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{{Short description|Study of disease}}
{{other uses}}
{{Redirect|Pathobiology|the journal|Karger Publishers||Pathology (disambiguation)}}
{{Redirect|Pathologist}}
{{Redirect|Pathological case|the corresponding case in engineering|Corner case}}
] (chromophobe type) viewed on a ] & ] stained slide]]


{{Infobox medical specialty
{{Refimprove|date=November 2010}}
| title = Pathology
| image = ]
| caption = A pathologist examines a tissue section for evidence of cancerous cells while a surgeon observes.
| focus = ]
| subdivisions = ], ], ], ], ], ], ], ]
| diseases = All ] and ] ] and physiological disorders
| tests = All medical diagnostic tests, particular ], ], ], and other applications of medical ]
| specialist = Pathologist
| glossary = ]
}}
{{Infobox Occupation
| name = Pathologist
| image =
| caption =
| official_names =
* Physician
* Surgeon
| type = ]
| activity_sector = ], ]
| competencies =
| formation =
* ] (M.D.)
* ] (D.O.)
* ] (D.V.M)
* ] (M.B.B.S./M.B.Ch.B.)
| employment_field = ]s, ]s
| related_occupation =
}}

'''Pathology''' is the study of ].<ref>{{Cite book |last=Herausgeber. |first=Cross, Simon S., Herausgeber. Underwood, James C. E. 1942- |url=http://worldcat.org/oclc/1043350646 |title=Underwood's pathology : a clinical approach |date=30 April 2018 |publisher=Elsevier – Health Sciences Division |isbn=978-0-7020-7212-3 |oclc=1043350646}}</ref> The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of ] research fields and medical practices. However, when used in the context of modern medical treatment, the term is often used in a narrower fashion to refer to processes and tests that fall within the contemporary medical field of "general pathology", an area that includes a number of distinct but inter-related ] that diagnose disease, mostly through analysis of ] and ] samples. Idiomatically, "a pathology" may also refer to the predicted or actual progression of particular diseases (as in the statement "the many different forms of ] have diverse pathologies", in which case a more proper choice of word would be "]"). The ] ''pathy'' is sometimes used to indicate a state of disease in cases of both physical ailment (as in ]) and ] conditions (such as ]).<ref>{{cite web|title=-pathy, comb. form |work=] |url=https://oed.com/view/Entry/138811|department=OED Online|publisher=Oxford University Press|access-date=23 March 2020|date=2005|edition=3rd}}</ref> A ] practicing pathology is called a ''pathologist''.


As a field of general inquiry and research, pathology addresses components of disease: cause, mechanisms of development (]), structural alterations of cells (morphologic changes), and the consequences of changes (clinical manifestations).<ref>{{cite book |last1=Kumar |first1=Vinay |last2=Abbas |first2=Abul K. |last3=Fausto |first3=Nelson |last4=Aster |first4=Jon C. |title= Robbins and Cotran Pathologic Basis of Disease |date=2010 |publisher=Saunders/Elsevier |location=Philadelphia |isbn=978-1-4160-3121-5 |edition=8th}}</ref> In common medical practice, general pathology is mostly concerned with analyzing known clinical abnormalities that are markers or precursors for both ] and ] disease, and is conducted by experts in one of two major specialties, ] and ].<ref name = october>{{cite web | title = Pathology Specialty Description | publisher = American Medical Association | url = https://www.ama-assn.org/specialty/pathology-specialty-description | access-date = 5 October 2020}}</ref> Further divisions in specialty exist on the basis of the involved sample types (comparing, for example, ], ], and ]), organs (as in ]), and physiological systems (]), as well as on the basis of the focus of the examination (as with ]).
'''Pathology''' is the precise study and ] of ]. The word '']'' is from ] {{lang|grc|πάθος}}, ''pathos'' which may be translated into English as either "experience" or "suffering". and {{lang|grc|-λογία}}, '']'', "An account of" or "the study of". '']'', to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. ]. '''Pathologies''' is synonymous with diseases. The suffix "path" is used to indicate a disease, e.g. ].


Pathology is a significant field in modern ] and ].
Pathology addresses four components of disease: cause/etiology, mechanisms of development (pathogenesis), structural alterations of cells (morphologic changes), and the consequences of changes (clinical manifestations).<ref>{{Cite book
| edition = 8th ed. /
| publisher = Saunders/Elsevier
| isbn = 978-1-4160-3121-5
| last = Robbins
| first = Stanley
| title = Robbins and Cotran pathologic basis of disease.
| location = Philadelphia
| year = 2010
}}</ref>


==Etymology==
Pathology is further separated into divisions, based on either the system being studied (e.g. ] and animal disease) or the focus of the examination (e.g. forensic pathology and determining the cause of death).
The ] term ''pathology'' derives from the ] ] ''pathos'' ({{lang|grc|πάθος}}), meaning "experience" or "suffering", and '']'' ({{lang|grc|]}}), meaning "study of". The term is of early 16th-century origin, and became increasingly popularized after the 1530s.<ref>{{Cite journal |last=Janssen |first=Diederik F. |date=April 2022 |title=From Pathognomicha and Passiologia to Pathologia: concise history of a neologism (1486-1598) |url=https://www.pathologica.it/article/view/261 |journal=Pathologica |volume=114 |issue=2 |pages=185–188 |doi=10.32074/1591-951X-261 |pmid=35481571 |pmc=9248257 |issn=1591-951X}}</ref>


==History== ==History==
{{Main|History of medicine}}
The history of pathology can be traced back to antiquity when people began examining bodies. The examination of bodies led to the dissection of bodies in order to justify the cause of death.
During that time, the people already began formulating today what we know as inflammation, tumors, boils, and much more.<ref name="Long1965">{{cite book|last=Long|first=Esmond|title=History of Pathology|year=1965|publisher=Dover|location=New York|isbn=0-486-61342-9|pages=1+}}</ref>


] in 1978 examine cultures containing ''Legionella pneumophila'', the pathogen responsible for ].]]
Pathology began to develop as a subject during the 19th Century through teachers and physicians that studied pathology. They referred
The study of pathology, including the detailed examination of the body, including dissection and inquiry into specific maladies, dates back to antiquity. Rudimentary understanding of many conditions was present in most early societies and is attested to in the records of the earliest ], including those of the ], ], and ].<ref name="Long1965">{{cite book|last=Long|first=Esmond|title=History of Pathology|date=1965|publisher=Dover|location=New York|isbn=978-0-486-61342-0|pages=1+}}</ref> By the ] of ], a concerted causal study of disease was underway (see ]), with many notable early physicians (such as ], for whom the modern ] is named) having developed methods of ] and ] for a number of diseases. ] and ] continued from these Greek roots, but, as with many areas of scientific inquiry, growth in understanding of medicine stagnated somewhat after the ], but continued to slowly develop throughout numerous cultures. Notably, many advances were made in the medieval era of Islam (see ]), during which numerous texts of complex pathologies were developed, also based on the Greek tradition.<ref>{{Cite web|last1=Arcolani |first1=Giovanni |title = Commentary on the Ninth Book of Medicine Dedicated to Mansur&nbsp;— Commentaria in nonum librum Rasis ad regem Almansorem| work = World Digital Library| language = la| access-date = 2014-03-02| date = 1542| url = http://www.wdl.org/en/item/10672/| url-status = live| archive-url = https://web.archive.org/web/20140214144236/http://www.wdl.org/en/item/10672/| archive-date = 2014-02-14}}</ref> Even so, growth in complex understanding of disease mostly languished until knowledge and experimentation again began to proliferate in the ], ], and ] eras, following the resurgence of the empirical method at new centers of scholarship. By the 17th century, the study of rudimentary ] was underway and examination of tissues had led ] member ] to coin the word "]", setting the stage for later ].{{citation needed|date=June 2022}}
to it as “pathological anatomy” or “morbid anatomy.”
However, pathology as a field of medicine was not recognized until the late 19th and early 20th centuries. In the 19th century, physicians realized that disease-causing pathogens, germs, created themselves and that symptoms were not the vital characteristics of a disease. Through the new information gathered regarding germ reproduction, physicians began to compare the characteristics of one germ’s symptoms as they developed within an affected individual to another germ’s characteristics and symptoms. This realization led to the foundational understanding that diseases are able to create themselves, and that they can affect human beings in unique ways. In order to determine causes of diseases, medical experts used the most common and widely accepted assumptions or symptoms of their times. This is true for those in the past and today.<ref>{{cite book|last=King|first=Lester|title=Transformations in American Medicine: From Benjamin Rush to William Osler|year=1991|publisher=Johns Hopkins UP|location=Baltimore|isbn=0-8018-4057-0|pages=27+}}</ref> <ref>{{cite journal|last=Machevsky|first=Alberto|title=Evidence-based Medicine, Medical Decision Analysis, and Pathology|journal=Human Pathology|year=2004|volume=35|issue=10|pages=1179–88|url=http://www.sciencedirect.com/science/article/pii/S0046817704003430|accessdate=21 March 2012|doi=10.1016/j.humpath.2004.06.004|pmid=15492984|last2=Wick|first2=MR}}</ref>


Modern pathology began to develop as a distinct field of inquiry during the 19th Century through ] and physicians that studied disease and the informal study of what they termed "pathological anatomy" or "morbid anatomy". However, pathology as a formal area of specialty was not fully developed until the late 19th and early 20th centuries, with the advent of detailed study of ]. In the 19th century, physicians had begun to understand that disease-causing pathogens, or "germs" (a catch-all for disease-causing, or pathogenic, microbes, such as ], ], ], ], ], ]s, and ]s) existed and were capable of reproduction and multiplication, replacing earlier beliefs in ] or even spiritual agents, that had dominated for much of the previous 1,500 years in European medicine. With the new understanding of causative agents, physicians began to compare the characteristics of one germ's symptoms as they developed within an affected individual to another germ's characteristics and symptoms. This approach led to the foundational understanding that diseases are able to replicate themselves, and that they can have many profound and varied effects on the human host. To determine causes of diseases, medical experts used the most common and widely accepted assumptions or symptoms of their times, a general principle of approach that persists in modern medicine.<ref>{{cite book|last=King|first=Lester|title=Transformations in American Medicine: From Benjamin Rush to William Osler|date=1991|publisher=Johns Hopkins UP|location=Baltimore|isbn=978-0-8018-4057-9|pages=27+}}</ref><ref>{{cite journal|last1=Machevsky|first1=Alberto|title=Evidence-based Medicine, Medical Decision Analysis, and Pathology|journal=Human Pathology|date=2004|volume=35|issue=10|pages=1179–88|doi=10.1016/j.humpath.2004.06.004|pmid=15492984|last2=Wick|first2=MR}}</ref>
What set pathology apart from other specialties was the ability to determine a symptom with the naked eye. During the 19th century, ] gave the biggest contribution to the field by introducing the procedure of
analyzing tissue and cells through a ] to pathologists. This greatly affected the discipline because it was another
way to analyze objects, and it led to more advanced technological developments.


