SYLLABUS

I. Department of Clinical Pathomorphology Collegium Medicum Nicolaus Copernicus University, Skłodowskiej-Curie 9, 85-094 Bydgoszcz

II. Head of the unit: dr hab. n. med. Dariusz Grzanka

III. Faculty of Medicine, Medical Program, 3rd year

IV. Course coordinator: Natalia Skoczylas-Makowska, MD

V. Form of classes: lectures, tutorials

VI. Form of crediting: Exam, 13 ECTS points

VII. Number of hours: Lectures – 64 hours, Tutorials – 96 hours

VIII. Aim of the course After completing the pathology course student has to know causes, pathomechanisms, clinical course and consequences of the disease and understand morphological and functional changes in specific diseases processes. IX. Topics of tutorials (THE SCHEDULE FROM PATHOMORPHOLOGY INCLUDING A LIST OF SLIDES) X. Topics of lectures

IX. THE SCHEDULE FROM PATHOMORPHOLOGY INCLUDING A LIST OF SLIDES. I WEEK 1. Introduce to pathology + autopsy (INT) Natalia Skoczylas-Makowska, MD Topics:

Introduce to pathology. Didactic regulations. Legal issue related to autopsy. Audiovisual presentation of autopsy techniques. Autopsy techniques for haed, neck, chest, abdominal and pelvis examination. Autopsy demonstration with discussion of autopsy techiques. Autopsy in special cases – e.g. emphysema, embolisms, poisoning etc. Signs of death.

2. a) Adaptive changes. Łukasz Szylberg, MD, PhD (A+H) Topics to prepare:

Atrophy, hyperplasia, hypertrophy, metaplasia – definition, division, causes, examples

Dystrophic and metastatic calcification Fatty change and cellular swelling Necrosis – definition, types, morphology

Topics of tutorials:

Adaptive changes Intracellular accumulations Pathologic calcification

Slides:

1. Brown atrophy of the heart atrophia fusca myocardii

146

2. Cardiac muscle hypertrophy (hypertrophia musculi cordis)

138,150

3. Endometrial hyperplasia (hyperplasia glandularis endometrii)

085, 085a, 085c, 085d

4. Vacuolar degeneration (hydropic change) of hepatocytes (degeneratio parenchymatosa hepatis)

134

5. Epidermal hyperkaratosis (hyperkeratosis epidermis)

135

6. Corpus albicans ovarii 143

7. Liquefactive necrosis (brain encephalomalacia) (necrosis colliquativa; na przykładzie rozmiękania mózgu [encephalomalatio cerebri])

152

8. Coagulative necrosis (liver and lung tuberculosis) (necrosis coagulativa; na przykładzie: gruźlicy płuc i wątroby [tuberculosis pulmonum et hepatis])

026

b) Hemodynamic disorders. Łukasz Szylberg, MD, PhD Topics to prepare:

Embolism Hyperemia and congestion Pale and red infraction.

Topics of tutorials:

Edema Hyperemia and congestion Embolism Thrombosis Hemorrhage Shock

Slides:

1. Hemorrhagic cerebral infarction (focus haemorrhagicum cerebri)

127, 133

2. Hemosiderosis whitish ovarian body (haemosisderosis corporis albicantis ovarii)

154 + żelazo

3. Passive congestion of liver (hyperaemia passiva hepatis)

155

4. Chronic venous stasis in the lungs (venostasis chronica pulmonum)

153, 157

5. Pale infarction of kidney (infarctus pallidus renis)

059

6. Hemorrhagic intestinal infartion (infarctus haemorrhagicus intestini)

160

7. Adhering thrombus (thrombosis parietalis)

097, 193

8. Recanalization of thrombus (thrombosis recanalisatus)

233

9. Pulmonary edema 062/256

3. Chronic and acute inflammation. Joanna Maciejewska, MD, PhD (INF) Topics to prepare:

Definitions and General Features Causes of Inflammation Recognition of Microbes and Damaged Cells Reactions of Blood Vessels in Acute Inflammation Leukocyte Recruitment to Sites of Inflammation Phagocytosis and Clerance of the Offending Agent Termination of the Acute Inflammatory Response Outcomes of Acute Inflammation Causes of Chronic Inflammation Cells and Mediators of Chronic Inflammation Granulomatous Inflammation Types of granulomas

Topics of tutorials:

Mediators of Inflammation Morphologic Patterns of Acute Inflammation Pathogenesis, morphology and clinical changes in syphilis and tuberculosis

Slides:

