OVERVIEW

The course of PATHOLOGICAL ANATOMY AND CLINICAL CORRELATIONS deals with

• the pathological bases of diseases,
• the macro and microscopic lesions associated with them,
• the histological, cytological, molecular and autoptic techniques,
• the interpretation of lesions with diagnostic, prognostic and predictive purposes.

It is therefore a course that opens up to the understanding many of the major neoplastic and non-neoplastic diseases.
In other words, this course is a crucial step for the training.of the future physician.

AIMS AND CONTENT

LEARNING OUTCOMES

To make known the pathogenetic mechanisms and morphological lesions that accompany the most common diseases, with particular emphasis on the most significant changes to the diagnostic and prognostic definition of the disease.

To provide the basis for understanding the classification principles of inflammatory, degenerative and neoplastic diseases.

At the end of the course, the student is expected to have acquired the ability to request histo- and cyto-pathogy exams appropriately and to correctly interpret the diagnostic reports in the light of the acquired knowledge.

AIMS AND LEARNING OUTCOMES

The course is divided into several parts that concern

• The techniques used in histopathology, cytopathology, immunohistochemistry, in situ hybridization and molecular pathology.

• Indications and purposes of autopsy.

• The systemic pathology of the various organs and apparatus.

• The correlations between macro and microscopic lesions and clinical findings.

• For neoplastic disease, prognostic and predictive factors of  therapeutic response.

• Guidelines for biopsy and cytopathology.

• The significance and value of microscopic and molecular findings for the definition of various diseases.

• The course also includes a professional part in which diagnostic cases are analyzed, highlighting how to require pathological exams and how a report is interpreted. This part also includes the discussion of clinical-pathological cases with digital microscopy.

PREREQUISITES

Knowledge of anatomy and normal human histology.
Knowledge of the main cellular and molecular mechanisms underlying diseases.

TEACHING METHODS

Plenary lessons in the classroom on the topics covered by the program.
At the end of the course, the last hours will be devoted to the interpretation of diagnostic reports and interactive slide seminars will be held with discussion of clinical-pathological cases.

Any Student with documented Specific Learning Disorders (SLD), or with any special needs, shall reach out to the Lecturer(s) and to the dedicated SLD Representative in the Department before class begins, in order to liase and arrange the specific teaching methods and ensure proper achievement of the learning aims and outcomes.

SYLLABUS/CONTENT

The following program also includes the topics of Pathological Anatomy covered during the 3rd year within the Courses of Dermatology, Clinical Immunology and Rheumatology, Cardiology and Pneumology, Nephrology and Endocrine-Metabolic Diseases.

TOPICS TREATED IN THE III YEAR, 2nd SEMESTER
GENERAL TOPICS
The purpose and techniques of the necroscopic examination
Clinical Pathology Anatomy, Surgical Pathology, Different Types of Biopsy
Indications and limits of the intraoperative examination (frozen sections)
Applications and limits of exfoliative, abrasive, and thin needle aspiration cytology.
Anatomy-pathological diagnostics techniques: routine histology, histochemistry, immunohistochemistry, electronic microscopy and molecular investigations.
Mechanisms of oncogenesis and oncogenesis at multiple stages. Classification, grading and staging criteria for neoplasms.
DERMATOLOGY, IMMUNOLOGY, REUMATOLOGY AND OSTEOARTICULAR PATHOLOGY
Basal cell and squamous epidermal cancer. Preneoplastic lesions and risk factors
Nevi and melanomas: risk factors, classification criteria, morphological aspects, histoprognostic correlations and natural history
Generalities on osteomyelitis and osteoporosis
Inflammatory and degenerative joint disease
CARDIOVASCULAR AND RESPIRATORY PATHOLOGY
Coronary syndromes and myocardial infarction (causes and mechanisms, morphology and evolution)
Endocarditis and valvulopathy (classification, pathology and complications)
Cardiac hypertrophy and cardiomegaly. Congestive heart failure
Myocarditis and cardiomyopathy. Diagnostic role of endomyocardial biopsy
Pericarditis and haemopericardium
Sudden cardiac death: morphological aspects
Aneurysms and degenerative pathology of large vases: morphological aspects
Vasculitis: morphological aspects
Pulmonary Edema, Infarction, Embolism, Pulmonary Hypertension
Respiratory distress in  adults and newborn
Air lung content alterations (emphysema and atelectasia).

Chronic obstructive and restrictive pneumopathies: natural history and morphological aspects
Pneumonia, bronchopneumonia and lung abscess: morphological aspects
Pneumoconiosis: etiopathogenesis, morphological aspects and natural history.
Interstitial lung diseases and pulmonary fibrosis: morphological aspects
Tuberculosis and sarcoidosis: morphological aspects
Lung tumors: Classification criteria, morphological aspects, isto-prognostic correlations and natural history
Pleuritis and pleural tumors: Morphological aspects
Cytological examination: generality and applications in pulmonary pathology
RENAL AND ENDOCRINE PATHOLOGY
Endocrine tumors of  pancreas and GI tract: morphological aspects and clinico-pathological correlations
Hyperplasia and adrenal tumors: classification and clinico-pathological correlations