Modern medicine was particularly advanced by further developments of the microscope to analyze tissues, to which ] gave a significant contribution, leading to a slew of research developments.
By the late 1920s to early 1930s pathology was deemed a medical specialty. <ref>{{cite journal|last=Rothstein|first=William G.|title=Pathology: The Evolution of a Specialty in American Medicine|journal=Medical Care|year=1979|volume=17|issue=10|pages= 975+|jstor=3763869|doi=10.1097/00005650-197910000-00001}}</ref> During the years following, the decision to split pathology into sub-specialties arose. Today, anatomical, clinical, molecular, plant, forensic, oral, veterinary, dermatopathology, hematopathology, and pathology exist as medical specialties.
By the late 1920s to early 1930s pathology was deemed a medical specialty.<ref>{{cite journal|last=Rothstein|first=William G.|title=Pathology: The Evolution of a Specialty in American Medicine|journal=Medical Care|date=1979|volume=17|issue=10|pages= 975–988|jstor=3763869|doi=10.1097/00005650-197910000-00001|pmid=386008|s2cid=23045808}}</ref> Combined with developments in the understanding of general ], by the beginning of the 20th century, the study of pathology had begun to split into a number of distinct fields, resulting in the development of a large number of modern specialties within pathology and related disciplines of ].<ref>{{Cite journal |last1=Race |first1=George J. |last2=Tillery |first2=G. Weldon |last3=Dysert |first3=Peter A. |date=January 2004 |title=A history of pathology and laboratory medicine at Baylor University Medical Center |journal=Proceedings (Baylor University. Medical Center) |volume=17 |issue=1 |pages=42–55 |doi=10.1080/08998280.2004.11927956 |issn=0899-8280 |pmc=1200640 |pmid=16200088}}</ref>
Today, pathologists are discovering new diseases, examining exotic diseases that enter the country, and working on a solution to cure diseases such as AIDS, HIV, Herpes, cancer, and more. Thus the evolution of pathology is evidence of the real value of
science, which lies in its ability to continually research and develop new methods while giving credit to those who originally developed the idea.<ref name="Long1965" />


==Anatomical pathology== ==General pathology==
]]]

The modern practice of pathology is divided into a number of subdisciplines within the distinct but deeply interconnected aims of biological research and ]. ] into disease incorporates the work of a vast variety of life science specialists, whereas, in most parts of the world, to be ] to practice pathology as a medical specialty, one has to complete ] and secure a license to practice medicine. Structurally, the study of disease is divided into many different fields that study or diagnose markers for disease using methods and technologies particular to specific scales, ], and tissue types.
===Anatomical pathology===
{{Main|Anatomical pathology}} {{Main|Anatomical pathology}}
Anatomical pathology (''Commonwealth'') or anatomic pathology (''United States'') is a medical specialty that is concerned with the diagnosis of disease based on the ], ], chemical, immunologic and ] examination of organs, tissues, and whole bodies (as in a general examination or an ]). Anatomical pathology is itself divided into subfields, the main divisions being ], ], and ]. Anatomical pathology is one of two main divisions of the medical practice of pathology, the other being clinical pathology, the diagnosis of disease through the ] analysis of bodily fluids and tissues. Sometimes, pathologists practice both anatomical and clinical pathology, a combination known as general pathology.<ref name="october" />
]
Anatomical pathology (''Commonwealth'') or anatomic pathology (''United States'') is a medical specialty that is concerned with the diagnosis of disease based on the ], ], chemical, immunologic and ] examination of organs, tissues, and whole bodies (]).


====Cytopathology====
Anatomical pathology is itself divided in subspecialties, the main ones being ], ], and ]. To be ] to practice pathology, one has to complete ] and secure a license to practice medicine. An approved ] program and certification (in the United States, the ] or the ]) is usually required to obtain employment or hospital privileges.
{{Main|Cytopathology}}
] ] from a case of ]. The large cell in the top center is an abnormal ]: it is ], with megaloblastoid ] ]. This is diagnostic of erythroleukemia.]]


Cytopathology (sometimes referred to as "cytology") is a branch of pathology that studies and diagnoses diseases on the cellular level. It is usually used to aid in the diagnosis of cancer, but also helps in the diagnosis of certain infectious diseases and other inflammatory conditions as well as thyroid lesions, diseases involving sterile body cavities (peritoneal, pleural, and cerebrospinal), and a wide range of other body sites. Cytopathology is generally used on samples of free cells or tissue fragments (in contrast to histopathology, which studies whole tissues) and cytopathologic tests are sometimes called smear tests because the samples may be smeared across a glass microscope slide for subsequent staining and microscopic examination. However, cytology samples may be prepared in other ways, including ].<ref>{{Cite book |last=Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson |title=Robbins Basic Pathology |publisher=Philadelphia: Saunders. |year=2007 |isbn=978-1-4160-2973-1 |edition=8th}}</ref>
Anatomical pathology is one of two branches of pathology, the other being clinical pathology, the diagnosis of disease through the ] analysis of bodily fluids and tissues. Often, pathologists practice both anatomical and clinical pathology, a combination known as general pathology. The distinction between anatomic and clinical pathology is increasingly blurred by the introduction of technologies that require new expertise and the need to provide patients and referring physicians with integrated diagnostic reports. Similar specialties exist in veterinary pathology.


====Dermatopathology====
==Clinical pathology==
{{Main|Clinical pathology}} {{Main|Dermatopathology}}
] can often be suspected from sight, but confirmation of the diagnosis or outright removal requires a biopsy.]]
]: an automated blood chemistry analyzer.]]Clinical pathology is a medical specialty that is concerned with the diagnosis of disease based on the ] analysis of bodily fluids such as blood and ], and tissues using the tools of ], ], ] and molecular pathology. Clinical pathologists work in close collaboration with ]s, hospital administrations, and referring physicians to ensure the accuracy and optimal utilization of laboratory testing.


Dermatopathology is a subspecialty of anatomic pathology that focuses on the skin and the rest of the ] as an organ. It is unique, in that there are two paths a physician can take to obtain the specialization. All general pathologists and general dermatologists train in the pathology of the skin, so the term ] denotes either of these who has reached a certain level of accreditation and experience; in the US, either a general pathologist or a ]<ref>{{cite web|url=http://www.abderm.org/subspecialties/derm.html|website = American Board of Dermatology|title=Dermatopathology|url-status=live|archive-url= https://web.archive.org/web/20101207093353/http://www.abderm.org/subspecialties/derm.html|archive-date=2010-12-07}}</ref> can undergo a 1 to 2 year fellowship in the field of dermatopathology. The completion of this fellowship allows one to take a subspecialty board examination, and becomes a board certified dermatopathologist. Dermatologists are able to recognize most skin diseases based on their appearances, anatomic distributions, and behavior. Sometimes, however, those criteria do not lead to a conclusive diagnosis, and a ] is taken to be examined under the microscope using usual histological tests. In some cases, additional specialized testing needs to be performed on biopsies, including ], ], ], ], and molecular-pathologic analysis.<ref>{{cite web|url=http://www.dermnetnz.org/doctors/dermatopathology/stains.html |title= Special stains and tests – DermNet New Zealand|url-status=live|archive-url=https://web.archive.org/web/20110520143832/http://dermnetnz.org/doctors/dermatopathology/stains.html |archive-date=2011-05-20|date=2008}}</ref> One of the greatest challenges of dermatopathology is its scope. More than 1500 different disorders of the skin exist, including cutaneous eruptions ("]") and ]. Therefore, dermatopathologists must maintain a broad base of knowledge in clinical dermatology, and be familiar with several other specialty areas in Medicine.<ref>{{Cite web |title=Dermatopathology |url=http://booksfriend.blogspot.com/2010/10/dermatopathology-third-edition-by.html}}</ref>
Clinical pathology is one of the two major divisions of pathology, the other being anatomical pathology. Often, pathologists practice both anatomical and clinical pathology, a combination sometimes known as general pathology.


====Forensic pathology====
==Dermatopathology==
{{Main|Dermatopathology}} {{Main|Forensic pathology}}
]
Dermatopathology is a subspecialty of anatomic pathology that focuses on the skin as an organ. It is unique in that there are two routes which a physician can use to obtain this specialization. All general pathologists and general dermatologists are trained in the pathology of the skin; however, the dermatopathologist is a specialist in this organ. In the USA, either a general pathologist or a ] can undergo a 1 to 2 year fellowship in the field of dermatopathology. The completion of this fellowship allows one to take a subspecialty board examination, and becomes a board certified ].


Forensic pathology focuses on determining the cause of death by ] of a corpse or partial remains. An autopsy is typically performed by a coroner or medical examiner, often during criminal investigations; in this role, ]s and medical examiners are also frequently asked to confirm the identity of a corpse. The requirements for becoming a licensed practitioner of forensic pathology varies from country to country (and even within a given nation<ref>{{cite journal |author=Lett D |title=National standards for forensic pathology training slow to develop |journal=CMAJ |volume=177 |issue=3 |pages=240–1 |date=July 2007 |pmid=17664437 |pmc=1930175 |doi=10.1503/cmaj.070881 }}</ref>) but typically a minimal requirement is a ] with a specialty in general or anatomical pathology with subsequent study in forensic medicine. The methods forensic scientists use to determine death include examination of tissue specimens to identify the presence or absence of natural disease and other microscopic findings, interpretations of ] on body tissues and fluids to determine the chemical cause of overdoses, poisonings or other cases involving toxic agents, and examinations of ]. Forensic pathology is a major component in the trans-disciplinary field of ].{{cn|date=August 2022}}
==Hematopathology==
{{Main|Hematopathology}}
]: A Wright's stained bone marrow aspirate smear of patient with precursor B-cell acute lymphoblastic leukemia.]]
Hematopathology is the study of diseases of blood cells (White blood cells, red blood cells, platelets) and cells/tissues/organs comprising the hematopoietic system. The term hematopoietic system refers to tissues and organs that produce and/or primarily host hematopoietic cells and include bone marrow, lymph node, ], ], and other lymphoid tissues. In the United States, hematopathology is a board certified subspecialty (American Board of Pathology) practiced by those physicians who have completed general pathology residency (anatomic, clinical, or combined) and an additional year of fellowship training in hematology. The hematopathologist reviews biopsies of lymph nodes, bone marrows and other tissues involved by an infiltrate of cells of the hematopoietic system. In addition, the hematopathologist may be in charge of flow cytometric and/or molecular hematopathology studies. After the hematopathologist makes the diagnosis, the hematologist or hemato-oncologist can make a decision about the best course of action.


====Histopathology====
== Renal pathology ==
{{main|Renal pathology}} {{Main|Histopathology}}
], this high-magnification ] of a ] of cardiac tissue reveals advanced ]. This sample was attained through an ].]]
{{Infobox disease
| Name = Membranous glomerulonephritis
| Image = Membranous nephropathy - mpas - very high mag.jpg
| Caption = ] of membranous nephropathy showing prominent glomerular basement membrane spikes. ].
}}
Renal pathology is the study of medial diseases (non-tumor) of the ]. In the United States, renal pathology is practiced by physicians who have completed general pathology residency training (anatomic or combined anatomic/clinical) and an additional year of fellowship training in renal pathology. A renal pathologist reviews biopsies of the kidney and integrates findings from multiple methodologies including light microscopy, immunofluorescence microscopy, and electron microscopy. Renal pathologists work closely with nephrologists and carefully integrate the clinical history/laboratory studies in the evaluation of renal biopsy specimens. Renal pathologists require a detailed understanding of ] as it is often critical in interpreting specimens (particularly from renal transplants) as well as conceptualizing pathogenesis of many renal diseases. Once a morphologic diagnosis is made by a renal pathologist, the diagnosis is communicated to the clinical physician (nephrologist) who can then formulate a plan of care/treatment.