1. Lymphnode sinus histiocytosis (histiocytosis lymphonoduli)

188

2. Nonspecyfic lymphadenitis Lymphonodulitis reactiva

226

3. Fibrinoid necrosis on the example of chronic peptic ulcer (degeneratio fibrinoidea; na przykładzie przewlekłego wrzodu trawiennego żołądka [ulcus chronicum pepticum ventriculi])

144

4. Lung abscess (abscessus pulmonis)

034

5. Serum acute appendicitis, appendicitis with lymphoid follicles hyperplasia, suppurative appendicitis, gangrenous appendicitis (appendicitis; [acuta serosa] [follicularis], [purulenta], [phlegmonosa], [gangrenosa],[obliterativa])

262, 027, 266, 268

6. meningitis purulenta 167

7. Miliary tuberculosis of lung (tuberculosis miliaris pulmonis)

025

8. Adrenal tuberculosis (tuberculosis glandulae suprarenalis)

151

9. Tuberculous meningitis (meningitis tuberculosa)

102

10. Lymph node sarcoidosis (sarcoidosis lymphonoduli)

111

11. Leprosy (lepra)

229

12. Inflammatory granulation tissue, foreign body reaction (granulatio, granuloma)

13. Scarring after myocardial infarction Cicatrisatio post infarctum myocardii)

069

4. Diseases of immunity. Natalia Skoczylas-Makowska, MD (IM) Topics to prepare:

Organ changes in systemic lupus erythematosus, rheumatoid arthritis, scleroderma (systemic sclerosis), amyloidosis.

Polyarteritis nodosa Topics of tutorials:

Systemic lupus erythematosus Scleroderma (systemic sclerosis) Rheumatoid arthritis Inflammatory myopathies Sjogren syndrome Vasculitides

Slides:

1. Renal amyloidosis (amyloidosis renis)

077 + amyloid

2. Rheumatoid nodule (nodulus rheumathoideus)

174

3. Rheumatoid arthritis (ang. rheumatoid artritis)

082

4. Polyarteritis nodosa

124

5. Sclerodermia (scleroderma localisata)

173, 196 Włókna sprężyste

6. Lupus erythematosus – renal changes (lupus erythematosus)

033, PAS

5. Neoplasms. Joanna Maciejewska, MD, PhD (NEO) Topics to prepare:

Morphological and clinical characteristic of benign and malignant neoplasms. Precancerous lesions. Metaplasia.Dysplasia. Carcinoma in situ. Microinvasion and early cancer. Pareneoplastic syndromes and kachexia Grading and staging. Tumor markers.

Topics of tutorials:

Abnormal differentiation and maturation of tissues. Intraepithelial neoplasia. Benign epithelial neoplasms Malignant and locally malignant tumors. Epidemiology and diagnostic of neoplasms. Clinical features of neoplasms.

Slides: 1. Epidermal actinic keratoses

(keratosis senilis) 177

2. Lichen sclerosus; (kraurosis) 168

3. Benign mammary dysplasia (mastopathia fibroso-cystica; dysplasia benigna mammae)

050, 179

4. Seborrheic skin whart (verruca seborrhoica)

243

5. Eversion in the cylindrical epithelium of the vaginal cervix, glandular erosion of the vaginal cervix (ectropion)

237

6. Neoplasia intraepithelialis cervicalis CINI/ LSIL (neoplasia intraepithelialis cervicalis; ang. CIN – cervical intraepithelial neoplasia) CIN I/ LSIL

178

7. Neoplasia intraepithelialis cervicalis CIN III/HSIL 176

8. Bowen disease (morbus Boweni)

166

9. Basal cell carcinoma of the skin (carcinoma basocellulare cutis)

110

10. Squamous cell carcionoma of the skin (carcinoma planoepitheliale/ carcinoma sinocellulare cutis)

022

11. Urothelial carcinoma of the bladder (carcinoma urotheliale)

186

12. Colorectal adenocarcinoma (adenocarcinoma coli)

279

13. Lipoma (lipoma)

195

14. Liposarcoma (liposarcoma)

049

15. Astrocytoma (astrocytoma)

053, 244

16. Glioblastoma multiforme (glioblastoma multiforme)

204, 260

17. Sarcoma synoviale – lung metastasis (sarcoma synoviale)

214

II, III and IV WEEK 1. Pathology of the gastrointestinal tract. Łukasz Szylberg.MD, PhD (GI) Topics to prepare:

Reflux Esophagitis Barrett Esophagus Esophageal tumors

Inflammatory disease of the stomach Gastric Adenocarcinoma Crohn disease and ulcerative colitis Adenocarcinoma of the colon

Topics of tutorials:

Congenital anomalies of gastrointestinal tract Esophagitis and tumors of esophagus Inflammatory diseases of gastrointestinal tract Peptic ulcer disease Neoplasms of stomach Intestinal vascular disease Diverticular disease Intestinal obstruction Tumors of the large and small intestine Hirschsprung disease Ischemic bowel disease

Slides:

1. Ulcerative colitis (colitis ulcerosa)

003, 008

2. Crohn disease (morbus Lesniowski-Crohn; także: ileitis terminali, ang: Crohn disease)

228

3. Celiac disease (celiakia)

165

4. Adenomatous polyp of the sigmoid colon (polypus adenomatosus)

042

5. Gastric adenocarcionoma (adenocarcinoma ventriculi)

041

6. Mucous degeneration on the example of mucinous adenocarcionoma

068 + śluz

7. Carcinoid of the appendix (carcinoidum appendicis)

270

8. Colorectal leyomyosarcoma (leyomyosarcoma coli)

006

9. Hemorrhagic intestinal infarction (infractus haemorrhagicus intestini)

160

10. Barret esophagus 283

2. Pathology of the liver, bile ducts and pancreas. Łukasz Szylberg, MD, PhD (LP) Topics to prepare:

Patterns of hepatic injury Acute and chronic viral hepatitis Drug and toxin-induced liver disease. Cirrhosis. Hemochromatosis Primary sclerosing choalngitis Circulatory disorders Malignant tumors of liver Cholelithiasis Acute pancreatitis

Topics of tutorials:

Infectieous disorders Autoimmune hapatitis Alcoholic liver disease. Insufficiency of liver. Impaired blood flow into and through the liver. Metabolic liver diseases Cholestasis and disorders of the intrahepatic bile ducts Nodules and tumors of liver Fine and core needle biopsy Cholecystitis Tumors of the gallbladder Pancreatitis Neoplasms of pancreas

Slides:

1. Intrahepatic cholestasis (stasis bilis intrahepatica)

148

2. Viral hepatitis (hepatitis viralis)

227

3. Alcoholic cirrhosis (cirrhosis hepatis alcoholica)

105, Masson, vanGiesson

4. Postinflammatory cirrhosis (cirrhosis hepatis postinfectiosa)

162

5. Centrilobular necrosis (necrosis centrolobularis hepatis)

070

6. Liver cancer (carcinoma hepatocellulare)

277

7. Cholecystitis (cholecystits)

280

8. Gallbladder cancer infiltrating the liver 269

3. Pathology of the respiratory tract part I. Joanna Maciejewska, MD, PhD (RI) Topics to prepare:

Pneumonia – morphology and clinical features Pulmonary vascular diseases Chronic obturative disorders of lung. Pathology changes in pleura

Topics of tutorials: Etiology, pathogenesis, division and morphology mouth, throat, nose and trachea

mucosa inflammations Bronchiectases Pneumonia – etiology, pathogenesis, morphology Pneumoconioses Obturative and restrictive disease of lung Cor pulmonale

Slides:

1. Pulmonary artery embolism (embolia thrombotica ramorum arteriae pulmonalis)

156

2. Hemorrhagic lung infarction (infarctus haemorrhagicus pulmonis)

060

3. Lobar pneumonia (pneumonia lobaris)

198

4. Bronchopneumonia (bronchopneumonia)

067, 058

5. Chronic bronchitis (bronchitis chronica)

076

6. Fungal pulmonary infection (pneumonia mycotica)

115

7. Mixed salivary gland tumor (tumor mixtus; edenoma pleomorphum)

031

8. Pnemoconioses (pneumoconioses)

272

4. Pathology of the respiratory tract part II. Joanna Maciejewska, MD, PhD (RII) Topics to prepare:

Lung cancer Cancer of larynx Malignant tumors of the salivary glands Nosopharyngeal cancer

Topics of tutorials:

Precancerous lesions and neoplasms of respiratory tract (including nasal cavity, larynx, trachea, bronchus, pleura)

Slides: 1. Squamous cell lung cancer

(carcinoma planoepitheliale pulmonis) 245

2. Lung adenocarcinoma (adenocarcinoma pulmonis)

046

3. Lung small cell carcionoma (carcinoma microcellulare pulmonis)

040

4. Laryngeal squamous cell carcinoma (carcinoma planoepitheliale laryngis)

210

5. Bronchial carcinoid and carcinoid of the appendix. (carcinoidum bronchit et appendicis) (barw.chromograniną A)

090, 249

5. Childhood and infancy diseases. Łukasz Szylberg, MD (CH) Topics to prepare:

Respiratory distress syndrome of the newborn Necrotizing enterocolitis Cystic Fibrosis Neuroblastoma Retinoblastoma Wilms Tumor Rhadbomyosarcoma

