Table Of ContentPATHOLOGY ILLUSTRATED
Commissioning Editor: Jeremy Bowes
Development Editor: Carole McMurray
Project Manager: Cheryl Brant
Cover Designer: Charles Gray
Illustration Buyer: Merlyn Harvey
Illustrator: Graeme Chambers
PATHOLOGY
ILLUSTRATED
Edited by
Robin Reid
BScMB ChB FRCPath
Consultant Pathologist
Western Infirmary
Glasgow; Senior Lecturer
Glasgow University, Glasgow, UK
Fiona Roberts
BSc MD MRCPath
Consultant Pathologist
Western Infirmary
Glasgow; Senior Lecturer
Glasgow University, Glasgow, UK
Elaine MacDuff
BSc MB ChB
Department of Pathology
Western Infirmary
Glasgow, UK
Original illustrations by
Robin Callander
FFPH FMAA AIMI
Formerly Director, Medical Illustrations Unit, Glasgow University, Glasgow, UK
Additional illustrations by
Ian Ramsden
Formerly Head of Medical Illustration, Glasgow University, Glasgow, UK
Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2011
© 2011, Elsevier Ltd. All rights reserved.
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This book and the individual contributions contained in it are protected under copyright by the
Publisher (other than as may be noted herein).
First edition 1981
Second edition 1986
Third edition 1991
Fourth edition 1995
Fifth edition 2000
Sixth edition 2005
Seventh edition 2011
ISBN 978 0 7020 3376 6
International ISBN – 978 0 7020 3375 9
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience
broaden our understanding, changes in research methods, professional practices, or medical treatment
may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating
and using any information, methods, compounds, or experiments described herein. In using such
information or methods they should be mindful of their own safety and the safety of others, including
parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the
most current information provided (i) on procedures featured or (ii) by the manufacturer of each
product to be administered, to verify the recommended dose or formula, the method and duration of
administration, and contraindications. It is the responsibility of practitioners, relying on their own
experience and knowledge of their patients, to make diagnoses, to determine dosages and the best
treatment for each individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors,
assume any liability for any injury and/or damage to persons or property as a matter of products
liability, negligence or otherwise, or from any use or operation of any methods, products, instructions,
or ideas contained in the material herein.
Printed in China
CONTENTS
Preface vii
Introduction ix
1. Cell and Tissue Damage 1
2. Inflammation 31
3. Healing 47
4. Infection 61
5. Immunity 87
6. Neoplasia 113
7. Cardiovascular Diseases 157
8. Respiratory System 245
9. Gastrointestinal Tract 285
10. Liver, Gall Bladder and Pancreas 337
11. Haemopoietic and Lympho-reticular Tissues 375
12. Genitourinary System 445
13. Female Genital System and Breast 493
14. Nervous System 525
15. Musculo-skeletal System 585
16. Endocrine System 621
Index 645
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PREFACE
‘We believe that communication by verbal and written methods is the fundamental basis for
study and learning. Nevertheless, in the modern setting where knowledge is increasing so
rapidly and in a subject where morphological changes are a major component, we consider
that the visual image has an important facilitating role’.
Since these comments were written in the preface to the first edition of 1981,
undergraduate medical education has evolved greatly, notably in the widespread adoption of
topic- or problem-based curricula and the generally diminished allocation of time, at least in
a formal sense, to pathology.
We do not believe, however, that there has been any reduction in the importance of
pathology as one of the foundations of clinical medicine.
In this seventh edition, the general layout and style of the book and its division into
general and systemic chapters have been retained. The volume aims to be simple yet
comprehensive and provide relevant information that can be assimilated in a reasonable time
scale. We have concentrated on ‘core’ topics and on what we regard as clinically important
pathology, not solely in ‘Western’ countries. Whilst including significant developments in
each area we have tried to avoid ‘information overload’ not least in the vast field of
molecular and cell biology. We recognize that our attempts at simplification do not tell the
whole story.
We are indebted to our predecessors, Alasdair Govan, Peter Macfarlane, Robin Callander
and Ian Ramsden, whose vision inspired the original concept of Pathology Illustrated. Much
of their work from earlier editions remains with, we hope, appropriate modification. The
credit for the book remains due to them; the shortcomings of this revision are our
responsibility.
The most recent illustrations are the work of Graeme Chambers, to whom we are
grateful. Many thanks are also owed to Carole McMurray, Development Editor at Elsevier
for her considerable efforts in bringing this project to completion.
R. Reid
F. Roberts
E. MacDuff
Glasgow, December, 2010
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INTRODUCTION
Pathology is the study of disease. It describes the effects, progress and consequences of the
disease and attempts to determine the cause (aetiology) and underlying mechanisms
(pathogenesis). It forms a bridge between basic science and clinical practice and has
traditionally had the same role in linking pre-clinical and clinical study for medical students.
Disease occurs when there are variations of function or structure outside the normal range.
Scientific study Clinical Practice
DISEASE PATHOLOGY MEDICINE & SURGERY
Variation (a) Causes (aetiology) Diagnosis
outside including echanisms Prognosis
normal (b) Manifestations Therapy and prophylaxis
range (c) Progress, sequelae (including pharmacology)
The manifestations of the disease are the sum of the damage done by the precipitating cause
and the body’s response (which may be helpful or unhelpful or both). The variations in these
components account for the great diversity of disease, which can then be classified into four
main groups:
DEVELOPMENTAL INFLAMMATORY NEOPLASTIC DEGENERATIVE
The relative importance of these groups varies with the age of the individual:
Childhood Old age
Inflammatory
Developmental
Neoplastic
Degenerative
Different diseases affect different age groups. Developmental disorders and degenerative
diseases affect the opposite extremes of life while tumours, in general, affect an ageing
population.
Physiological ageing itself implies a gradual loss of cellular and body vitality usually
associated with atrophy of tissues and organs. This process is aggravated and mimicked by
the degenerative diseases of old age so that the physiological and pathological states tend to
merge. Nonetheless, the student should attempt to identify the distinctions between ageing
and disease. Additionally, in old age multiple diseases often coexist and interact with one
another, and drug induced disorders are also common in this age group.
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