Histopathology refers to the microscopic examination of various forms of ]. Specifically, in clinical medicine, histopathology refers to the examination of a biopsy or surgical specimen by a pathologist, after the specimen has been processed and histological sections have been placed onto glass slides.<ref name="Carson">{{cite book |title=Histotechnology: A Self-Instructional Text |last1=Carson |first1=Freida L |last2=Hladik|first2=Christa |edition=3rd |date=2009 |publisher=] Press |location=Hong Kong |isbn=978-0-89189-581-7 |page=2 }}</ref> This contrasts with the methods of cytopathology, which uses free cells or tissue fragments. Histopathological examination of tissues starts with ], ], or autopsy. The tissue is removed from the body of an organism and then placed in a fixative that stabilizes the tissues to prevent decay. The most common fixative is ], although ] fixing is also common.<ref>{{cite journal |author= Wilson LB|title= A method for the rapid preparation of fresh tissues for the microscope|journal=J Am Med Assoc|volume=45 |issue= 23|pages=1737|date= 1905|doi=10.1001/jama.1905.52510230037003c|url= https://zenodo.org/record/1423356}}</ref> To see the tissue under a microscope, the sections are stained with one or more pigments. The aim of staining is to reveal cellular components; counterstains are used to provide contrast. Histochemistry refers to the science of using chemical reactions between laboratory chemicals and components within tissue. The histological slides are then interpreted diagnostically and the resulting pathology report describes the histological findings and the opinion of the pathologist. In the case of cancer, this represents the tissue diagnosis required for most treatment protocols.
==Oral and Maxillofacial Pathology==
{{main|Oral and Maxillofacial Pathology}}
Oral and Maxillofacial Pathology is one of nine dental specialties recognized by the ]. Oral Pathologists must complete three years of post doctoral training in an accredited program and subsequently obtain Diplomate status from the American Board of Oral and Maxillofacial Pathology. The specialty focuses on the diagnosis, clinical management and investigation of diseases that affect the oral cavity and surrounding maxillofacial structures including but not limited to odontogenic, infectious, epithelial, salivary gland, bone and soft tissue pathologies.


====Neuropathology====
==Forensic pathology==
{{Main|Forensic pathology}} {{Main|Neuropathology}}
Forensic pathology is a branch of pathology concerned with determining the ] by examination of a ]. The ] is performed by the pathologist at the request of a ] usually during the investigation of ] cases and ] cases in some ]. Forensic pathologists are also frequently asked to confirm the identity of a cadaver.


] ] of a brain reveals a significant ] that occupies much of the ].]]
The word '']'' is derived from the Latin ''forēnsis'' meaning ''forum''.


Neuropathology is the study of disease of nervous system tissue, usually in the form of either surgical biopsies or sometimes whole brains in the case of autopsy. Neuropathology is a subspecialty of anatomic pathology, ], and ]. In many English-speaking countries, neuropathology is considered a subfield of anatomical pathology. A physician who specializes in neuropathology, usually by completing a fellowship after a residency in anatomical or general pathology, is called a neuropathologist. In day-to-day clinical practice, a neuropathologist generates diagnoses for patients. If a disease of the nervous system is suspected, and the diagnosis cannot be made by less invasive methods, a biopsy of nervous tissue is taken from the brain or spinal cord to aid in diagnosis. Biopsy is usually requested after a mass is detected by ]. With autopsies, the principal work of the neuropathologist is to help in the post-mortem diagnosis of various conditions that affect the central nervous system. Biopsies can also consist of the skin. Epidermal nerve fiber density testing (ENFD) is a more recently developed neuropathology test in which a ] is taken to identify small fiber ] by analyzing the nerve fibers of the skin. This test is becoming available in select labs as well as many universities; it replaces the traditional nerve biopsy test as less ].{{cn|date=August 2022}}
==Veterinary pathology==
{{Main|Veterinary pathology}}
Veterinary pathologists are ] who specialize in the ] of diseases through the examination of animal tissue and body fluids. As with medical pathology, veterinary pathology is divided in two branches, anatomical pathology and clinical pathology.


====Pulmonary pathology====
Veterinary pathologists are also critical participants in the ] and ]. Drug discovery is most often accomplished by testing for efficacy in ]s of disease such as ].<ref name="pmid15064442">{{cite journal | author = Williams RO | title = Collagen-induced arthritis as a model for rheumatoid arthritis | journal = Methods Mol. Med. | volume = 98 | issue = | pages = 207–16 | year = 2004 | pmid = 15064442 | doi = 10.1385/1-59259-771-8:207 | isbn = 1-59259-771-8 }}</ref><ref name="pmid17546023">{{cite journal | author = Brand DD, Latham KA, Rosloniec EF | title = Collagen-induced arthritis | journal = Nat Protoc | volume = 2 | issue = 5 | pages = 1269–75 | year = 2007 | pmid = 17546023 | doi = 10.1038/nprot.2007.173 }}</ref> Drug discovery involves modification of chemical molecules to improve their biological characteristics of absorption, distribution, metabolism and elimination (]) where veterinary toxicologic pathologists evaluate new candidate drugs for toxic effects in animals before they are tested on humans.
{{Main|Pulmonary pathology}}
]
Pulmonary pathology is a subspecialty of anatomic (and especially surgical) pathology that deals with diagnosis and characterization of ] and non-neoplastic diseases of the ]s and ] ]. Diagnostic specimens are often obtained via ] transbronchial biopsy, ]-guided percutaneous biopsy, or ]. These tests can be necessary to diagnose between infection, ], or ] conditions.{{cn|date=August 2022}}


==Plant pathology== ====Renal pathology====
{{Main|Phytopathology}} {{Main|Renal pathology}}
].]]
], a biotrophic fungus]]
Plant pathology (also phytopathology) is the scientific study of plant diseases caused by pathogens (infectious diseases) and environmental conditions (physiological factors). Organisms that cause infectious disease include fungi, oomycetes, bacteria, viruses, viroids, virus-like organisms, phytoplasmas, protozoa, nematodes and parasitic plants. Not included are insects, mites, vertebrate or other pests that affect plant health by consumption of plant tissues. Plant pathology also involves the study of pathogen identification, disease etiology, disease cycles, economic impact, ], ], how plant diseases affect humans and animals, pathosystem genetics, and management of plant diseases.


Renal pathology is a subspecialty of anatomic pathology that deals with the diagnosis and characterization of disease of the ]s. In a medical setting, renal pathologists work closely with ] and ], who typically obtain diagnostic specimens via percutaneous renal biopsy. The renal pathologist must synthesize findings from traditional microscope histology, ], and ] to obtain a definitive diagnosis. Medical renal diseases may affect the ], the ] and ], the vessels, or a combination of these compartments.
The "disease triangle" is a central concept of plant pathology.<ref name=Arios>{{cite book |first=George N. |last=Agrios |year=1997 |title=Plant Pathology |edition=Fourth |publisher=Academic Press |location=New York |isbn=0-12-044564-6 }}</ref> It is based on the principle that infectious diseases develop, or do not develop, based on three-way interactions between the host, the pathogen, and environmental conditions.
Pathology is the medical specialty concerned with the study of the nature and causes of diseases. It underpins every aspect of medicine, from diagnostic testing and monitoring of chronic diseases to cutting-edge genetic research and blood transfusion technologies. Pathology is integral to the diagnosis of every cancer.
Pathology plays a vital role across all facets of medicine throughout our lives, from pre-conception to post mortem. In fact it has been said that “Medicine IS Pathology”.
Due to the popularity of many television programs, the word ‘pathology’ conjures images of dead bodies and people in lab coats investigating the cause of suspicious deaths for the police. That’s certainly a side of pathology, but in fact it’s far more likely that pathologists are busy in a hospital clinic or laboratory helping living people.
Pathologists are specialist medical practitioners who study the cause of disease and the ways in which diseases affect our bodies by examining changes in the tissues and in blood and other body fluids. Some of these changes show the potential to develop a disease, while others show its presence, cause or severity or monitor its progress or the effects of treatment.
The doctors you see in surgery or at a clinic all depend on the knowledge, diagnostic skills and advice of pathologists. Whether it’s a GP arranging a blood test or a surgeon wanting to know the nature of the lump removed at operation, the definitive answer is usually provided by a pathologist. Some pathologists also see patients and are involved directly in the day-to-day delivery of patient care.
Currently pathology has nine major areas of activity. These relate to either the methods used or the types of disease which they investigate. For further information on each discipline please click on one of the following:
Anatomical Pathology
Chemical Pathology
Clinical Pathology
Forensic Pathology
General Pathology
Genetic Pathology
Haematology
Immunopathology
Microbiology


==Molecular pathology== ====Surgical pathology====
{{see|Molecular pathology}} {{Main|Surgical pathology}}
] under ]. A small part of the tumor is taken via a needle with a vacuum system.]]


Surgical pathology is one of the primary areas of practice for most anatomical pathologists. Surgical pathology involves the ] and microscopic examination of surgical specimens, as well as biopsies submitted by surgeons and non-surgeons such as ], ], ], and ]. Often an ] ] is the best and most definitive evidence of disease (or lack thereof) in cases where tissue is surgically removed from a patient. These determinations are usually accomplished by a combination of gross (i.e., macroscopic) and histologic (i.e., microscopic) examination of the tissue, and may involve evaluations of molecular properties of the tissue by immunohistochemistry or other laboratory tests.{{cn|date=August 2022}}
Molecular pathology is an emerging discipline within pathology, and focuses in the study and diagnosis of disease through the examination of molecules within organs, tissues or bodily fluids. Molecular pathology shares some aspects of practice with both anatomic pathology and clinical pathology, ], ], ] and ], and is sometimes considered a "crossover" discipline. It is multi-disciplinary in nature and focuses mainly on the sub-microscopic aspects of disease and unknown illnesses with strange causes.