Topics of tutorials:

Tumors of infancy and childhood Congenital anomalies Fetal hydrops Respiratory distress syndrome Sudden infant death syndrome Perinatal infections Mucowiscidosis

Slides:

1. Testicular hypoplasia (hypoplasia testis)

145

2. Neonatal respriratory distress syndrome (membranae hyalinae pulmonum)

159

3. Trichinosis (trichinellosis)

164

4. Echonococcosis (echinococcosis cystica pulmonum)

106

5. Cerebral toxoplasmosis toxoplasmosis cerebri)

139, PAS

6. Craniopharyngioma (craniopharyngeoma)

208

7. Retinoblastoma (retinoblastoma)

202

!! TEST (exercises 1-10 and lectures 1,2)

6. Pathology of heart and vascular diseases Natalia Skoczylas-Makowska, MD (HV) Topics to prepare:

Morphology of infarction Hypertensive heart disease Endocarditis

Topics of tutorials:

Atherosclerosis Aneurysms and varicoses Ischemic heart disease Myocardial infarction Right sided heart failure Endocarditis

Slides

1. Arteriosclerosis (arterioclerosis centralis)

128, 131, 132

2. Arteriosclerosis of renal arteries (renes arteriosclerotici)

212 +PAS

3. Myocardial infarction (infractus myocardii)

255

4. Myocardial scarring (cicatrisatio postinfractosa myocardii)

069

5. Heart valve endocarditis (endocarditis valvularis)

216

6. Fibrinous pericarditis (pericarditis fibrinoidea)

096

7. Acute myocarditis (myocarditis acuta)

163, 250

8. Hemorrhoids (varices haemorrhoidales ani)

251

9. Hemangioma (haemangioma)

099

7. Pathology of the urinary tract. Natalia Skoczylas-Makowska, MD (U) Topics to prepare:

Nephritic syndrome, nephrotic syndrome Acute and chronic pyelonephritis Vascular lesions in benign and malignant hypertension Urolithiasis Hydronephrosis Renal cell carcinoma Urothelial carcinoma of bladder

Topics of tutorials:

Nephritic syndrome and associated glomerulonephritis Tubulointerstitial nephritis induced by drugs and toxins Analgesic nephropathy Acute tubular necrosis Diseases of blood vessels

Cystic diseases of kidney Tumors of the kidney and urinary tract

Slides:

1. Changes in diebetic kidney (degeneratio glycogenica renum)

092, glikogen

2. glomerulosclerosis intercapillaris 030, PAS

3. Glomerular sclerosis (glomerulonephritis sclerosans)

169, PAS

4. Pyelonephritis (pyelonephritis)

199, PAS

5. Renal cell carcinoma (carcinoma clarocellulare renis)

002, 247, PAS

6. Urothelial carcinoma of the bladder (carcinoma urotheliale)

186

7. Kidney transplant – rejection (ang. Kidney rejection)

273, PAS

8. Hemopathology. Joanna Maciejewska, MD, PhD (H) Topics to prepare:

Reactive lymphadenitis Definition of lymphoma and leukemia Clinical manifestations of proliferative diseases of the lymphatic system Hodgkin lymphoma – definition, types, morphology, clinical manifestation

Topics of tutorials:

Non-neoplastic diseases of lymphatic system Hematological malignances – leukemias and lymphomas Neoplasms of histiocytes

Slides:

1. acute myelogenous leukemia; AML 063

2. Lymphoma (lymphoma malignum)

180,183

3. Hodgkin lymphoma, lymphocyte depletion type 220

4. Hodgkin lymphoma, mixed cellularity type 089

5. Hodgkin lymphoma, nodular sclerosis type

007

6. Multiple myeloma (myeloma multiplex)

055

7. Solitary myeloma- rib tumor (plasmocytoma; plasma cel myeloma)

231

8. Disseminated Intravascular Coagulation DIC (microangipatia thrombotica, ang. DIC)

211

9. Pathology of the endocrine system. Łukasz Szylberg, MD, PhD (E) Topics to prepare:

Graves disease Chronic Lymphocytic (Hashimoto) Thyroiditis Carcinomas of the thyroid Hypercortisolism and Cushing Syndrome Pheochromocytoma Multiple endocrine neoplasia syndromes

Topics of tutorials:

Morphological causes of hypothalamic pituitary axis failure Morphological causes of failure of anterior and posterior lobe of the pituitary gland Tumors of the anterior pituitary gland Parathyroid glands - hyperparathyroidism and hypoparathyroidism Thyroiditis Benign and malignant tumors of thyroid Acute and chronic adrenal insufficiency Adrenocortical neoplasms Neoplasms of adrenal medulla Pancreatic endocrine neoplasms Multiple endocrine neoplasia syndromes

