Netter's Illustrated Human Pathology

Netter's Illustrated Human Pathology

By Maximilian L. Buja, MD; and Gerhard R. F. Krueger


Chapter 1: General Reaction Patterns

Introduction 1
Degeneration 2
Atrophy 3
Apoptosis and Necrosis 4
Acute Inflammation 5
Chronic Inflammation 6
Immunologic Inflammation: B Cell 7
Immunologic Inflammation: T Cell 9
Hypertrophy and Hyperplasia 10
Dysplasia and Neoplasia 11
Malignant Tumors 12


Chapter 2: Cardiovascular System

Introduction 15
Congenital Malformations
Ventricular Septal Defect: Membranous Type 18
Patent Ductus Arteriosus 19
Atrial Septal Defects 20
Atrioventricular Septal Defects 21
Tetralogy of Fallot 22
Transposition of the Great Vessels 23
Tricuspid Atresia 24
Coarctation of the Aorta 25
Aortic Atresia and Aortic Valvular Stenosis 26
Atherosclerosis
Atherosclerosis 27
Critical Areas of Atherosclerosis 28
Coronary Heart Disease
Pathologic Changes in Coronary Artery Disease 29
Acute and Subacute Myocardial Infarcts 30
Healed Myocardial Infarcts 31
Rupture of Myocardial Infarcts 32
Hypertensive Cardiovascular Disease
Causes of Hypertension 33
The Kidneys in Hypertension: Benign and Malignant 34
The Heart in Hypertension: Concentric Hypertrophy 35
Heart Failure
Pathophysiology of Heart Failure 36
The Kidneys in Congestive Heart Failure 37
Left-Sided Heart Failure: Eccentric Hypertrophy 38
Right-Sided Heart Failure: Acute Cor Pulmonale 39
Right-Sided Heart Failure: Chronic Cor Pulmonale 40
Diseases of the Aorta
Aortic Atherosclerosis 41
Cystic Medial Necrosis of the Aorta 42
Dissecting Aneurysm of the Aorta 43
Immunologic Diseases
Rheumatic Fever 44
Rheumatic Heart Disease 45
Chronic Rheumatic Heart Disease 46
Rheumatic Heart Disease: Mitral Stenosis 47
Systemic Lupus Erythematosus 48
Myocarditis in Sarcoidosis and Scleroderma 49
Infections and Other Inflammatory Diseases of the Heart
Nonbacterial Thrombotic Endocarditis 50
Infective Endocarditis: Portals of Entry and Predisposing Factors 51
Infective Endocarditis: Early Lesions 52
Infective Endocarditis: Advanced Lesions 53
Infective Endocarditis: Right-Sided Involvement 54
Infective Endocarditis: Remote Embolic Effects 55
Septic Myocarditis 56
Diphtheritic and Viral Myocarditis 57
Cardiomyopathies and Metabolic Diseases
Dilated (Congestive) Cardiomyopathy 58
Idiopathic Hypertrophic Subaortic Stenosis: Hypertrophic Cardiomyopathy 59
Cardiac Involvement in Amyloidosis: Restrictive Cardiomyopathy 60
Valvular Heart Disease
Rheumatic Heart Disease 61
Aortic Valve Disease 62
Mitral Valve Prolapse 63
Tumors of the Heart
Primary Heart Tumors 64
Metastatic Heart Tumors 65
Diseases of the Pericardium
Diseases of the Pericardium 66
Adhesive Pericarditis 67
Trauma
Nonpenetrating and Penetrating Heart Wounds 68


Chapter 3: Respiratory System

Introduction 69
Obstructive Lung Diseases
Chronic Obstructive Pulmonary Disease 70
Chronic Bronchitis 71
Cystic Fibrosis 72
Emphysema 73
Asthma 74
Restrictive Lung Diseases
Adult Respiratory Distress Syndrome 75
Extrinsic Allergic Alveolitis 76
Idiopathic Pulmonary Fibrosis 77
Collagen-Vascular Disease: Lung Involvement 78
Systemic Vasculitis: Wegener Disease 79
Pneumoconiosis 80
Sarcoidosis 82
Vascular Lung Diseases
Pulmonary Embolism 83
Pulmonary Infectious Diseases
Bacterial Pneumonias 85
Viral Pneumonias 86
Opportunistic Pneumonias 87
Pulmonary Tuberculosis 88
Tumors in the Lungs and the Pleura
Lung Cancer 90
Small-Cell Lung Cancer 91
Non?Small-Cell Lung Cancer 92
Lung Cancer: Extrapulmonary Manifestations 93
Pancoast Tumor 94
Other Lung Tumors 95
Metastatic Malignancy to the Lung 96