There are two major types of specimens submitted for surgical pathology analysis: biopsies and surgical resections. A biopsy is a small piece of tissue removed primarily for surgical pathology analysis, most often in order to render a definitive diagnosis. Types of biopsies include core biopsies, which are obtained through the use of large-bore needles, sometimes under the guidance of radiological techniques such as ], ], or ]. Incisional biopsies are obtained through diagnostic surgical procedures that remove part of a suspicious ], whereas excisional biopsies remove the entire lesion, and are similar to therapeutic surgical resections. Excisional biopsies of ] and ] ] are very common. The pathologist's interpretation of a biopsy is critical to establishing the diagnosis of a benign or malignant tumor, and can differentiate between different types and grades of cancer, as well as determining the activity of specific molecular pathways in the tumor. Surgical resection specimens are obtained by the therapeutic surgical removal of an entire diseased area or organ (and occasionally multiple organs). These procedures are often intended as definitive surgical treatment of a disease in which the diagnosis is already known or strongly suspected, but pathological analysis of these specimens remains important in confirming the previous diagnosis.{{cn|date=August 2022}}
It is a scientific discipline that encompasses the development of molecular and genetic approaches to the diagnosis and classification of human tumors, the design and validation of predictive biomarkers for treatment response and disease progression, the susceptibility of individuals of different genetic constitution to develop cancer, and the environmental and lifestyle factors implicated in carcinogenesis.<ref>{{cite web|url=http://www.molecularpathology.org.uk/ |title=Molecular Pathology of Cancer |publisher=Molecularpathology.org.uk |date= |accessdate=2012-02-19}}</ref>


== General pathology== ===Clinical pathology===
{{Main|Clinical pathology}}


Clinical pathology is a medical specialty that is concerned with the diagnosis of disease based on the ] analysis of bodily fluids such as blood and ], as well as tissues, using the tools of ], ], ] and molecular pathology. Clinical pathologists work in close collaboration with ]s, hospital administrations, and referring physicians. Clinical pathologists learn to administer a number of visual and microscopic tests and an especially large variety of tests of the ] properties of tissue samples involving ]s and ]s. Sometimes the general term "laboratory medicine specialist" is used to refer to those working in clinical pathology, including medical doctors, Ph.D.s and doctors of pharmacology.<ref>{{cite news |last1=Zérah |first1=Simone |last2=McMurray |first2=Janet |last3=Horváth |first3=Andrea Rita |title=Our profession now has a European name: Specialist in Laboratory Medicine |url=https://www.eflm.eu/files/efcc/files/EFLM%20Newsletter%202011-05.pdf |archive-url=https://web.archive.org/web/20200323171203/https://www.eflm.eu/files/efcc/files/EFLM%2520Newsletter%25202011-05.pdf |archive-date=2020-03-23 |url-status=live |access-date=23 March 2020 |work=EFCC Newsletter |publisher=European Federation of Clinical Chemistry and Laboratory Medicine |date=May 2011 |location=Paris |page=5}}</ref> ], the study of an organism's immune response to infection, is sometimes considered to fall within the domain of clinical pathology.<ref name="bulletin">{{cite web| publisher=Ministère de l'Éducation nationale, de l'Enseignement supérieur et de la Recherche |language=fr|url=http://www.education.gouv.fr/bo/2003/32/MENS0301444A.htm|title=Bulletin officiel du n°32 du 4 septembre 2003 – MENS0301444A|url-status=live|archive-url=https://web.archive.org/web/20080302102242/http://www.education.gouv.fr/bo/2003/32/MENS0301444A.htm|archive-date=2008-03-02|date=4 September 2003}}</ref>
General pathology is a broad and complex ] which covers all of the areas of more specialist pathologies.<ref>{{cite web|title=General Pathology|url=http://www.rcpa.edu.au/Pathology/Disciplines/GeneralPathology.htm|publisher=The Royal College of Pathologists of Australasia (RCPA)}}</ref> General pathologists seek to understand the mechanisms of injury to ] and ], as well as the body's means of responding to and repairing injury. Areas of study include cellular adaptation to injury, ], ], ] and ]. The term "general pathology" is also used to describe the practice of both ] and ].


====Hematopathology====
== Pathology as a medical specialty ==
{{Main|Pathology as a medical specialty}} {{Main|Hematopathology}}
]: an ]]]


Hematopathology is the study of diseases of blood cells (including constituents such as ], ], and ]) and the tissues, and organs comprising
{{Infobox Occupation
the hematopoietic system. The term hematopoietic system refers to tissues and organs that produce and/or primarily host hematopoietic cells and includes ], the ], ], ], and other lymphoid tissues. In the United States, hematopathology is a board certified subspecialty (licensed under the American Board of Pathology) practiced by those physicians who have completed a general pathology residency (anatomic, clinical, or combined) and an additional year of fellowship training in hematology. The hematopathologist reviews biopsies of lymph nodes, bone marrows and other tissues involved by an ] of cells of the hematopoietic system. In addition, the hematopathologist may be in charge of flow cytometric and/or molecular hematopathology studies.{{cn|date=August 2022}}
| name= Pathologist
| image=
| caption=
| official_names= Doctor, Medical Specialist
<!------------Details------------------->
| type= ]
| activity_sector= ]
| competencies=
| formation= Doctor of Medicine, Doctor of Osteopathic Medicine
| employment_field= ]s, ]s
| related_occupation=
| average_salary= {{profit}} USD $242,000
}}


===Molecular pathology===
Pathologists are doctors who diagnose and characterize disease in living patients by examining ] or ]. In addition, pathologists interpret medical laboratory tests to help prevent illness or monitor a chronic condition.
{{Main|Molecular pathology}}


Molecular pathology is focused upon the study and diagnosis of disease through the examination of molecules within organs, tissues or ].<ref>{{Cite journal|title=The molecular pathology of cancer|author=Harris TJ| author2=McCormick F. |date=2010|journal=Nat Rev Clin Oncol|volume=7|issue=5|pages=251–265|pmid=20351699|pmc=2222796|doi=10.1038/nrclinonc.2010.41}}</ref> Molecular pathology is multidisciplinary by nature and shares some aspects of practice with both anatomic pathology and clinical pathology, ], ], ] and ]. It is often applied in a context that is as much scientific as directly medical and encompasses the development of molecular and genetic approaches to the diagnosis and classification of human diseases, the design and validation of predictive biomarkers for treatment response and disease progression, and the susceptibility of individuals of different genetic constitution to particular disorders. The crossover between molecular pathology and ] is represented by a related field "]".<ref>{{cite journal |vauthors=Ogino S, Chan AT, Fuchs CS, Giovannucci E | year = 2011 | title = Molecular pathological epidemiology of colorectal neoplasia: an emerging transdisciplinary and interdisciplinary field | journal = Gut | volume = 60 | issue = 3| pages = 397–411 | doi=10.1136/gut.2010.217182| pmid = 21036793 | pmc = 3040598}}</ref> Molecular pathology is commonly used in diagnosis of cancer and infectious diseases. Molecular Pathology is primarily used to detect cancers such as melanoma, brainstem glioma, brain tumors as well as many other types of cancer and infectious diseases.<ref>{{cite journal |last1=Zhang |first1=Liwei |last2=Pan |first2=Chang-cun |last3=Li |first3=Deling |title=The historical change of brainstem glioma diagnosis and treatment: from imaging to molecular pathology and then molecular imaging |journal=Chinese Neurosurgical Journal |date=December 2015 |volume=1 |issue=1 |pages=4 |doi=10.1186/s41016-015-0006-3|s2cid=29219804 |doi-access=free }}</ref> Techniques are numerous but include ] (qPCR), ], ], ], ], antibody-based ] tissue assays, molecular profiling of pathogens, and analysis of bacterial genes for ].<ref name=Cai2014>{{cite journal|last=Cai|first=H|author2=Caswell JL|author3=Prescott JF|title=Nonculture Molecular Techniques for Diagnosis of Bacterial Disease in Animals: A Diagnostic Laboratory Perspective|journal=Veterinary Pathology|date=March 2014|volume=51|issue=2|pages=341–350|doi=10.1177/0300985813511132|pmid=24569613|doi-access=|s2cid=206510903}}</ref> Techniques used are based on analyzing samples of DNA and RNA. Pathology is widely used for gene therapy and disease diagnosis.<ref>{{cite journal |last1=Netto |first1=George J |last2=Saad |first2=Rana D |last3=Dysert |first3=Peter A |title=Diagnostic molecular pathology: current techniques and clinical applications, part I. |journal=Proc (Bayl Univ Med Cent) |date=October 2003 |volume=16 |issue=4 |pages=379–83 |doi=10.1080/08998280.2003.11927931 |pmid=16278751 |pmc=1214554}}</ref>
The vast majority of ] diagnoses are made by pathologists. Pathologists examine tissue biopsies to determine if they are benign or cancerous. Some pathologists specialize in genetic testing that can, for example, determine the most appropriate treatment for particular types of cancer. In addition, a pathologist analyzes blood samples from a patient's annual physical and alerts their primary care physician to any changes in their health early, when successful treatment is most likely. Pathologists also review results of tests ordered or performed by specialists, such as blood tests ordered by a cardiologist, a biopsy of a skin lesion removed by a dermatologist, or a Pap test performed by a gynecologist, to detect abnormalities.


===Oral and maxillofacial pathology===
]
{{main|Oral and maxillofacial pathology}}
], can be diagnosed partly on gross examination, but may be confirmed with tissue pathology.]]


Oral and Maxillofacial Pathology is one of nine dental specialties recognized by the ], and is sometimes considered a specialty of both dentistry and pathology.<ref name="Neville 2001">{{cite book|author=Neville BW|author2=Damm DD|author3=Allen CA|author4=Bouquot JE|name-list-style=amp|title=Oral & maxillofacial pathology|date=2002|publisher=W.B. Saunders|location=Philadelphia?page=ix (preface)|isbn=978-0721690032|edition=2nd}}</ref> Oral Pathologists must complete three years of post doctoral training in an accredited program and subsequently obtain diplomate status from the American Board of Oral and Maxillofacial Pathology. The specialty focuses on the diagnosis, clinical management and investigation of diseases that affect the oral cavity and surrounding maxillofacial structures including but not limited to ], infectious, ], ], ] and ] pathologies. It also significantly intersects with the field of ]. Although concerned with a broad variety of diseases of the oral cavity, they have roles distinct from ] ("ear, nose, and throat" specialists), and ], the latter of which helps diagnose many neurological or ] conditions relevant to ] or ]. Owing to the availability of the ] to non-invasive examination, many conditions in the study of oral disease can be diagnosed, or at least suspected, from gross examination, but biopsies, cell smears, and other tissue analysis remain important diagnostic tools in oral pathology.{{cn|date=August 2022}}
Pathologists work with other doctors, medical specialty societies, medical laboratory professionals, and health care consumer organizations to set guidelines and standards for medical laboratory testing that help improve a patient's medical care and guide treatment, as well as ensure the quality and safety of domestic and international medical laboratories.


==Medical training and accreditation==
Pathologists may also conduct autopsies to investigate causes of death. Autopsy results can aid living patients by revealing a hereditary disease unknown to a patient's family.
]


Becoming a pathologist generally requires ]-training after ], but individual nations vary some in the ] required of pathologists. In the United States, pathologists are physicians (] or ]) who have completed a four-year undergraduate program, four years of medical school training, and three to four years of postgraduate training in the form of a pathology ]. Training may be within two primary specialties, as recognized by the American Board of Pathology: ] also recognizes four primary specialties: anatomic pathology, dermatopathology, forensic pathology, and ]. Pathologists may pursue specialised fellowship training within one or more subspecialties of either anatomical or clinical pathology. Some of these subspecialties permit additional board certification, while others do not.<ref> {{webarchive|url=https://web.archive.org/web/20070630171453/http://www.abpath.org/default.aspx |date=2007-06-30 }} of the American Board of Pathology</ref>
Pathology is a core discipline of ] and many pathologists are also teachers. As managers of ] (which include chemistry, microbiology, cytology, the blood bank, etc.), pathologists play an important role in the development of ]s. Although the medical practice of pathology grew out of the tradition of investigative pathology, most modern pathologists do not perform original research.


