Upper Aerodigestive Tract

Oral Cavity and Oropharynx Normal Anatomy The oral cavity and oropharyngeal region represent the upper portion of the digestive tract; in addition, the oropharynx constitutes a portion of the upper respiratory tract. The oropharynx and hypopharynx share many of the diseases of the two adjacent digestive tract organs—oral cavity and esophagus—whereas the nasopharynx shares them with the two other components of the upper respiratory tract, that…

Tumors and Tumorlike Conditions of the Skin

The skin is, contrary to the ubiquitous simplistic concept, a remarkably heterogeneous organ. The nodular lesions (hamartomatous, reactive, and neoplastic) that occur in the skin are more numerous than those produced by any other organ. For example, the eccrine sweat gland alone gives rise to 10 or more histologically distinct adenomas. This diversity, combined with a body of descriptive data (clinical, histologic, histochemical, immunohistochemical, and ultrastructural)…

Dermatoses

Introduction to Dermatopathology The entities described in this section are a select group taken from the large number of diseases that affect the skin. They have been chosen to encompass the types of non-neoplastic material generally seen in surgical pathology laboratories. Many of the infrequently biopsied, histologically nonspecific, and rare dermatoses are excluded. Their characteristics are described in texts devoted wholly to dermatopathology and in the…

Skin

The contributions to this chapter by Dr. Alexander J. Lazar, Department of Pathology, MD Anderson Cancer Center, Houston, Texas, in several previous editions of this book are gratefully acknowledged. Skin disorders are common and diverse, ranging from irritating itching to life-threatening melanoma. Many of these conditions are confined to the skin, but others are manifestations of multiorgan diseases, such as systemic lupus erythematosus or neurofibromatosis. In…

Central Nervous System and Eye

The contributions to this chapter by Dr. Matthew P. Frosch, Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston Massachusetts, and Dr. Robert Folberg in several previous editions of this book are gratefully acknowledged. The principal focus of this chapter is on diseases of the central nervous system (CNS). At the end, we briefly describe some important disorders of the eye, which is linked anatomically…

Peripheral Nerves and Muscles

The contributions to this chapter by Dr. Peter Pytel, Department of Pathology, University of Chicago, in several previous editions of this book are gratefully acknowledged. The peripheral nerves and skeletal muscles permit purposeful movement and provide the brain with sensory information about our surroundings. Both the anatomic distribution of lesions and their associated signs and symptoms are helpful in classifying neuromuscular diseases. The following discussion of…

Bones, Joints, and Soft Tissue Tumors

The contributions to this chapter by Dr. Andrew Horvai, Department of Pathology, University of California, San Francisco in the previous edition of this book are gratefully acknowledged. Bone Structure and Function of Bone Bone provides mechanical support for the body, transmits forces generated by muscles, protects viscera, provides a niche for blood cell progenitors, and is intimately involved in calcium and phosphate homeostasis. It is produced…

Endocrine System

The contributions to this chapter by Dr. Anirban Maitra, Professor of Pathology and Translational Molecular Pathology, The University of Texas, MD Anderson Cancer Center, Houston, Texas, in several previous editions of this book are gratefully acknowledged. Endocrine organs (also called glands ) secrete hormones that act on other tissues to maintain the body’s metabolic homeostasis and to mediate responses to the metabolic demands of acute stresses.…

Female Genital System and Breast

The contributions to this chapter by Dr. Lora Hedrick Ellenson, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York, and Dr. Susan C. Lester, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, in the previous edition of this book are gratefully acknowledged. We also appreciate Dr. Lester's assistance in the current edition. Vulva The vulva is the external…

Male Genital System and Lower Urinary Tract

Penis Malformations Among the most common malformations of the penis are those in which the distal urethral orifice is abnormally located, either on the ventral (hypospadias) or dorsal (epispadias) aspect of the penis. The anomalous orifice may be constricted, resulting in urinary tract obstruction and an increased risk for urinary tract infections. Hypospadias occurs in 1 in 300 live male births and may be associated with…

Pancreas

The contributions to this chapter by Dr. Anirban Maitra, University of Texas, MD Anderson Cancer Center, Houston, Texas, in previous editions of this book are gratefully acknowledged. The pancreas is a transversely oriented retroperitoneal organ extending from the so-called “C loop” of the duodenum to the hilum of the spleen. Although the pancreas does not have well-defined anatomic subdivisions, adjacent vessels and ligaments serve to demarcate…

Liver and Gallbladder

Liver The contributions to this chapter by Dr. Neil D. Theise, Department of Pathology at NYU Grossman School of Medicine, New York, New York, and the late Dr. Nelson Fausto, Department of Pathology, University of Washington, Seattle, Washington, in previous editions of this book are gratefully acknowledged. The healthy adult liver weighs 1400 to 1600 gm. It has a dual blood supply, with the portal vein…

Oral Cavity and Gastrointestinal Tract

The contributions to this chapter by Dr. Jerrold R. Turner, Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, in several previous editions of this book are gratefully acknowledged. The gastrointestinal tract is a hollow tube consisting of the esophagus, stomach, small intestine, colon, rectum, and anus. Each region has complementary, highly integrated functions that regulate the intake, processing, and absorption of ingested nutrients and the…

Kidney

The contributions of Dr. Anthony Chang, Department of Pathology, University of Chicago, and Dr. Zoltan Laszik, Department of Pathology, University of California San Francisco, to previous editions of this chapter are gratefully acknowledged. The well-known quotation “What is man…but an ingenious machine for turning, with infinite artfulness, the wine of Shiraz into urine” gives rather dramatic importance to the renal apparatus. In reality, the kidney is…

Lung

The contributions to this chapter by Dr. Aliya Husain, Department of Pathology, University of Chicago, Chicago, Illinois, in several previous editions of this book are gratefully acknowledged. The major function of the lung is to provide the body with oxygen and to remove carbon dioxide. Efficient gas exchange is enabled by the lung’s anatomy, which serves to maximize the surface area of air spaces through which…

Hematopoietic and Lymphoid Systems

The hematopoietic and lymphoid systems are affected by a wide spectrum of diseases. One useful way to organize these disorders is based on whether they primarily affect red cells, white cells, or the coagulation system, which includes platelets and clotting factors. The most common red cell disorders are those that lead to anemia, a state of red cell deficiency. Clinically significant white cell disorders, by contrast,…

Heart

The heart is a truly remarkable organ, beating more than 40 million times per year and pumping over 7500 liters of blood a day; in a typical life span, its cumulative output would fill three supertankers. The cardiovascular system is the first organ system to become functional in utero (at approximately 8 weeks of gestation); without a beating heart and vascular supply, development cannot proceed, and the…

Blood Vessels

Vascular diseases are responsible for some of the most common and lethal conditions afflicting humans. Although most clinically significant disorders involve arterial lesions, venous pathologies can also wreak havoc. Two types of vascular lesions cause disease: Narrowing or complete obstruction of vessel lumina, occurring either progressively (e.g., by atherosclerosis) or acutely (e.g., by thrombosis or embolism) Weakening of vessel walls, causing dilation and/or rupture The contributions to this…

Environmental and Nutritional Diseases

Most diseases are influenced by environmental factors, and some are directly caused by environmental insults. Broadly defined, the ambient environment encompasses the various outdoor, indoor, and occupational settings in which humans live and work. In each of these settings, the air people breathe, the food and water they consume, the toxic agents they are exposed to, and the stresses they encounter are major determinants of health.…