the Man or the animal, human anatomo-pathology and anatomo-pathology veterinary surgeon are distinguished.

One considers:

the general anatomo-pathology, which is interested in the great organic processes concerning the basic elements of an organization: the Ignition, the Cancerology, the vascular disorders, cellular deteriorations, necroses it, cicatrization etc
the special anatomo-pathology, which studies pathology by apparatuses (heart, lung, liver, etc)

Lesion

One defines by Lésion any nonphysiological, macroscopic or microscopic modification, of a cell, a fabric or a body, and occurring of living animal. This last condition is important because it eliminates deteriorations post-mortem from fabrics such as the Autolyse, the Putréfaction, the rigor mortis (Rigor mortis) or the livor mortis (cadaveric lividity). If the pathologist should not regard them as true lesions, it holds account however of it, in particular like tools of dating of death, within the framework of the Legal medicine for example.

In order to distinguish lesions and not-lesions well, anatomo-pathology requires a good control of the basic concepts of Anatomie, Histologie and Physiologie: the normal one should well be known to recognize the abnormal one.

Cytopathology

The cytopathology is very often associated with anatomo-pathology. It is characterized some by the fact that the studied elements are not it any more in the form of fixed fabrics and half-compartments, but of taking away obtained generally by Ponction or copies, and directly spread out over a blade. The cells are then whole but the architecture of fabric is lost. Being of a spreading out and either a cut, the size of the cells is there larger and makes it possible to better appreciate cellular morphology (from where the name of Cytologie) rather than the tissue characteristics (field of the Histologie). Among the current taking away in cytopathology, let us quote the lumbar punctures (taking away of céphalo-rachidian Liquide), the articular punctures (taking away of synovial liquid), the cervical Smear, the punctures of mass, the punctures of hematopoietic osseous marrow (myélogramme), the lymphatic punctures of nodes (adénogramme), bronchoalveolar washings etc This discipline is in fact a mixed discipline depending at the same time on the medical Biologie and the Anatomopathologie.

Clinical pathology

Anatomo-pathology does not relate to the study of the composition of the biological liquids, which is reserved for medical biology. The Hématologie, which studies the illustrated elements of blood, was detached from anatomo-pathology and constitutes a speciality with whole share. medical Biology and Hématologie are often gathered under the clinical term of pathology.

Classification of the lesions

A simple classification of the lesions and diseases is founded on their etiology. A first dichotomy is carried out between the tumoral lesions and the nontumoral lesions. In the nontumoral lesions, one considers the lesions of origins inflammatory, degenerative, nutritional, metabolic, toxic, infectious, physical, chemical, traumatic, behavioral, genetic, embryologic, etc These categories are far from being hermetic because for the same lesion, it can exist the numerous ones inter-connected. Thus, certain viral infections can generate tumors, and degenerative lesions often cause strong inflammatory reactions.

Tools of anatomo-pathology

The macroscopic examination

The eye is the first tool of the pathologist. Indeed, anatomo-pathology is before a a whole science of description. According to the cases, the other directions can also be solicited. For example, during the examination of a Tumor on a corpse, one will endeavor to describe his localization, his size, his color, his form, his consistency, his delimitation, his reports/ratios with the other bodies, his aspect with the cut, etc With this stage, of much information can direct the diagnosis. During the macroscopic examination, the pathologist can have recourse to a balance in order to appreciate possible variations of weight of the bodies.

The microscopic examination

The microscopic analysis is generally the principal activity of the pathologist. It has for that recourse to the tools of microscopy, mainly optical or photonic, but also electronic. The immunofluorescence, the immunohistochimy and hybridization in situ are also used in order to look further into the diagnosis.

This stage makes it possible to affirm the tumoral character or not lesion and to lead if necessary to the denomination of the tumor, based on the cellular type of origin. The microscopic examination also makes it possible to appreciate the lesions of the inflammatory type and to possibly identify a causal agent (Virus, Bactérie S, Protozoaire S, Mycète S, Parasite S etc)

Applications of anatomo-pathology

Anatomo-pathology is occupied:

Of the diagnosis of certain diseases which claim a anatomo-pathological certainty: for example the Cancer S, where only the specialist will be able to affirm that a lesion that one subjected to him includes/understands cancer cells. The pathologist identifies the type of tumor in addition and can if necessary provide a forecast on the gravity of the lesion.
to affirm the complete character of the ablation of a tumor, by examining its edges (either its limits of exérèse): to be sure to have removed all the tumor, the Chirurgie N makes check by the anatomo-pathologist whom the limits of résection do not contain of tumoral cells.
Of the Nécropsie S (or Autopsie S), which are the examination of the Cadavre S whose causes of death are doubtful on a medical level (suspect deaths from a legal point of view are autopsiées by a medical examiner).
to analyze the lesions generated by the medicamentous substances on the animals of laboratory. The pathologist is then a chain link leading to the marketing authorization of a drug or other chemical substances. Henceforth, this way is almost exclusively reserved to the veterinary pathologists.

See too

External bonds

AFIAP (French Association of the Interns in Anatomy and Pathological cytology)
French company of Veterinary Pathology
Site of the Diploma of Studies Specialized in Pathological anatomy
Site of the College Veterinary European of Pathology (European College Off Veterinary Pathology)

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