In the United Kingdom, pathologists are physicians licensed by the UK ]. The training to become a pathologist is under the oversight of the ]. After four to six years of undergraduate medical study, trainees proceed to a two-year foundation program. Full-time training in histopathology currently lasts between five and five and a half years and includes specialist training in surgical pathology, cytopathology, and autopsy pathology. It is also possible to take a ] diploma in forensic pathology, dermatopathology, or cytopathology, recognising additional specialist training and expertise and to get specialist accreditation in forensic pathology, ], and neuropathology. All postgraduate medical training and education in the UK is overseen by the General Medical Council.
Pathology is a unique medical specialty. Pathology touches all of medicine, as diagnosis is the foundation of all patient care. In fact, more than 70 percent of all decisions about diagnosis and treatment, hospital admission, and discharge rest on medical test results.<ref> (see embedded powerpoint presentation)</ref>


In France, pathology is separated into two distinct specialties, anatomical pathology, and clinical pathology. Residencies for both lasts four years. Residency in anatomical pathology is open to physicians only, while clinical pathology is open to both physicians and ]s. At the end of the second year of clinical pathology residency, residents can choose between general clinical pathology and a specialization in one of the disciplines, but they can not practice anatomical pathology, nor can anatomical pathology residents practice clinical pathology.<ref name="bulletin"/><ref> {{webarchive|url=https://web.archive.org/web/20080228225540/http://www.sante.gouv.fr/adm/dagpb/bo/2003/03-05/a0050272.htm |date=2008-02-28 }}</ref>
Pathologists play a critical role on the patient care team, working with other doctors to treat patients and guide care. To be licensed, candidates must complete medical training, an approved residency program, and be certified by an appropriate body. In the US, certification is by the American Board of Pathology or the American Osteopathic Board of Pathology. The organization of subspecialties within pathology varies between nations, but usually includes anatomic pathology and clinical pathology.

==Overlap with other diagnostic medicine==
{{Main|Diagnostic medicine|Oncology|Infectious disease|Medical imaging}}

Though separate fields in terms of medical practice, a number of areas of inquiry in medicine and
medical science either overlap greatly with general pathology, work in tandem with it, or contribute significantly to the understanding of the pathology of a given disease or its course in an individual. As a significant portion of all general pathology practice is concerned with ], the practice of ] makes extensive use of both anatomical and clinical pathology in diagnosis and treatment.<ref name="Cancer.Net">{{cite web|title=Types of Oncologists|url=http://www.cancer.net/all-about-cancer/newly-diagnosed/find-oncologist/types-oncologists|publisher=Cancer.Net : American Society of Clinical Oncology (ASCO)|access-date=25 May 2013|url-status=live|archive-url=https://web.archive.org/web/20130601155338/http://www.cancer.net/all-about-cancer/newly-diagnosed/find-oncologist/types-oncologists|archive-date=1 June 2013|date=2011-05-09}}</ref> In particular, biopsy, ], and blood tests are all examples of pathology work that is essential for the diagnoses of many kinds of cancer and for the ] of ]. In a similar fashion, the tissue and blood analysis techniques of general pathology are of central significance to the investigation of serious ] and as such inform significantly upon the fields of ], ], ], and ]. General pathology methods are of great importance to biomedical research into disease, wherein they are sometimes referred to as ].{{cn|date=August 2022}}

] is the generating of visual representations of the interior of a body for clinical analysis and medical intervention. Medical imaging reveals details of ] physiology that help medical professionals plan appropriate treatments for tissue infection and trauma. Medical imaging is also central in supplying the ] data necessary to establish baseline features of ] and ] so as to increase the accuracy with which early or fine-detail abnormalities are detected. These diagnostic techniques are often performed in combination with general pathology procedures and are themselves often essential to developing new understanding of the ] of a given disease and tracking the progress of disease in specific medical cases. Examples of important subdivisions in medical imaging include ] (which uses the imaging technologies of X-ray ]) ], ] (or ultrasound), ], ], ], ], ], ] and ] techniques such as ]. Though they do not strictly relay images, readings from diagnostics tests involving ], ], and ] often give hints as to the state and function of certain tissues in the brain and heart respectively.

==Pathology informatics==
{{See|Digital pathology}}
], ], networks, databases and ].]]
Pathology informatics is a subfield of ]. It is the use of information technology in pathology. It encompasses pathology laboratory operations, data analysis, and the interpretation of pathology-related information.

Key aspects of pathology informatics include:
*]s (LIMS): Implementing and managing computer systems specifically designed for pathology departments. These systems help in tracking and managing patient specimens, results, and other pathology data.
*]: Involves the use of digital technology to create, manage, and analyze pathology images. This includes side scanning and automated image analysis.
*]: Using technology to enable remote pathology consultation and collaboration.
*] and reporting: Implementing informatics solutions to ensure the quality and accuracy of pathology processes.

==Psychopathology==
{{Main|Psychopathology}}

Psychopathology is the study of ], particularly of severe disorders. Informed heavily by both ] and ], its purpose is to classify mental illness, elucidate its underlying causes, and guide clinical ] treatment accordingly. Although diagnosis and classification of mental norms and disorders is largely the purview of psychiatry—the results of which are guidelines such as the ], which attempt to classify mental disease mostly on behavioural evidence, though not without controversy<ref name=frana>{{cite web |url=http://annals.org/article.aspx?articleid=1688399 |title=The New Crisis in Confidence in Psychiatric Diagnosis |author=Allen Frances |author-link=Allen Frances |date=17 May 2013 |work=Annals of Internal Medicine |url-status=live |archive-url=https://web.archive.org/web/20130607183245/http://annals.org/article.aspx?articleid=1688399 |archive-date=7 June 2013 }}</ref><ref name="concept&evolution">Dalal PK, Sivakumar T. (2009) {{webarchive|url=https://web.archive.org/web/20180602062407/http://www.indianjpsychiatry.org/text.asp?2009%2F51%2F4%2F310%2F58302 |date=2018-06-02 }} Indian Journal of Psychiatry, Volume 51, Issue 4, Page 310-319.</ref><ref>{{cite journal | pmid = 12505793 | name-list-style =vanc | doi=10.1176/appi.ajp.160.1.4 | volume=160 | issue=1 |date=January 2003 | pages=4–12 | title = Distinguishing Between the Validity and Utility of Psychiatric Diagnoses | last1 = Kendell | first1 = R. | journal = American Journal of Psychiatry | last2 = Jablensky | first2 = A| s2cid =16151623 }}</ref>—the field is also heavily, and increasingly, informed upon by ] and other of the biological ]s. Mental or social disorders or behaviours seen as generally unhealthy or excessive in a given individual, to the point where they cause harm or severe disruption to the person's lifestyle, are often called "pathological" (e.g., ] or ]).

==Non-humans==
] of a ] has revealed ] consistent with acute ] ], possibly due to ''Pasteurella haemolytica''.]]
Although the vast majority of lab work and research in pathology concerns the development of disease in humans, pathology is of significance throughout the biological sciences. Two main catch-all fields exist to represent most complex organisms capable of serving as host to a pathogen or other form of disease: veterinary pathology (concerned with all non-human species of ] of ]) and ], which studies disease in plants.

===Veterinary pathology===
{{Main|Veterinary pathology|Animal testing}}

Veterinary pathology covers a vast array of species, but with a significantly smaller number of practitioners, so understanding of disease in non-human animals, especially as regards ], varies considerably by species. Nevertheless, significant amounts of pathology research are conducted on animals, for two primary reasons: 1) The origins of diseases are typically ] in nature, and many infectious pathogens have animal vectors and, as such, understanding the mechanisms of action for these pathogens in non-human hosts is essential to the understanding and application of ] and 2) those animals that share physiological and genetic traits with humans can be used as surrogates for the study of the disease and potential treatments<ref>{{cite web|url=http://www.acvp.org/public/WhatIsVetPath.cfm |title=American College of Veterinary Pathologists &#124; for the Public |access-date=October 3, 2013 |url-status=dead |archive-url=https://web.archive.org/web/20131024125740/http://www.acvp.org/public/WhatIsVetPath.cfm |archive-date=October 24, 2013 }}</ref> as well as the effects of various synthetic products. For this reason, as well as their roles as ] and ], ] generally have the largest body of research in veterinary pathology. Animal testing remains a controversial practice, even in cases where it is used to research treatment for human disease.<ref>{{cite journal |last1=Rollin |first1=Bernard E. |title=The Regulation of Animal Research and the Emergence of Animal Ethics: A Conceptual History |journal=Theoretical Medicine and Bioethics |volume=27 |pages=285–304 |date=2006 |doi=10.1007/s11017-006-9007-8 |pmid=16937023 |issue=4 |s2cid=18620094 |url=https://org.uib.no/dyreavd/handouts/Rollin__B._2006._Animal_Research_Regulation_in_Theoret._Medicin_....PDF |access-date=2019-12-17 |archive-date=2020-10-08 |archive-url=https://web.archive.org/web/20201008152801/https://org.uib.no/dyreavd/handouts/Rollin__B._2006._Animal_Research_Regulation_in_Theoret._Medicin_....PDF |url-status=dead }}</ref> As in human medical pathology, the practice of veterinary pathology is customarily divided into the two main fields of anatomical and clinical pathology.

] infected with the ]]]

===Plant pathology===
{{Main|Plant pathology}}

Although the pathogens and their mechanics differ greatly from those of animals, plants are subject to a wide variety of diseases, including those caused by ], ]s, ], ]es, ]s, virus-like organisms, ]s, ], ]s and ]s. Damage caused by ], ]s, ], and other small herbivores is not considered a part of the domain of plant pathology. The field is connected to ] and especially concerned with the ] of species that are of high importance to the ] or other human utility.


==See also== ==See also==
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==References== ==References==
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==External links== ==External links==
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*{{Commonscatinline|Pathology}}
* : Comprehensive pathology website with numerous resources.
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* (Atlas in Human Pathology) *
*: Comprehensive pathology website with numerous resources.
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* * (Atlas in Human Pathology)
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* the most comprehensive book information of pathology-related
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* : pathology image search
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Latest revision as of 21:51, 7 December 2024

Study of disease "Pathobiology" redirects here. For the journal, see Karger Publishers. For other uses, see Pathology (disambiguation). "Pathological case" redirects here. For the corresponding case in engineering, see Corner case. Medical specialty
Pathology
A pathologist examines a tissue section for evidence of cancerous cells while a surgeon observes.
FocusDisease
SubdivisionsAnatomical pathology, clinical pathology, dermatopathology, forensic pathology, hematopathology, histopathology, molecular pathology, surgical pathology
Significant diseasesAll infectious and organic diseases and physiological disorders
Significant testsAll medical diagnostic tests, particular biopsy, blood analysis, dissection, and other applications of medical microscopy
SpecialistPathologist
GlossaryGlossary of medicine
Pathologist
Occupation
Names
  • Physician
  • Surgeon
Occupation typeSpecialty
Activity sectorsMedicine, Surgery
Description
Education required
Fields of
employment
Hospitals, Clinics

Pathology is the study of disease. The word pathology also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in the context of modern medical treatment, the term is often used in a narrower fashion to refer to processes and tests that fall within the contemporary medical field of "general pathology", an area that includes a number of distinct but inter-related medical specialties that diagnose disease, mostly through analysis of tissue and human cell samples. Idiomatically, "a pathology" may also refer to the predicted or actual progression of particular diseases (as in the statement "the many different forms of cancer have diverse pathologies", in which case a more proper choice of word would be "pathophysiologies"). The suffix pathy is sometimes used to indicate a state of disease in cases of both physical ailment (as in cardiomyopathy) and psychological conditions (such as psychopathy). A physician practicing pathology is called a pathologist.