Chapter 4: Gastrointestinal System

Introduction 97
Diseases of the Esophagus
Esophagitis 99
Chronic Reflux Esophagitis and Barrett Esophagus 100
Esophageal Cancer: Squamous Cell Carcinoma 101
Esophageal Cancer: Adenocarcinoma 102
Diseases of the Stomach
Gastric Hernia 103
Gastritis 105
Atrophic Gastritis 106
Peptic Ulcers 107
Duodenal Ulcers 108
Carcinomas of the Stomach 109
Early Gastric Cancer 110
Spread of Gastric Carcinomas 111
Diseases of the Small and Large Intestines
Diverticulosis of the Colon 112
Malabsorption Syndrome 114
Food Poisoning 116
Shigellosis 118
Typhoid Fever 119
Amebiasis 120
Gastrointestinal Tuberculosis 121
Parasitic Disease of the Gastrointestinal Tract 122
Mesenteric Vascular Occlusion 124
Acute Appendicitis 125
Acute Peritonitis 126
Crohn Disease 127
Ulcerative Colitis 128
Bowel Obstruction
Obstruction of the Bowel 130
Tumors of the Small and Large Intestines
Tumors of the Small Intestine 132
Familial Polyposis of the Large Intestine 133
Cancer of the Small Intestine: Adenocarcinomas 134
Cancer of the Small Intestine: Lymphomas 135
Cancer of the Small Intestine: Carcinoid Tumors 136
Colon Cancer 137


Chapter 5: Liver, Gallbladder, and Pancreas

Introduction 139
Inflammatory Diseases of the Liver
Acute Viral Hepatitis 142
Chronic Hepatitis 143
Cirrhosis of the Liver 144
Portal Hypertension 145
Bacterial Infections of the Liver 146
Liver Abscesses 147
Granulomatous Hepatitis 148
Weil Disease 149
Echinococcus Cyst 150
Schistosomiasis 151
Toxic and Immunologic Disorders of the Liver
Alcoholism 152
Toxic Injuries 153
Metabolic Diseases Involving the Liver
Hemochromatosis 154
Wilson Disease 155
Amyloidosis of the Liver 156
Storage Diseases 157
Primary Tumors of the Liver
Hepatocellular Carcinoma 158
Intrahepatic Cholangiocarcinoma 159
Cholelithiasis and Cholecystitis
Cholelithiasis 160
Cholelithiasis: Complications 161
Cholestasis: Extrahepatic and Intrahepatic 162
Cholecystitis 164
Tumors of the Gallbladder and the Bile Ducts
Cancer of the Gallbladder 165
Cancer of the Bile Ducts and the Ampullary Region 166
Acute and Chronic Pancreatitis
Acute Pancreatitis 167
Chronic Pancreatitis 168
Cystic Fibrosis
Cystic Fibrosis 169
Carcinoma of the Pancreas
Pancreatic Cancer 170
Tumors of the Pancreas: Metastases 171


Chapter 6: Kidneys, Ureters, and Urinary Bladder

Introduction 173
Primary Diseases of the Kidney
Acute Renal Failure I 175
Acute Renal Failure II 176
Chronic Renal Failure 177
Uremia 178
Nephrotic Syndrome: Pathophysiology 179
Nephrotic Syndrome: Pathology 180
Anti?Glomerular Basement Membrane Disease 181
Acute and Chronic Glomerular Injury Produced by Circulating Immune Complexes 182
Acute Glomerulonephritis 184
Chronic Glomerulonephritis: Early Stage 185
Chronic Glomerulonephritis: Mesangiocapillary Glomerulonephritis 186
Chronic Glomerulonephritis: Membranous Glomerulonephritis 187
Focal Segmental Glomerulonephritis 188
Nephropathy in Anaphylactoid Purpura 189
Lupus Nephritis 190
Acute Diffuse Interstitial Nephritis 192
The Kidney and Systemic Diseases
Diabetic Nephropathy: Renal Pathology 193
Benign Essential Hypertension 194
Malignant Phase of Essential Hypertension: Renal Pathology 195
Renovascular Hypertension 196
Hemolytic-Uremic Syndrome 197
Renal Amyloidosis 198
Progressive Systemic Sclerosis and Rheumatoid Arthritis 199
Polyarteritis Nodosa 200
Toxic Nephropathy 201
Renal Vein Thrombosis 202
Lung Purpura With Nephritis 203
Hypokalemic Nephropathy 204
Calcium Nephropathy 205
Myeloma 206
Diseases of the Urinary System
Obstructive Uropathy 207
Cystitis 208
Pyelonephritis 209
Papillary Necrosis 210
Renal Carbuncle and Perirenal Abscess 211
Tuberculosis of the Urinary Tract 212
Urinary Schistosomiasis 213
Urinary Tract Calculi 214
Renal Cystic Diseases: Simple Cysts 215
Renal Cystic Diseases: Adult Polycystic Kidney 216
Benign Renal Tumors 217
Malignant Tumors of the Kidney 218
Tumors of the Pelvis and the Ureter 220
Tumors of the Bladder 221
Nephroblastoma 222
Diverticula of the Bladder 223
Neurogenic Bladder 224


