Pathology (for international students)
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1 Pathology (for international students) Zhou Ren M.D., Ph.D Institute of Pathology & Forensic Medicine Department of Pathology & Patho-physiology Centre of Forensic Science & Technology Services Zhejiang Univeristy
2 Part II. Sexually transmitted diseases, STD Acquired Immunodificiency Syndrome (AIDS) Condyloma acuminatum Syphilis Gonorrhea
3 Acquired Immunodificiency Syndrome (AIDS) acquired immunodificiency syndrome ( AIDS): An epidemic of human immunodificiency retroviral (HIV) disease characterized by profound immunosuppression associated with opportunistic infections,secondary neoplasms and neurologic manifestations
4 AIDS-a worldwide disease The report from China s investigation and comment in 2007 for AIDS. To the end of 2007, HIV-infected and patients accumulate to 700,000 including patients 85,000. The infected rate in whole population: 0.05%. New HIV-infected in 2007 reaches 50,000. average 137 per day New dead from AIDS in 2007: 20,000, average 55 per day.
5 Etiology: human immunodificiency virus ( HIV )
6
7
8 Transmission 1.sexual contact: homosexual and bisexual; 2.parenteral inoculation: a.intravenous drug abusers; b.hemophiliacs: factorⅧ ; c.blood transfusion 3.passage of the virus from infected mothers to their newborns
9 pathogenesis 1. CD4 T cell; 2. macrophage; 3. follicular dendritic cell (FDCs)
10
11
12
13 AIDS can best be characterized as an epidemic of a retroviral disease characterized by profound immunosuppression associatted with opportunistic infections, secondary neoplasms, and neurologic manifestations.
14 Pathogenesis 1. HIV infected CD4 + T cells CD4 + T cells deficiency in cellular immunity 2. HIV infected macrophages
15 humoral immunity cellular immunity CD4+T cells
16 Pathological changes: 1.changes in the lymphoid organs: Early stages: enlarged LN; HIV infect FDCs; Macrophage, CD4 Tc Later stages:generalized lymphocyte depletion burnt-out LN empty-looking LN spleen and thymus are dameged
17 2. Widespread opportunistic infections Protozoal and helminthic Candidiasis, esophageal,tracheal enteritis
18 The oval, round and collapse pneumocystis carinii group in pulmonary alveoli (amino-toluene blue stain). Chest X-ray film of AIDS patient with pneumocystis carinii pneumonia (PCP).
19 Oral candidiasis Esophagus invaded by candida albicans of
20 Cytomegalovirus, Toxoplasm
21
22 Herpes zoster Mycobacterium tuberculosis var. avium
23 Malignant tumor Kaposi sarcoma, lymphoid tumors
24 Morphology The anatomic changes in the tissues (with the exception of lesion in the brain) are neither specific nor diagnostic. In general the pathologic features of AIDS are those characteristic of widespread opportunistic infections, Kaposi sarcoma, and Lymphoid tumors.
25 Infectious wart ( AIDS patient) 传染性软疣 (AIDS 患者 )
26 Herpes zoster ( AIDS patient) 带状疱疹 (AIDS 患者 )
27 Candidiasis in mouth 白念珠菌感染 (AIDS 患者 )
28 Herpes simplex in AIDS (AIDS 患者)单纯疱疹
29 Hepatic cytomegalovirus infection in AIDS 肝巨细胞病毒感染
30 Cryptococcosis enteritis 隐孢子性肠炎 ( 抗酸染色 )
31 Pneumocystis carinii pneumonia in AIDS 卡氏肺孢子虫
32 Pneumocystis carinii pneumonia in AIDS 卡氏肺孢子虫性肺炎
33 Kaposi sarcoma in AIDS 皮肤卡波氏肉瘤
34 艾滋病之淋巴瘤Lymphoma in AIDS
35 Clinical course
36
37
38 Condyloma acuminatum
39 Etiology Human papillomavirus, HPV
40 Morphology Location: external genitalia, around genital organs and anus
41 Macroscopically: 阴茎尖锐湿疣 Condylomas of penis
42 Condylomas around anus 肛周尖锐湿疣
43 外阴部尖锐湿疣Condylomas of the vulva
44 Condylomas of penis 阴茎尖锐湿疣
45 Microscopically: koilocyte
46 Koilocyte 凹空细胞
47 Clinical diagnosis Immunohistochemistry Hybridization in situ PCR in situ
48 HPV positive in immunohistochemistry 免疫组化显示 HPV 抗原 ( 棕色颗粒 )
49 Syphilis
50 Etiology Treponema pallidum
51 苍白密螺旋体Treponema pallidum
52 Basic morphology 1. Obliterative endoarteritis and perivasculitis 2. Characteristic lesion: Gumma (syphiloma)
53 Perivasculitis with plasma cell infiltration 血管周围炎 浆细胞浸润
54 树胶样肿- 结核样结节Gumma (syphiloma)
55 树胶样肿- 浆细胞反应Gumma
56 树胶样肿 Gumma
57 1. Acquired syphilis Staging First stage: chancre Second stage: syphilid Third stage: grumma and scar formation
58 硬下疳CHANCROID
59 硬下疳 CHANCROID
60 足底梅毒疹SYPHILID
61 结节性梅毒疹SYPHILID
62 背部梅毒疹 SYPHILID
63 SYPHILID 手部梅毒疹
64 SYPHILID under microscope
65 SYPHILID under microscope
66 树胶样肿 GUMMA
67 Syphilis aneurysm in ascending aorta 升主动脉瘤
68 Gonorrhea An acute purulent inflammation caused by gonococcus The most common STD
69 Pathological characteristic: Purulent inflammation with formation of granulation Plasmacyte infiltration and fibrosis
70 PRULENT EXUDATES 脓性渗出物
71 PRULENT EXUDATES 脓性渗出物
72 Cervicitis caused by gonococcus 淋菌性宫颈炎
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