As a field of general inquiry and research, pathology addresses components of disease: cause, mechanisms of development (pathogenesis), structural alterations of cells (morphologic changes), and the consequences of changes (clinical manifestations). In common medical practice, general pathology is mostly concerned with analyzing known clinical abnormalities that are markers or precursors for both infectious and non-infectious disease, and is conducted by experts in one of two major specialties, anatomical pathology and clinical pathology. Further divisions in specialty exist on the basis of the involved sample types (comparing, for example, cytopathology, hematopathology, and histopathology), organs (as in renal pathology), and physiological systems (oral pathology), as well as on the basis of the focus of the examination (as with forensic pathology).

Pathology is a significant field in modern medical diagnosis and medical research.

Etymology

The Latin term pathology derives from the Ancient Greek roots pathos (πάθος), meaning "experience" or "suffering", and -logia (-λογία), meaning "study of". The term is of early 16th-century origin, and became increasingly popularized after the 1530s.

History

Main article: History of medicine
The advent of the microscope was one of the major developments in the history of pathology. Here researchers at the Centers for Disease Control in 1978 examine cultures containing Legionella pneumophila, the pathogen responsible for Legionnaire's disease.

The study of pathology, including the detailed examination of the body, including dissection and inquiry into specific maladies, dates back to antiquity. Rudimentary understanding of many conditions was present in most early societies and is attested to in the records of the earliest historical societies, including those of the Middle East, India, and China. By the Hellenic period of ancient Greece, a concerted causal study of disease was underway (see Medicine in ancient Greece), with many notable early physicians (such as Hippocrates, for whom the modern Hippocratic Oath is named) having developed methods of diagnosis and prognosis for a number of diseases. The medical practices of the Romans and those of the Byzantines continued from these Greek roots, but, as with many areas of scientific inquiry, growth in understanding of medicine stagnated somewhat after the Classical Era, but continued to slowly develop throughout numerous cultures. Notably, many advances were made in the medieval era of Islam (see Medicine in medieval Islam), during which numerous texts of complex pathologies were developed, also based on the Greek tradition. Even so, growth in complex understanding of disease mostly languished until knowledge and experimentation again began to proliferate in the Renaissance, Enlightenment, and Baroque eras, following the resurgence of the empirical method at new centers of scholarship. By the 17th century, the study of rudimentary microscopy was underway and examination of tissues had led British Royal Society member Robert Hooke to coin the word "cell", setting the stage for later germ theory.

Modern pathology began to develop as a distinct field of inquiry during the 19th Century through natural philosophers and physicians that studied disease and the informal study of what they termed "pathological anatomy" or "morbid anatomy". However, pathology as a formal area of specialty was not fully developed until the late 19th and early 20th centuries, with the advent of detailed study of microbiology. In the 19th century, physicians had begun to understand that disease-causing pathogens, or "germs" (a catch-all for disease-causing, or pathogenic, microbes, such as bacteria, viruses, fungi, amoebae, molds, protists, and prions) existed and were capable of reproduction and multiplication, replacing earlier beliefs in humors or even spiritual agents, that had dominated for much of the previous 1,500 years in European medicine. With the new understanding of causative agents, physicians began to compare the characteristics of one germ's symptoms as they developed within an affected individual to another germ's characteristics and symptoms. This approach led to the foundational understanding that diseases are able to replicate themselves, and that they can have many profound and varied effects on the human host. To determine causes of diseases, medical experts used the most common and widely accepted assumptions or symptoms of their times, a general principle of approach that persists in modern medicine.

Modern medicine was particularly advanced by further developments of the microscope to analyze tissues, to which Rudolf Virchow gave a significant contribution, leading to a slew of research developments. By the late 1920s to early 1930s pathology was deemed a medical specialty. Combined with developments in the understanding of general physiology, by the beginning of the 20th century, the study of pathology had begun to split into a number of distinct fields, resulting in the development of a large number of modern specialties within pathology and related disciplines of diagnostic medicine.

General pathology

A modern pathology lab at the Services Institute of Medical Sciences

The modern practice of pathology is divided into a number of subdisciplines within the distinct but deeply interconnected aims of biological research and medical practice. Biomedical research into disease incorporates the work of a vast variety of life science specialists, whereas, in most parts of the world, to be licensed to practice pathology as a medical specialty, one has to complete medical school and secure a license to practice medicine. Structurally, the study of disease is divided into many different fields that study or diagnose markers for disease using methods and technologies particular to specific scales, organs, and tissue types.

Anatomical pathology

Main article: Anatomical pathology

Anatomical pathology (Commonwealth) or anatomic pathology (United States) is a medical specialty that is concerned with the diagnosis of disease based on the gross, microscopic, chemical, immunologic and molecular examination of organs, tissues, and whole bodies (as in a general examination or an autopsy). Anatomical pathology is itself divided into subfields, the main divisions being surgical pathology, cytopathology, and forensic pathology. Anatomical pathology is one of two main divisions of the medical practice of pathology, the other being clinical pathology, the diagnosis of disease through the laboratory analysis of bodily fluids and tissues. Sometimes, pathologists practice both anatomical and clinical pathology, a combination known as general pathology.

Cytopathology

Main article: Cytopathology
A bone marrow smear from a case of erythroleukemia. The large cell in the top center is an abnormal erythroblast: it is multinucleated, with megaloblastoid nuclear chromatin. This is diagnostic of erythroleukemia.

Cytopathology (sometimes referred to as "cytology") is a branch of pathology that studies and diagnoses diseases on the cellular level. It is usually used to aid in the diagnosis of cancer, but also helps in the diagnosis of certain infectious diseases and other inflammatory conditions as well as thyroid lesions, diseases involving sterile body cavities (peritoneal, pleural, and cerebrospinal), and a wide range of other body sites. Cytopathology is generally used on samples of free cells or tissue fragments (in contrast to histopathology, which studies whole tissues) and cytopathologic tests are sometimes called smear tests because the samples may be smeared across a glass microscope slide for subsequent staining and microscopic examination. However, cytology samples may be prepared in other ways, including cytocentrifugation.

Dermatopathology

Main article: Dermatopathology
A malignant melanoma can often be suspected from sight, but confirmation of the diagnosis or outright removal requires a biopsy.

Dermatopathology is a subspecialty of anatomic pathology that focuses on the skin and the rest of the integumentary system as an organ. It is unique, in that there are two paths a physician can take to obtain the specialization. All general pathologists and general dermatologists train in the pathology of the skin, so the term dermatopathologist denotes either of these who has reached a certain level of accreditation and experience; in the US, either a general pathologist or a dermatologist can undergo a 1 to 2 year fellowship in the field of dermatopathology. The completion of this fellowship allows one to take a subspecialty board examination, and becomes a board certified dermatopathologist. Dermatologists are able to recognize most skin diseases based on their appearances, anatomic distributions, and behavior. Sometimes, however, those criteria do not lead to a conclusive diagnosis, and a skin biopsy is taken to be examined under the microscope using usual histological tests. In some cases, additional specialized testing needs to be performed on biopsies, including immunofluorescence, immunohistochemistry, electron microscopy, flow cytometry, and molecular-pathologic analysis. One of the greatest challenges of dermatopathology is its scope. More than 1500 different disorders of the skin exist, including cutaneous eruptions ("rashes") and neoplasms. Therefore, dermatopathologists must maintain a broad base of knowledge in clinical dermatology, and be familiar with several other specialty areas in Medicine.

Forensic pathology

Main article: Forensic pathology
Pathologist performing a human dissection of the abdominal and thoracic organs in an autopsy room

Forensic pathology focuses on determining the cause of death by post-mortem examination of a corpse or partial remains. An autopsy is typically performed by a coroner or medical examiner, often during criminal investigations; in this role, coroners and medical examiners are also frequently asked to confirm the identity of a corpse. The requirements for becoming a licensed practitioner of forensic pathology varies from country to country (and even within a given nation) but typically a minimal requirement is a medical doctorate with a specialty in general or anatomical pathology with subsequent study in forensic medicine. The methods forensic scientists use to determine death include examination of tissue specimens to identify the presence or absence of natural disease and other microscopic findings, interpretations of toxicology on body tissues and fluids to determine the chemical cause of overdoses, poisonings or other cases involving toxic agents, and examinations of physical trauma. Forensic pathology is a major component in the trans-disciplinary field of forensic science.

Histopathology

Main article: Histopathology
An instance of diagnosis via histopathology, this high-magnification micrograph of a section of cardiac tissue reveals advanced cardiac amyloidosis. This sample was attained through an autopsy.

Histopathology refers to the microscopic examination of various forms of human tissue. Specifically, in clinical medicine, histopathology refers to the examination of a biopsy or surgical specimen by a pathologist, after the specimen has been processed and histological sections have been placed onto glass slides. This contrasts with the methods of cytopathology, which uses free cells or tissue fragments. Histopathological examination of tissues starts with surgery, biopsy, or autopsy. The tissue is removed from the body of an organism and then placed in a fixative that stabilizes the tissues to prevent decay. The most common fixative is formalin, although frozen section fixing is also common. To see the tissue under a microscope, the sections are stained with one or more pigments. The aim of staining is to reveal cellular components; counterstains are used to provide contrast. Histochemistry refers to the science of using chemical reactions between laboratory chemicals and components within tissue. The histological slides are then interpreted diagnostically and the resulting pathology report describes the histological findings and the opinion of the pathologist. In the case of cancer, this represents the tissue diagnosis required for most treatment protocols.

Neuropathology

Main article: Neuropathology
This coronal cross-section of a brain reveals a significant arteriovenous malformation that occupies much of the parietal lobe.

Neuropathology is the study of disease of nervous system tissue, usually in the form of either surgical biopsies or sometimes whole brains in the case of autopsy. Neuropathology is a subspecialty of anatomic pathology, neurology, and neurosurgery. In many English-speaking countries, neuropathology is considered a subfield of anatomical pathology. A physician who specializes in neuropathology, usually by completing a fellowship after a residency in anatomical or general pathology, is called a neuropathologist. In day-to-day clinical practice, a neuropathologist generates diagnoses for patients. If a disease of the nervous system is suspected, and the diagnosis cannot be made by less invasive methods, a biopsy of nervous tissue is taken from the brain or spinal cord to aid in diagnosis. Biopsy is usually requested after a mass is detected by medical imaging. With autopsies, the principal work of the neuropathologist is to help in the post-mortem diagnosis of various conditions that affect the central nervous system. Biopsies can also consist of the skin. Epidermal nerve fiber density testing (ENFD) is a more recently developed neuropathology test in which a punch skin biopsy is taken to identify small fiber neuropathies by analyzing the nerve fibers of the skin. This test is becoming available in select labs as well as many universities; it replaces the traditional nerve biopsy test as less invasive.