Chapter 7: Diseases of the Male Reproductive System

Introduction 225
Development of the Genital Tracts
Functional Gonadal Relations 227
Hermaphroditism 228
Diseases of the Penis and the Urethra
Congenital Anomalies: Congenital Valves, Epispadia, and Hypospadia 229
Phimosis, Paraphimosis, and Strangulation 230
Peyronie Disease, Priapism, and Thrombosis 231
Balanitis 232
Urethritis 233
Syphilis 234
Chancroid, Lymphogranuloma Venereum, and Granuloma Inguinale 235
Strictures 236
Warts, Precancerous Lesions, and Early Cancer 237
Papilloma and Cancer of the Urethra 239
Diseases of the Prostate Gland and the Seminal Tract
Prostatitis 240
Nodular Hyperplasia: Benign Prostatic Hypertrophy 241
Carcinoma of the Prostate: Types, Extension, and Metastases 243
Diseases of the Scrotum and the Testis
Hydrocele and Spermatocele 245
Varicocele, Hematocele, and Torsion 246
Infection and Gangrene 247
Testicular Failure: Primary or Hypogonadotrophic Hypogonadism and Prepubertal Failure 248
Testicular Failure: Secondary or Hypogonadotrophic Hypogonadism 249
Sexual Precocity 250
Infection and Abscess of the Testis and the Epididymis 251
Testicular Tumors: Seminoma and Embryonal Carcinoma 252
Testicular Tumors: Chorioepithelioma, Teratoma, and Teratocarcinoma 253


Chapter 8: Diseases of the Female Reproductive System

Introduction 255
Diseases of the Vulva
Dermatoses 258
Diabetic Vulvitis, Trichomoniasis, Moniliasis, and Gonorrhea 259
Syphilis and Genital (Venereal) Warts 260
Chancroid, Lymphogranuloma Venereum, and Granuloma Inguinale 261
Circulatory Disturbances, Cysts, and Benign Tumors 262
Malignant Tumors 263
Diseases of the Vagina
Congenital Anomalies 264
Vaginal Atrophy 265
Cystocele and Rectocele 266
Trichomoniasis, Moniliasis, Nonspecific Vaginitis, and Chemical and Traumatic Vaginitis 267
Syphilis, Gonorrhea, and Tuberculosis 269
Cysts and Primary Benign and Malignant Tumors 270
Malignant Tumors: Metastases and Extension 272
Endometriosis of the Vulva, the Vagina, and the Cervix 273
Diseases of the Uterus
Congenital Anomalies 274
Displacements and Prolapse 275
Lacerations, Strictures, and Polyps 277
Endometrial Hyperplasia and Polyps and Tuberculous Endometritis 278
Cervicitis: Erosions, Moniliasis, Trichomoniasis, and Syphilis 279
Cervicitis: Gonorrhea and Pyogenic Infections 280
Leiomyoma (Fibroid) 281
Myoma: Secondary Changes 282
Sarcoma 283
Cervical Cancer: Cytology 284
Cervical Cancer: Stages and Types 285
Cancer of the Uterine Corpus: Stages and Types 286
Cancer of the Uterine Corpus: Histology and Extension 287
Functional and Pathologic Causes of Uterine Bleeding 288
Diseases of the Fallopian Tubes
Acute Salpingitis: Pathways of Infection and Parametritis 289
Acute Salpingitis: Pyosalpinx 290
Pelvic Peritonitis: Abscess 291
Tubo-ovarian Abscess 292
Tuberculosis 293
Salpingitis Isthmica Nodosa and Carcinoma 294
Diseases of the Ovary
Developmental Abnormalities 295
Physiologic Variations and Nonneoplastic Cysts 296
Endometriosis of the Pelvis 297
Serous Cystoma and Serous Cystadenoma 298
Papillary Serous Cystadenoma 299
Mucinous Cystadenoma 300
Teratoma: Dermoid Cyst and Solid Teratoma 301
Feminizing Neoplasms: Granulosa Cell Tumor and Theca Cell Tumor 302
Masculinizing Neoplasms: Arrhenoblastoma and Adrenal Rest Tumor 303
Stein-Leventhal Syndrome 304
Dysgerminoma and Brenner Tumor 305
Stromatogenous Neoplasms: Fibroma, Meigs Syndrome, and Sarcoma 306
Primary Cystic Carcinoma 307
Primary Solid Carcinoma 308
Secondary Ovarian Carcinoma 309
Pregnancy and Its Diseases
Placenta Previa and Abruptio Placentae 310
Couvelaire Uterus, Rupture of the Uterus, and Maternal Pulmonary Embolism 312
Ectopic Pregnancy: Tubal Pregnancy 313
Abortion 314
Syphilis 315
Puerperal Infection 316
Intrauterine Neoplasms 317
Erythroblastosis Fetalis 318
Acute Toxemia of Pregnancy: Symptomatology of Preeclampsia and Eclampsia 319
Acute Toxemia of Pregnancy: Visceral Lesions in Preeclampsia and Eclampsia 320
Acute Toxemia of Pregnancy: Placental Lesions in Preeclampsia and Eclampsia and Infarcts 321
Pathology of the Mammary Gland
Painful Engorgement and Puerperal Mastitis 322
Fibrocystic Disease: Early Changes 323
Fibrocystic Disease: Cystic Changes 324
Fibrocystic Disease: Adenosis 325
Benign Fibroadenoma and Intracystic Papilloma 326
Giant Myxoma and Sarcoma 327
Infiltrating Carcinoma 328
Fulminant Carcinoma 329
Circumscribed Forms of Adenocarcinoma 330
Paget Disease of the Nipple 331


