Table Of ContentBasic Pathology
Fifth edition
Basic Pathology
An introduction to the mechanisms of disease
Sunil R Lakhani BSc MBBS MD FRCPath FRCPA
Professor and Head, Molecular and Cellular Pathology, School of Medicine,
University of Queensland and State Director, Anatomical Pathology,
Pathology Queensland, Brisbane, Australia
Susan A Dilly BSc MBBS FRCPath
Emeritus Professor of Pathological Sciences, Barts and The London Medical
School, Queen Mary University of London, UK
Caroline J Finlayson MBBS FRCPath
Formerly Honorary Senior Lecturer and Consultant in Histopathology,
St George’s Hospital Medical School,
London, UK
Mitesh Gandhi MBBS MRCP FRCR FRANZCR
Princess Alexandra Hospital and Queensland X-ray, Woolloongabba,
Brisbane, Australia
CRC Press
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CONTENTS
Preface
Acknowledgements
PART 1 Disease, health and medicine 1
Introduction: Disease, health and medicine 3
Chapter 1: What causes disease? 7
Chapter 2: What are the common mechanisms of disease? 40
PART 2 Defence against disease 87
Introduction: The role of epidemiology in disease 89
Chapter 3: The body’s response to infection 95
Chapter 4: The acute inflammatory response 109
Chapter 5: Healing and repair, chronic and granulomatous
inflammation 147
Chapter 6: Chronic inflammation and the adaptive
immune response 178
Part 3 Features of cardiovascular disorders 209
Introduction: Features of cardiovascular disorders 211
Chapter 7: Vascular occlusion and thrombosis 215
Chapter 8: Atherosclerosis and hypertension 235
Chapter 9: Circulatory failure 258
Part 4 Cell growth and its disorders 291
Introduction: A brief history of cancer 293
Chapter 10: Benign growth disorders 295
Chapter 11: Malignant neoplasms 305
Chapter 12: What causes cancer? 320
Chapter 13: Molecular genetics of cancer 332
Chapter 14: The behaviour of tumours 354
Chapter 15: The clinical effects of tumours 361
Epilogue 373
Index 374
PREFACE
‘What is the use of a book’, thought Alice, ‘without become more logical. Time spent building a f ramework
pictures or conversations.’ of mechanisms will assist your clinical practice.
Lewis Carroll This fifth edition of Basic Pathology can be used in
conjunction with a companion volume called Pathology
Any artist will tell you that in drawing objects, you in Clinical Practice: 50 Case Studies, which is designed to
cannot ignore the spaces in between: the picture ceases help you use your pathology knowledge in clinical set-
to exist when only one aspect is viewed in isolation. tings. Some extracts from Pathology in Clinical Practice
Musical pieces composed entirely of notes and without are included in this book as well as links to the full cases
pauses would be nothing more than a noise and an irri- highlighted with a ‘link’ symbol.
tation. Yet when it comes to teaching, we may ignore
this fact and fail to put our own specialty into the con- Read more about bacterial infection in
text of the whole curriculum. Pathology in Clinical Practice Case 7
Over the last decade, there has been a trend towards
a more integrated approach to medical education. We When you access the e-book of Basic Pathology, either
are delighted that such an approach, which we have via the unique code printed in your hard copy or if you
always used in our teaching, is now widely adopted have purchased the e-book only, you will have access
throughout the world. to the full text of both titles, and hyperlinks from Basic
Our aim in this book has been to create a tutorial Pathology will take you directly to relevant cases in
on the mechanisms of disease over a background of Pathology in Clinical Practice. We hope that you will find
history, science and clinical relevance. The goal is to these stimulating, fun and complementary to this book
give the student a sense of belonging to a movement, because they contain more advanced, clinically relevant
the movement from past to present and from cell to information.
patient. This edition introduces radiological images in place
This book has been written in the hope that the stu- of some of the traditional autopsy-based photographs
dent will read the text fully and at leisure. This not only of diseased organs. We recognise how significantly
contains detail about the disease processes but also his- technology has changed everyday clinical practice and
torical anecdotes and clinical scenarios. The cartoons students are expected to be familiar with the increasing
are intended to amuse as well as illustrate the import- repertoire of scanned images. Over the next decades,
ance of certain topics, and we sincerely hope that stu- the same may become true for genomic information,
dents reading the book will be able to shed the dull, and we have extensively revised and expanded these
dreary image of pathology that they all seem to be born sections.
with. Pathology is one of the most fascinating and fun This book is primarily intended for medical students,
subjects students are likely to encounter during their but should also be useful to students of dentistry, human
undergraduate training. If you understand the basic biology and other health professions. Postgraduate stu-
principles of disease, then the interpretation of clinical dents studying for pathology or surgical exams may also
symptoms and signs, the rationale behind investigation wish to consult these books.
and treatment, and the unravelling of complex cases
ACKNOWLEDGEMENTS
When we set out more than 20 years ago to write a has evolved through each edition and all contributors
textbook in which we would take the students on a to earlier editions have influenced this latest version.
journey, from past to present and from patient to the They include Professor Philip Butcher, Professor Mike
cell and back again, the phrase ‘integrated curricu- Davies and Dr Grant Robinson at St George’s Hospital;
lum’ was not in common usage. Today, most medical Dr Ahmet Dogan, one of our co-authors from the third
schools have switched to the new-style curriculum in edition, and Dr Barry Newell, the lead author on the
which pathology is taught as an integrated subject with companion volume of Pathology in Clinical Practice.
other disciplines. With each version of this book, there Dr Peter Simpson and Dr Amy McCart Reed from
has been a move towards greater integration, especially Brisbane made a useful contribution to the molecular
with our colleagues in radiology who share our key role sections of the current edition.
in diagnosing and monitoring disease in patients. We We would like to thank the staff of Queensland X-ray
have also been influenced considerably by the many and the radiology department of the Princess Alexandra
clinicians who attend joint clinico–pathological meetings Hospital, Brisbane for their help in providing the
to discuss individual patients and the best approach for radiology images which have been used.
their clinical management. All these should be acknow- Finally, and most importantly, we would like to
ledged as informing and shaping this book. thank our families for their encouragement and sup-
In addition, our endeavours to produce this fifth edi- port. But for their understanding, it would be difficult
tion have been considerably aided by help, comments to get away with the disproportionate amount of time
and constructive criticism from a number of people, that such projects consume.
and we would like to acknowledge their time and SRL, SAD, CJF, MG
effort. In particular, thanks to Peter Riley, Alison Milne 2016
and Alex Roche for their useful comments. This book