Pulmonary pathology

Main article: Pulmonary pathology
Gross pathology of miliary tuberculosis of the lung

Pulmonary pathology is a subspecialty of anatomic (and especially surgical) pathology that deals with diagnosis and characterization of neoplastic and non-neoplastic diseases of the lungs and thoracic pleura. Diagnostic specimens are often obtained via bronchoscopic transbronchial biopsy, CT-guided percutaneous biopsy, or video-assisted thoracic surgery. These tests can be necessary to diagnose between infection, inflammation, or fibrotic conditions.

Renal pathology

Main article: Renal pathology
This tissue cross-section demonstrates the gross pathology of polycystic kidneys.

Renal pathology is a subspecialty of anatomic pathology that deals with the diagnosis and characterization of disease of the kidneys. In a medical setting, renal pathologists work closely with nephrologists and transplant surgeons, who typically obtain diagnostic specimens via percutaneous renal biopsy. The renal pathologist must synthesize findings from traditional microscope histology, electron microscopy, and immunofluorescence to obtain a definitive diagnosis. Medical renal diseases may affect the glomerulus, the tubules and interstitium, the vessels, or a combination of these compartments.

Surgical pathology

Main article: Surgical pathology
Brain biopsy under stereotaxy. A small part of the tumor is taken via a needle with a vacuum system.

Surgical pathology is one of the primary areas of practice for most anatomical pathologists. Surgical pathology involves the gross and microscopic examination of surgical specimens, as well as biopsies submitted by surgeons and non-surgeons such as general internists, medical subspecialists, dermatologists, and interventional radiologists. Often an excised tissue sample is the best and most definitive evidence of disease (or lack thereof) in cases where tissue is surgically removed from a patient. These determinations are usually accomplished by a combination of gross (i.e., macroscopic) and histologic (i.e., microscopic) examination of the tissue, and may involve evaluations of molecular properties of the tissue by immunohistochemistry or other laboratory tests.

There are two major types of specimens submitted for surgical pathology analysis: biopsies and surgical resections. A biopsy is a small piece of tissue removed primarily for surgical pathology analysis, most often in order to render a definitive diagnosis. Types of biopsies include core biopsies, which are obtained through the use of large-bore needles, sometimes under the guidance of radiological techniques such as ultrasound, CT scan, or magnetic resonance imaging. Incisional biopsies are obtained through diagnostic surgical procedures that remove part of a suspicious lesion, whereas excisional biopsies remove the entire lesion, and are similar to therapeutic surgical resections. Excisional biopsies of skin lesions and gastrointestinal polyps are very common. The pathologist's interpretation of a biopsy is critical to establishing the diagnosis of a benign or malignant tumor, and can differentiate between different types and grades of cancer, as well as determining the activity of specific molecular pathways in the tumor. Surgical resection specimens are obtained by the therapeutic surgical removal of an entire diseased area or organ (and occasionally multiple organs). These procedures are often intended as definitive surgical treatment of a disease in which the diagnosis is already known or strongly suspected, but pathological analysis of these specimens remains important in confirming the previous diagnosis.

Clinical pathology

Main article: Clinical pathology

Clinical pathology is a medical specialty that is concerned with the diagnosis of disease based on the laboratory analysis of bodily fluids such as blood and urine, as well as tissues, using the tools of chemistry, clinical microbiology, hematology and molecular pathology. Clinical pathologists work in close collaboration with medical technologists, hospital administrations, and referring physicians. Clinical pathologists learn to administer a number of visual and microscopic tests and an especially large variety of tests of the biophysical properties of tissue samples involving automated analysers and cultures. Sometimes the general term "laboratory medicine specialist" is used to refer to those working in clinical pathology, including medical doctors, Ph.D.s and doctors of pharmacology. Immunopathology, the study of an organism's immune response to infection, is sometimes considered to fall within the domain of clinical pathology.

Hematopathology

Main article: Hematopathology
Clinical chemistry: an automated blood chemistry analyzer

Hematopathology is the study of diseases of blood cells (including constituents such as white blood cells, red blood cells, and platelets) and the tissues, and organs comprising the hematopoietic system. The term hematopoietic system refers to tissues and organs that produce and/or primarily host hematopoietic cells and includes bone marrow, the lymph nodes, thymus, spleen, and other lymphoid tissues. In the United States, hematopathology is a board certified subspecialty (licensed under the American Board of Pathology) practiced by those physicians who have completed a general pathology residency (anatomic, clinical, or combined) and an additional year of fellowship training in hematology. The hematopathologist reviews biopsies of lymph nodes, bone marrows and other tissues involved by an infiltrate of cells of the hematopoietic system. In addition, the hematopathologist may be in charge of flow cytometric and/or molecular hematopathology studies.

Molecular pathology

Main article: Molecular pathology

Molecular pathology is focused upon the study and diagnosis of disease through the examination of molecules within organs, tissues or bodily fluids. Molecular pathology is multidisciplinary by nature and shares some aspects of practice with both anatomic pathology and clinical pathology, molecular biology, biochemistry, proteomics and genetics. It is often applied in a context that is as much scientific as directly medical and encompasses the development of molecular and genetic approaches to the diagnosis and classification of human diseases, the design and validation of predictive biomarkers for treatment response and disease progression, and the susceptibility of individuals of different genetic constitution to particular disorders. The crossover between molecular pathology and epidemiology is represented by a related field "molecular pathological epidemiology". Molecular pathology is commonly used in diagnosis of cancer and infectious diseases. Molecular Pathology is primarily used to detect cancers such as melanoma, brainstem glioma, brain tumors as well as many other types of cancer and infectious diseases. Techniques are numerous but include quantitative polymerase chain reaction (qPCR), multiplex PCR, DNA microarray, in situ hybridization, DNA sequencing, antibody-based immunofluorescence tissue assays, molecular profiling of pathogens, and analysis of bacterial genes for antimicrobial resistance. Techniques used are based on analyzing samples of DNA and RNA. Pathology is widely used for gene therapy and disease diagnosis.

Oral and maxillofacial pathology

Main article: Oral and maxillofacial pathology
Many conditions, such as this case of geographic tongue, can be diagnosed partly on gross examination, but may be confirmed with tissue pathology.

Oral and Maxillofacial Pathology is one of nine dental specialties recognized by the American Dental Association, and is sometimes considered a specialty of both dentistry and pathology. Oral Pathologists must complete three years of post doctoral training in an accredited program and subsequently obtain diplomate status from the American Board of Oral and Maxillofacial Pathology. The specialty focuses on the diagnosis, clinical management and investigation of diseases that affect the oral cavity and surrounding maxillofacial structures including but not limited to odontogenic, infectious, epithelial, salivary gland, bone and soft tissue pathologies. It also significantly intersects with the field of dental pathology. Although concerned with a broad variety of diseases of the oral cavity, they have roles distinct from otorhinolaryngologists ("ear, nose, and throat" specialists), and speech pathologists, the latter of which helps diagnose many neurological or neuromuscular conditions relevant to speech phonology or swallowing. Owing to the availability of the oral cavity to non-invasive examination, many conditions in the study of oral disease can be diagnosed, or at least suspected, from gross examination, but biopsies, cell smears, and other tissue analysis remain important diagnostic tools in oral pathology.

Medical training and accreditation

An anatomical pathology instructor uses a microscope with multiple eyepieces to instruct students in diagnostic microscopy.

Becoming a pathologist generally requires specialty-training after medical school, but individual nations vary some in the medical licensing required of pathologists. In the United States, pathologists are physicians (D.O. or M.D.) who have completed a four-year undergraduate program, four years of medical school training, and three to four years of postgraduate training in the form of a pathology residency. Training may be within two primary specialties, as recognized by the American Board of Pathology: [anatomical pathology and clinical pathology, each of which requires separate board certification. The American Osteopathic Board of Pathology also recognizes four primary specialties: anatomic pathology, dermatopathology, forensic pathology, and laboratory medicine. Pathologists may pursue specialised fellowship training within one or more subspecialties of either anatomical or clinical pathology. Some of these subspecialties permit additional board certification, while others do not.

In the United Kingdom, pathologists are physicians licensed by the UK General Medical Council. The training to become a pathologist is under the oversight of the Royal College of Pathologists. After four to six years of undergraduate medical study, trainees proceed to a two-year foundation program. Full-time training in histopathology currently lasts between five and five and a half years and includes specialist training in surgical pathology, cytopathology, and autopsy pathology. It is also possible to take a Royal College of Pathologists diploma in forensic pathology, dermatopathology, or cytopathology, recognising additional specialist training and expertise and to get specialist accreditation in forensic pathology, pediatric pathology, and neuropathology. All postgraduate medical training and education in the UK is overseen by the General Medical Council.

In France, pathology is separated into two distinct specialties, anatomical pathology, and clinical pathology. Residencies for both lasts four years. Residency in anatomical pathology is open to physicians only, while clinical pathology is open to both physicians and pharmacists. At the end of the second year of clinical pathology residency, residents can choose between general clinical pathology and a specialization in one of the disciplines, but they can not practice anatomical pathology, nor can anatomical pathology residents practice clinical pathology.

Overlap with other diagnostic medicine

Main articles: Diagnostic medicine, Oncology, Infectious disease, and Medical imaging

Though separate fields in terms of medical practice, a number of areas of inquiry in medicine and medical science either overlap greatly with general pathology, work in tandem with it, or contribute significantly to the understanding of the pathology of a given disease or its course in an individual. As a significant portion of all general pathology practice is concerned with cancer, the practice of oncology makes extensive use of both anatomical and clinical pathology in diagnosis and treatment. In particular, biopsy, resection, and blood tests are all examples of pathology work that is essential for the diagnoses of many kinds of cancer and for the staging of cancerous masses. In a similar fashion, the tissue and blood analysis techniques of general pathology are of central significance to the investigation of serious infectious disease and as such inform significantly upon the fields of epidemiology, etiology, immunology, and parasitology. General pathology methods are of great importance to biomedical research into disease, wherein they are sometimes referred to as "experimental" or "investigative" pathology.

Medical imaging is the generating of visual representations of the interior of a body for clinical analysis and medical intervention. Medical imaging reveals details of internal physiology that help medical professionals plan appropriate treatments for tissue infection and trauma. Medical imaging is also central in supplying the biometric data necessary to establish baseline features of anatomy and physiology so as to increase the accuracy with which early or fine-detail abnormalities are detected. These diagnostic techniques are often performed in combination with general pathology procedures and are themselves often essential to developing new understanding of the pathogenesis of a given disease and tracking the progress of disease in specific medical cases. Examples of important subdivisions in medical imaging include radiology (which uses the imaging technologies of X-ray radiography) magnetic resonance imaging, medical ultrasonography (or ultrasound), endoscopy, elastography, tactile imaging, thermography, medical photography, nuclear medicine and functional imaging techniques such as positron emission tomography. Though they do not strictly relay images, readings from diagnostics tests involving electroencephalography, magnetoencephalography, and electrocardiography often give hints as to the state and function of certain tissues in the brain and heart respectively.