Slides:

1. Diffuse toxic goiter (degeneratio colloidea glandulae thyreoideae)

141

2. Lymphocytic thyroiditis (thyreoiditis lymphocytaria)

175

3. Invasive thyroiditis with fibrosis (struma Riedl)

189

4. Thyroid adenoma (adenoma glandulae thyroideae)

021

5. Papillary carcinoma of thyroid gland (carcinoma papillare glandulae thyroideae)

035

6. Follicular carcinoma of thyroid gland (carcinoma folliculare glandulae thyroideae)

274

7. Parathyroid carcinoma (carcinoma glandulae parathyroideae)

281

10. Pathology of the female reproductive system, part I Natalia Skoczylas-Makowska, MD (FI) Topics to prepare:

Cervical neoplasia Risk factors in cervical carcinoma and carcinoma of the endometrium Carcinoma of the endometrium – pathogenesis, morphology and clinical aspects Leiomyomas of uterus

Topics of tutorials:

Neoplasms and inflammations of cervix Neoplasms and inflammations of uterus Endometriosis Dysfunctional endometrial bleeding

Slides:

1. Invasive cervical cancer (carcinoma colli uteri)

101

2. Uterine adenocarcionoma (adenocarcinoma endometrii)

010

3. Purulent salpingitis (salipingitis purulenta)

038

11. Pathology of the female reproductive system part II. Natalia Skoczylas-Makowska, MD (FII) Topics to prepare:

Overian neoplasms

Topics of tutorials: Inflammations and neoplasms of ovaries Inflammation and neoplasms of fallopian tube Gestational and placental disorders

Slides:

1. Simple ovary cyst (cystis simplex ovarii)

142

2. Ovary cystadenoma (cystadenocarcinoma ovarii)

019

3. Ovary cystadenocarcinoma (cystadenoma ovarii)

181

12. a) Pathology of the breast Natalia Skoczylas-Makowska, MD (B+S) Topics to prepare:

Fibroadenoma Phyllodes tumor Intraductal papilloma Breast cancers and precancerous lesions

Topics of tutorials:

Fibrocystic changes Inflammation of the breast Tumors of the Breast (nonproliferative and proliferative breast disease)

Slides: 1. Infiltrating ductal carcinoma of the breast

(carcinoma ductale invasivum mammae) 048

2. Mucinous carcinoma (carcinoma gelatinosum mammae)

219, śluz

3. Intraductal papilloma of the breast (papilloma intraductale mammae)

224

b) Pathology of the skin. Izabela Neska-Długosz, MD Topics to prepare:

Malignant epidermal tumors (basal and squamous cell carcinoma) Melanocytic Proliferations (melanocytic navi, melanoma)

Topics of tutorials:

Benign, premalignant and malignant conditions of the skin. Slides:

1. Pigmented nevus (nevus pigmentosus)

109

2. Melanoma malignum (melanoma malignum)

122, 057, 242 melanina

13. Pathology of the male genital system. Izabela Neska-Długosz, MD (M) Topics to peapare:

Neoplasms of testis and penis – morphology and clinical features Prostate – adenocarcinoma and hyperplasia

Topics of tutorials:

Congenital anomalies and tumors of penis Congenital anomalies, vascular disturbances and tumors of testis Tumors of prostate and prostatic benign enlargement

Slides:

1. Embryonal carcinoma of testis (carcinoma embrionalne testis)

051, 230

2. Seminoma (seminoma) (seminoma)

271

3. Benign prostatic hyperplasia (hyperplasia nodularis prostatae)

264

4. Prostate cancer (carcinoma prostatae)

282

14. Central nervous system Joanna Maciejewska, MD, PhD (CN)

Topics to prepare:

Bacterial meningitidis – causes, morphology Cerebral infarction Glial neoplasms of CNS Meningiomas

Topics of tutorials:

Trauma of central nervous system Edema and hernation Cerebrovascular diseases Infections

Slides:

1. Neurilemmoma, Schwannoma (neurilemmoma; Schwannoma)

184

2. Malignant epipheral nerve sheat tumor 045

3. Oligodenroglioma (oligodenroglioma)

209

4. Ependymomoma (ependymoma)

206

5. Ganglion cells tumor (ganglioneurocytoma)

235, Masson, vanGiesson

6. Meningioma (meningeoma)

246

7. meningeoma malignum 074

8. Medulloblastoma (medulloblastoma)

207

15. Classes in the laboratory. Sections.

!! TEST (exercises 11-20 and lectures 3,4)