Hypo- and hyper-thyroid dysfunction and natural history.
Thyroiditis: classification, etiopathogenesis, natural history and morphology
Thyroid tumors: Classification criteria, morphological aspects, natural history and diagnostic assessment techniques.
Parathyroid hyperplasia and tumors: morphological aspects and anatomic-clinical correlations
Renal biopsy: diagnostic role
Nephritic syndrome: primitive and secondary causes
Nephrotic syndrome: primitive and secondary causes
Acute renal failure and tubulopathy: morphological aspects
Renal lesions in lupus erythematosus
Renal pathology of Diabetes Mellitus.
Acute and chronic pielonephritis

TOPICS TREATED IN THE 4th YEAR, 1st SEMESTER
DIGESTIVE DISEASE PATHOLOGY
Precancer and oral cavity cancers
Salivary gland diseases
Laryngeal and rhinopharyngeal Tumors
Endoscopic biopsy in digestive disease diagnosis
Esophagitis and gastro-esophageal reflux disease
Preneoplastic and neoplastic lesions of the esophagus: Classification criteria, morphological aspects and natural history
Pre-cancerous lesions and gastric cancers: classification criteria, morphological aspects, histo-prognostic correlations and natural history
Gastritis and peptic ulcer
Mechanical and circulatory disorders of the intestine
Malabsorption: nosography, morphological aspects, role of biopsy
Enteritis and acute and chronic colitis (infectious and non-infectious)
Benign and malignant tumors of the intestine: classification criteria, morphological aspects, histo-prognostic correlations, natural history
Alterations of the liver circulation
Infectious and non-infectious hepatitis (autoimmune): morphological aspects and natural history
Pathological basics of nodular lesions of the liver: Classification criteria, morphology, histo-prognostic correlations, natural history
Genetic liver diseases
Exogenous toxic liver diseases (drugs and alcohol)
Liver cirrhosis: morphogenesis, morphological aspetcs and natural history
Neoplastic and non-neoplastic pathology of the bile ducts (intra and extraepathic)
Acute and chronic pancreatitis: morphological aspects and natural history
Exocrine pancreas tumors: classification criteria and histo-prognostic correlations
Eye tumors

Pathological aspects of HIV infection

TOPICS TREATED IN THE 4th YEAR, 2nd SEMESTER
GENERAL TOPICS
Collaboration between Clinicians and Pathologists in the construction of the diagnosis and definition of prognosis
The request for  histo-cytologic exams and interpretation of the reports
Major malformative syndromes (encephalitis, heart and kidney)
Male infertility causes

HEMATOPATHOLOGY
Hodgkin and non-Hodgkin malignant lymphomas: classification, morphological aspects, prognostic indicators, clinical-pathological correlations.
Acute and chronic lymphadenitis
Multiple myeloma and plasmocytoma.
Mediastinal tumors: classification and clinical-pathological correlations
PATHOLOGICAL ANATOMY OF THE CENTRAL & PERIPHERAL NERVOUS SYSTEM
Ipo- and hyper-pituitaryism. Tumors of the pituitary gland: classification and clinico-pathological correlations

Traumatic injuries of the CNS
Cerebrovascular lesions.
Infections of the CNS
Demyelinating diseases
CNS degenerative diseases
Tumors of the CNS
ONCOLOGICAL PATHOLOGY
Breast cancer: Classification criteria, morphological aspects, histo-prognostic correlations, natural history, role of cytology and screening techniques
Skeletal tumors: classification and prognostic correlation
Soft tissue tumors: classification approach
Kidney tumors in adulthood and childhood: morphological aspects, histo-prognostic correlations, natural history
Urinary tract tumors: morphological aspects, histo-prognostic correlations, natural history
Prostate tumors: morphological aspects, histo-prognostic correlations, natural history
Testicular and epididymal tumors: classification criteria, morphological aspects, histo-prognostic correlations, natural history

The pathology of female genital tract is treated in the Course of Obstetrics and Gynecology.

RECOMMENDED READING/BIBLIOGRAPHY

Gallo D'Amati- Anatomia Patologica – La sistematica. EDRA (2a ediz., 2018)

Robbins & Cotran- Le basi patologiche delle malattie. EDRA (10° ediz. Italiana, 2022)

All slides shown in lessons are published on Aulaweb

TEACHERS AND EXAM BOARD

Exam Board

ROBERTO FRANCO FIOCCA (President)

FEDERICA GRILLO (President)

LUCA MASTRACCI (President)

MICHELE PAUDICE (President)

CARLO PESCE (President)

VALERIO GAETANO VELLONE (President)

LESSONS

LESSONS START

September 2023

Class schedule

PATHOLOGY

EXAMS

EXAM DESCRIPTION

Partial “ongoing” assessmente of topics covered in 3rd year, 2nd semester at the end of the 3rd year.

The exam of the course of Pathological Anatomy and Clinical Correlations at the end of 4th year also includes the assessment of topics treated in the 4th year - 1st semester.

ASSESSMENT METHODS

ORAL EXAM: The final exam takes place at the end of the 4th year. Each candidate is offered 4 topics of oncological and non-oncological nature. After the submission of the arguments, the candidate is given a variable time (about 15') to arrange his/her own presentation even by producing written notes. After this first stage, an oral assessment is held with at least two professors.
The final evaluation also takes into account the result of the previous test on the topics covered during the third year - II semester.

Exam schedule