Pathology informatics

Further information: Digital pathology
Major topics and processes of pathology informatics: Data management from molecular testing, slide scanning, digital imaging and image analysis, networks, databases and telepathology.

Pathology informatics is a subfield of health informatics. It is the use of information technology in pathology. It encompasses pathology laboratory operations, data analysis, and the interpretation of pathology-related information.

Key aspects of pathology informatics include:

  • Laboratory information management systems (LIMS): Implementing and managing computer systems specifically designed for pathology departments. These systems help in tracking and managing patient specimens, results, and other pathology data.
  • Digital pathology: Involves the use of digital technology to create, manage, and analyze pathology images. This includes side scanning and automated image analysis.
  • Telepathology: Using technology to enable remote pathology consultation and collaboration.
  • Quality assurance and reporting: Implementing informatics solutions to ensure the quality and accuracy of pathology processes.

Psychopathology

Main article: Psychopathology

Psychopathology is the study of mental illness, particularly of severe disorders. Informed heavily by both psychology and neurology, its purpose is to classify mental illness, elucidate its underlying causes, and guide clinical psychiatric treatment accordingly. Although diagnosis and classification of mental norms and disorders is largely the purview of psychiatry—the results of which are guidelines such as the Diagnostic and Statistical Manual of Mental Disorders, which attempt to classify mental disease mostly on behavioural evidence, though not without controversy—the field is also heavily, and increasingly, informed upon by neuroscience and other of the biological cognitive sciences. Mental or social disorders or behaviours seen as generally unhealthy or excessive in a given individual, to the point where they cause harm or severe disruption to the person's lifestyle, are often called "pathological" (e.g., pathological gambling or pathological liar).

Non-humans

This field post-mortem of a ewe has revealed lesions consistent with acute haemolytic pneumonia, possibly due to Pasteurella haemolytica.

Although the vast majority of lab work and research in pathology concerns the development of disease in humans, pathology is of significance throughout the biological sciences. Two main catch-all fields exist to represent most complex organisms capable of serving as host to a pathogen or other form of disease: veterinary pathology (concerned with all non-human species of kingdom of Animalia) and phytopathology, which studies disease in plants.

Veterinary pathology

Main articles: Veterinary pathology and Animal testing

Veterinary pathology covers a vast array of species, but with a significantly smaller number of practitioners, so understanding of disease in non-human animals, especially as regards veterinary practice, varies considerably by species. Nevertheless, significant amounts of pathology research are conducted on animals, for two primary reasons: 1) The origins of diseases are typically zoonotic in nature, and many infectious pathogens have animal vectors and, as such, understanding the mechanisms of action for these pathogens in non-human hosts is essential to the understanding and application of epidemiology and 2) those animals that share physiological and genetic traits with humans can be used as surrogates for the study of the disease and potential treatments as well as the effects of various synthetic products. For this reason, as well as their roles as livestock and companion animals, mammals generally have the largest body of research in veterinary pathology. Animal testing remains a controversial practice, even in cases where it is used to research treatment for human disease. As in human medical pathology, the practice of veterinary pathology is customarily divided into the two main fields of anatomical and clinical pathology.

A tobacco plant infected with the tobacco mosaic virus

Plant pathology

Main article: Plant pathology

Although the pathogens and their mechanics differ greatly from those of animals, plants are subject to a wide variety of diseases, including those caused by fungi, oomycetes, bacteria, viruses, viroids, virus-like organisms, phytoplasmas, protozoa, nematodes and parasitic plants. Damage caused by insects, mites, vertebrate, and other small herbivores is not considered a part of the domain of plant pathology. The field is connected to plant disease epidemiology and especially concerned with the horticulture of species that are of high importance to the human diet or other human utility.

See also

References

  1. Herausgeber., Cross, Simon S., Herausgeber. Underwood, James C. E. 1942- (30 April 2018). Underwood's pathology : a clinical approach. Elsevier – Health Sciences Division. ISBN 978-0-7020-7212-3. OCLC 1043350646.{{cite book}}: CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link)
  2. "-pathy, comb. form". OED Online. Oxford English Dictionary (3rd ed.). Oxford University Press. 2005. Retrieved 23 March 2020.
  3. Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; Aster, Jon C. (2010). Robbins and Cotran Pathologic Basis of Disease (8th ed.). Philadelphia: Saunders/Elsevier. ISBN 978-1-4160-3121-5.
  4. ^ "Pathology Specialty Description". American Medical Association. Retrieved 5 October 2020.
  5. Janssen, Diederik F. (April 2022). "From Pathognomicha and Passiologia to Pathologia: concise history of a neologism (1486-1598)". Pathologica. 114 (2): 185–188. doi:10.32074/1591-951X-261. ISSN 1591-951X. PMC 9248257. PMID 35481571.
  6. Long, Esmond (1965). History of Pathology. New York: Dover. pp. 1+. ISBN 978-0-486-61342-0.
  7. Arcolani, Giovanni (1542). "Commentary on the Ninth Book of Medicine Dedicated to Mansur — Commentaria in nonum librum Rasis ad regem Almansorem". World Digital Library (in Latin). Archived from the original on 2014-02-14. Retrieved 2014-03-02.
  8. King, Lester (1991). Transformations in American Medicine: From Benjamin Rush to William Osler. Baltimore: Johns Hopkins UP. pp. 27+. ISBN 978-0-8018-4057-9.
  9. Machevsky, Alberto; Wick, MR (2004). "Evidence-based Medicine, Medical Decision Analysis, and Pathology". Human Pathology. 35 (10): 1179–88. doi:10.1016/j.humpath.2004.06.004. PMID 15492984.
  10. Rothstein, William G. (1979). "Pathology: The Evolution of a Specialty in American Medicine". Medical Care. 17 (10): 975–988. doi:10.1097/00005650-197910000-00001. JSTOR 3763869. PMID 386008. S2CID 23045808.
  11. Race, George J.; Tillery, G. Weldon; Dysert, Peter A. (January 2004). "A history of pathology and laboratory medicine at Baylor University Medical Center". Proceedings (Baylor University. Medical Center). 17 (1): 42–55. doi:10.1080/08998280.2004.11927956. ISSN 0899-8280. PMC 1200640. PMID 16200088.
  12. Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson (2007). Robbins Basic Pathology (8th ed.). Philadelphia: Saunders. ISBN 978-1-4160-2973-1.{{cite book}}: CS1 maint: multiple names: authors list (link)
  13. "Dermatopathology". American Board of Dermatology. Archived from the original on 2010-12-07.
  14. "Special stains and tests – DermNet New Zealand". 2008. Archived from the original on 2011-05-20.
  15. "Dermatopathology".
  16. Lett D (July 2007). "National standards for forensic pathology training slow to develop". CMAJ. 177 (3): 240–1. doi:10.1503/cmaj.070881. PMC 1930175. PMID 17664437.
  17. Carson, Freida L; Hladik, Christa (2009). Histotechnology: A Self-Instructional Text (3rd ed.). Hong Kong: American Society for Clinical Pathology Press. p. 2. ISBN 978-0-89189-581-7.
  18. Wilson LB (1905). "A method for the rapid preparation of fresh tissues for the microscope". J Am Med Assoc. 45 (23): 1737. doi:10.1001/jama.1905.52510230037003c.
  19. Zérah, Simone; McMurray, Janet; Horváth, Andrea Rita (May 2011). "Our profession now has a European name: Specialist in Laboratory Medicine" (PDF). EFCC Newsletter. Paris: European Federation of Clinical Chemistry and Laboratory Medicine. p. 5. Archived (PDF) from the original on 2020-03-23. Retrieved 23 March 2020.
  20. ^ "Bulletin officiel du n°32 du 4 septembre 2003 – MENS0301444A" (in French). Ministère de l'Éducation nationale, de l'Enseignement supérieur et de la Recherche. 4 September 2003. Archived from the original on 2008-03-02.
  21. Harris TJ; McCormick F. (2010). "The molecular pathology of cancer". Nat Rev Clin Oncol. 7 (5): 251–265. doi:10.1038/nrclinonc.2010.41. PMC 2222796. PMID 20351699.
  22. Ogino S, Chan AT, Fuchs CS, Giovannucci E (2011). "Molecular pathological epidemiology of colorectal neoplasia: an emerging transdisciplinary and interdisciplinary field". Gut. 60 (3): 397–411. doi:10.1136/gut.2010.217182. PMC 3040598. PMID 21036793.
  23. Zhang, Liwei; Pan, Chang-cun; Li, Deling (December 2015). "The historical change of brainstem glioma diagnosis and treatment: from imaging to molecular pathology and then molecular imaging". Chinese Neurosurgical Journal. 1 (1): 4. doi:10.1186/s41016-015-0006-3. S2CID 29219804.
  24. Cai, H; Caswell JL; Prescott JF (March 2014). "Nonculture Molecular Techniques for Diagnosis of Bacterial Disease in Animals: A Diagnostic Laboratory Perspective". Veterinary Pathology. 51 (2): 341–350. doi:10.1177/0300985813511132. PMID 24569613. S2CID 206510903.
  25. Netto, George J; Saad, Rana D; Dysert, Peter A (October 2003). "Diagnostic molecular pathology: current techniques and clinical applications, part I." Proc (Bayl Univ Med Cent). 16 (4): 379–83. doi:10.1080/08998280.2003.11927931. PMC 1214554. PMID 16278751.
  26. Neville BW; Damm DD; Allen CA & Bouquot JE (2002). Oral & maxillofacial pathology (2nd ed.). Philadelphia?page=ix (preface): W.B. Saunders. ISBN 978-0721690032.
  27. Homepage Archived 2007-06-30 at the Wayback Machine of the American Board of Pathology
  28. Reglementation for French Residency in Clinical Pathology (Biologie médicale) Archived 2008-02-28 at the Wayback Machine
  29. "Types of Oncologists". Cancer.Net : American Society of Clinical Oncology (ASCO). 2011-05-09. Archived from the original on 1 June 2013. Retrieved 25 May 2013.
  30. Allen Frances (17 May 2013). "The New Crisis in Confidence in Psychiatric Diagnosis". Annals of Internal Medicine. Archived from the original on 7 June 2013.
  31. Dalal PK, Sivakumar T. (2009) Moving towards ICD-11 and DSM-5: Concept and evolution of psychiatric classification. Archived 2018-06-02 at the Wayback Machine Indian Journal of Psychiatry, Volume 51, Issue 4, Page 310-319.
  32. Kendell R, Jablensky A (January 2003). "Distinguishing Between the Validity and Utility of Psychiatric Diagnoses". American Journal of Psychiatry. 160 (1): 4–12. doi:10.1176/appi.ajp.160.1.4. PMID 12505793. S2CID 16151623.
  33. "American College of Veterinary Pathologists | for the Public". Archived from the original on October 24, 2013. Retrieved October 3, 2013.
  34. Rollin, Bernard E. (2006). "The Regulation of Animal Research and the Emergence of Animal Ethics: A Conceptual History" (PDF). Theoretical Medicine and Bioethics. 27 (4): 285–304. doi:10.1007/s11017-006-9007-8. PMID 16937023. S2CID 18620094. Archived from the original (PDF) on 2020-10-08. Retrieved 2019-12-17.

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