Pathological Basis of Disease

Module details

Title

Pathological Basis of Disease

Type

Specialist

Module code

SLS335

Credits

10

Requirement

Compulsory

Aim of this module

This module will provide the trainee with knowledge and understanding of the pathological basis of disease and the use of histopathology and cytopathology to detect and diagnose disease. They will apply a range of techniques to case studies in clinical practice and gain experience of interpreting results from patient investigations.

This module is also part of cytopathology specialist training. The module may be delivered as a combined module or as separate modules with appropriate clinical context.

Competencies

#	Learning outcome	Competency	Action
# 1	Learning outcome 1,4	Competency Using representative specimens from a range of tissues, identify the different types of inflammatory disease: acute inflammation chronic inflammation granulomatous inflammation.	Action View
# 2	Learning outcome 1,4	Competency Using representative specimens from a range of tissues, identify cell proliferation, growth and death: hypoplasia hyperplasia metaplasia benign neoplasia premalignancy neoplastic proliferation cell injury and adaptation apoptosis necrosis degenerative disease.	Action View
# 3	Learning outcome 1,4	Competency Identify the mechanisms of transmission and clinical manifestations of both acute and chronic infections in tissue sections: bacteria viruses fungi parasites.	Action View
# 4	Learning outcome 1,4	Competency Using representative specimens from a range of tissues, identify the immune response and immunological disease in: normal immune system primary and secondary immunodeficiency autoimmune disease transplant rejection.	Action View
# 5	Learning outcome 1,4	Competency Using representative specimens from a range of tissues, identify cell injury, wound healing and repair in: tissue and cell injury hypertrophy thrombosis atherosclerosis embolism oedema.	Action View
# 6	Learning outcome 2,3,5	Competency Using representative specimens from a range of tissues, identify carcinoma and local and metastatic tumour spread, including: premalignancy change benign neoplastic change malignant neoplastic change angiogenesis metastasis.	Action View
# 7	Learning outcome 6,7	Competency Interpret the histological or cytological findings in the correct clinical context and discuss in detail with a senior colleague.	Action View

Assessments

You must complete:

• 2 case-based discussion(s)
• 2 of the following DOPS/ OCEs:

Perform microscopical assessment of H and E stained slides for adequacy of sample	DOPS
Perform microscopical analysis of H and E stained slides and identify the morphological characteristics of all 3 types of inflammation	DOPS
Perform microscopical analysis of H and E stained slides to identify, type and describe cell proliferation	DOPS
Perform microscopical analysis of stained slides to identify the presence infectious disease.	DOPS
Perform microscopical analysis of stained slides to identify the presence of immunological response and disorders of the immune system.	DOPS
Perform microscopical analysis of stained slides and identify the presence of cell injury and repair.	DOPS
Perform microscopical analysis of stained slides and identify the presence of neoplastic disease, including metastasis.	DOPS
In the clinic, perform sample adequacy assessment during biopsy procedure and advise sampling clinician if sample meets adequacy requirements.	OCE
In the clinic, perform sample adequacy assessment during fine needle aspiration procedure and advise sampling clinician if sample meets requirements.	OCE
Perform sample adequacy assessment during specimen dissection procedure and advise Consultant Histopathologist if sample meets adequacy requirements.	OCE
Perform section quality and adequacy assessment during frozen section procedure and advise Consultant Histopathologist if sample meets adequacy requirements.	OCE
Discuss individual cases with a Consultant Pathologist and suggest additional investigative techniques if required to determine a diagnosis	OCE
From evidence gathered from microsopical analysis, discuss sample quality and adequacy assessments at relevant MDT meetings	OCE
From evidence gathered from microscopial analysis discuss a differential diagnosis at a relevant MDT meeting.	OCE
From evidence gathered from stained slides and discussions with relevant clinical colleagues, produce a reflective account of the learning acquired	OCE
In discussion with a Consultant Histopathologist, use information gathered from microscopical analysis to recommend additional special stains to further define the disease process present.	OCE
In discussion with a Consultant Histopathologist, use information gathered from microscopical analysis to recommend additional immunohistochemistry stains to further define the disease process present.	OCE
In discussion with a Consultant Histopathologist, use information gathered from microscopical analysis of H and E, other tinctorial and immunohistochemical stained slides to produce a preliminary diagnosis.	OCE

Learning outcomes

1. Recognise and interpret the microscopical appearance of the tissue or cell and relate to the pathobiological process.
2. Determine adequacy of samples taken by clinicians.
3. Determine adequacy of margins of excision or clearance, where applicable.
4. Advise on or request appropriate additional tests to aid in the diagnosis of disease.
5. Recognise carcinoma and local and metastatic tumour spread in microscopic specimens.
6. Under supervision, prepare preliminary reports based on using interpretive and diagnostic skills.
7. Work in partnership with other clinical specialisms as part of the diagnosis and review of individual cases.

Learning outcomes

1. Describe the mechanisms and microscopic appearances of inflammatory disease.
2. Describe the mechanisms and microscopic appearances of cell proliferation, growth and death.
3. Describe the mechanisms and microscopic appearances of infectious disease.
4. Describe the mechanisms and microscopic appearances of the immune response and immunological disease.
5. Describe the mechanisms and microscopic appearances of tissue and cell injury, wound healing and repair.
6. Describe the mechanisms and microscopic appearances of local and metastatic tumour spread.
7. Discuss the partnership between histopathology and cytopathology laboratories and other clinical specialisms as part of the diagnosis and review of individual cases and the contribution to patient care.

Indicative content

• General principles of different pathological processes at the macroscopic, microscopic and molecular level
• Normal appearance of a variety of tissues, including endocrine, renal, gastrointestinal, respiratory, cardiovascular, male and female genital tract, central and peripheral nervous systems, and the urinary and lymphatic systems
• An understanding of pathological processes such as oncogenesis, carcinogenesis, inflammation, embolism, infarction, ischaemia, congestion, oedema and hypertension
• Epidemiology of common named pathologies associated with the tissues studied
• Principles of infectious diseases and the immune response to infection
• An appreciation of the relationship between cytopathological diagnosis, histopathological diagnosis and clinical outcomes

Activities

• Review prepared microscope slides with your supervisor and draft a diagnosis, taking into account all relevant clinical details, and the macroscopical and microscopical appearances of the
• Double-headed microscopical slide review – working directly with a pathologist perform light microscopy studies on specimens from a range of clinical referrals. In each case identify key histological or cytological features and agree how these may be incorporated into a report prepared in the correct clinical context
• Attend multidisciplinary team meetings – participate in multidisciplinary review meetings at which histopathology results are presented as part of the clinical record. Prepare a portfolio of cases to illustrate how key histological and cytological findings influenced diagnosis and patient management
• Prepare a portfolio of cases from named clinical conditions where you have played a significant role in the systematic investigation
• Become familiar with the laboratory quality management system and perform examination and other audits as part of the laboratory accreditation process (applies to all specialist modules).