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Orf Infections and Molluscum Contagiosum

Pox Family of Viruses The poxvirus family Poxviridae consists of a group of large, enveloped, double-stranded DNA viruses capable of infecting vertebrates and invertebrates. Poxviruses are the largest known animal viruses, and the characteristic viral inclusions caused by infection with a poxvirus are identifiable on light microscopy. The subfamily Chordopoxvirinae infects vertebrate animals and humans ( Table 9-1 ), whereas the subfamily Entomopoxvirinae infects invertebrate animals.…

Viral Encephalomyelitis: Rabies, Enterovirus, and LCM

This chapter is directed to pathologists who are confronted by certain viral infections of the central nervous system (CNS) that may have systemic involvement. The arboviral encephalitides and CNS infections caused by DNA viruses have been covered in other chapters. This chapter focuses on infections caused by RNA viruses in three different families: Rhabdoviridae, Arenaviridae (both enveloped viruses), and Picornaviridae (nonenveloped RNA viruses). An overview of…

Arbovirus Encephalomyelitis

The findings and conclusions in this work are those of the author and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Introduction Overview of Viral Encephalitis Infections of the central nervous system (CNS) are usually associated with tremendous clinical significance. Because of the unique anatomic structure and physiologic functions of the CNS, even mild neurologic damage caused by infectious…

Influenza and Other Respiratory Virus Infections

Influenza Viruses Influenza A and B viruses are antigenically, ecologically, and epidemiologically distinct members of the family Orthomyxoviridae that have segmented, negative-sense RNA genomes and are surrounded by a lipid envelope. Globally, both virus groups are associated with an enormous burden of human disease. In the United States, influenza virus infections affect an estimated 5% to 20% of the population each year. From 1976 to 2007,…

Human Immunodeficiency Virus Infection

Introduction Human immunodeficiency virus (HIV) infection has become, just since the 1980s, one of the priority infections in global health. HIV is unique among infectious diseases in that the clinical and pathologic manifestations of HIV itself are not the major causes of mortality and morbidity. The immunosuppression induced by infection of the T-cell lymphocytes and macrophages creates a milieu that allows for myriad opportunistic infections that…

Human Papillomavirus, Polyomaviruses, and Parvovirus Infections

Introduction The Papillomaviridae, Parvoviridae, and Polyomaviridae are three families of small, nonenveloped, DNA viruses. Despite their structural and taxonomic similarities, these viruses infect different tissue types and cause very different human diseases. This chapter examines the viruses in each family that are responsible for the most significant forms of human infection. Human Papillomavirus Clinical Features Prevalence and Etiology Human papillomaviruses (HPVs) are members of the Papillomaviridae…

Viral Hepatitis

The hepatitis viruses are grouped because of their tendency to preferentially infect hepatocytes. They are not all taxonomically related, however, and descend from a number of different virus families. Each has a distinct structure, type of genome, mode of transmission, and pathobiology. Hepatitis A, B, and E tend to cause acute, self-limited illness. The hepatitis B virus (HBV) also has the potential to cause chronic infection,…

Herpes Virus Infections

Herpesviridae are characterized by an ability to establish latency within specific tissues and reactivate at a later time. The latent viral genetic material may exist extrachromosomally or it may become integrated into the host cell DNA. Eight herpes viruses are currently recognized and are classified into α, β, and γ groups ( Box 2-1 ). Box 2-1 α-Group Viruses Herpes simplex virus (HSV) types 1 and…

Principles of Infectious Disease Pathology: An Introduction

Diagnosis of Infectious Diseases: An Integrated Approach The diagnosis of infectious diseases ranges from straightforward clinical diagnoses to those that are possible only with the use of advanced molecular methods. Between these two extremes are the many infectious diseases for which an accurate and timely diagnosis requires the combined use of microbiologic cultures, histopathology/cytopathology, and molecular methods. It is this broad group of infectious diseases where…

Online Resources

Online resources have exploded in the last decade, providing a sometimes bewildering array of information, which varies greatly in quality and annotation. Although this provides free access to an unparalleled depth and breadth of content, search engines yield indiscriminate lists unfiltered for accuracy, and some of the best sites cannot be appreciated without exploration. Many online resources have added value beyond what was ever possible in…

Gestational Trophoblastic Disease

Introduction Gestational trophoblastic disease is a spectrum of disorders ranging from unusual presentations of normal implantation, through premalignant hydatidiform moles (complete, partial, and invasive mole) to malignant disorders including choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor ( Table 34.1 ). Often, trophoblast remnants of normal gestations, including placental site nodules, and exaggerated placental site reaction may cause clinical symptoms, which can be clinically and…

Non-Neoplastic Maternal Gestational Diseases

Gross examination of the placenta by the obstetrician or midwife is a routine practice at the time of delivery. Inspection of the membranes, umbilical cord, and cotyledons can help determine whether there is any retained tissue that may result in postpartum hemorrhage, or any gross abnormalities that might prompt a closer evaluation of the newborn baby. In most institutions the decision to request a pathologic evaluation…

Implantation and Placenta

Introduction Interest in placental examination has increased in the last two decades, with more appreciation by obstetricians and neonatologists of the contribution the report can make to understanding adverse perinatal outcomes. Not every placenta need be examined, and a triage system is essential. Indications for examination are essentially any disease of the mother, and abnormality of pregnancy, labor, delivery, or the immediate postnatal period. Placental abnormalities…

The Peritoneum

Normal Peritoneum Knowledge of the peritoneum is important in understanding the pathology of the female genital tract. The uterine corpus, along with the fallopian tubes, the cervix, and the upper part of the vagina, develop from the müllerian ducts, which in turn derive from the mesenchyme of the urogenital ridge and the celomic lining epithelium (mesothelium) or primitive peritoneum. The mesothelium lining the peritoneal cavity is…

Metastatic Tumors of the Ovary

Chapter Outline General Features 694 Mode of Spread 694 Site of Origin 696 Intestinal Carcinomas 696 Krukenberg Tumor 699 Carcinoid Tumors 701 Breast Carcinoma 702 Tumors of the Pancreas, Biliary Tract, and Liver 703 Tumors of the Appendix 704 Renal Tumors 705 Tumors of the Urinary Tract 706 Adrenal Gland Tumors 707 Malignant Melanoma 707 Pulmonary and Mediastinal Tumors 707 Uterine Tumors 707 Lymphoma and Leukemia…

Ovarian Germ Cell Tumors

General Features Germ cell tumors arise from primordial germ cells and account for approximately 30% of all ovarian tumors. Over 95% of them are benign dermoid cysts (mature cystic teratomas) and the remaining 5% are malignant. Malignant germ cell tumors (MGCTs) represent approximately 3% of all ovarian cancers in Western countries and about 20% in Asian and African populations, where surface epithelial cancers are much less…

Ovarian Sex Cord–Stromal and Steroid Cell Tumors

General Features Sex cord–stromal tumors account for approximately 8% of all ovarian tumors and are the most common functioning tumors associated with endocrine manifestations. These tumors contain granulosa cells, theca cells (and their luteinized derivatives), Sertoli cells, Leydig cells, and fibroblasts of gonadal stromal origin, either separately or in combination and exhibiting varying degrees of differentiation. Sex cord–stromal tumors arise from ovarian cells specialized in steroid…