Chapter 9: Integumentary System (Skin)

Introduction 333
Acute Dermatitis
Urticaria and Acute Eczematous Dermatitis 334
Erythema Multiforme 335
Chronic Dermatitis
Lichen Planus and Psoriasis 336
Vesicular and Bullous Dermatoses
Dermatitis Herpetiformis and Pemphigus Vulgaris 337
Infectious Diseases
Impetigo, Cellulitis, and Erysipelas 338
Herpes Simplex and Varicella Zoster 339
Miscellaneous Viral Skin Infections 340
Dermal Candidiasis 341
Lyme Disease 342
Hyperplasia and Benign Tumors
Keratoses 343
Nevi 344
Malignant Tumors
Basal Cell Carcinoma 345
Squamous Cell Carcinoma 345
Malignant Lymphomas 346
Malignant Melanoma 347


Chapter 10: Hematopoietic and Lymphatic Tissues

Introduction 349
Red Blood Cell Disorders
Acquired Anemias 350
Hereditary Anemias 351
Anemias of Deficient Hemopoiesis 352
Polycythemia Vera 353
Malaria 354
White Blood Cell Disorders (Nonlymphatic)
Hematopoietic Hypoplasia 355
Myelodysplastic Syndrome 356
Osteomyelofibrosis 357
Chronic Myelogenous Leukemia 358
Primary Thrombocythemia 359
Acute Myelogenous Leukemia 360
AML Subtypes M0, M1, and M2 361
AML Subtype M3 362
AML Subtypes M4 and M5 362
AML Subtypes M6 and M7 363
Nonneoplastic Lymphatic Disorders
Lymphatic Hyperplasia 364
Autoimmune Diseases 365
Suppurative Inflammation 366
Granulomatous Inflammation 367
Viral Infections 368
Immune Deficiency Disorders 369
Acquired Immune Deficiency Disorders 370
Graft-Versus-Host Reaction 371
Neoplastic Lymphatic Disorders
Hodgkin Disease 372
Non-Hodgkin Lymphomas, Gross 373
Non-Hodgkin Lymphomas, Microscopic View 375
Lymphocytic Leukemias 376
Multiple Myeloma and Waldenström Disease 377


Chapter 11: Bones, Joints, and Soft Tissues

Introduction 379
Diseases of Calcium Metabolism
Osteoporosis 381
Osteoporosis: Clinical Manifestations 382
Rickets and Osteomalacia 383
Renal Osteodystrophy 384
Primary Hyperparathyroidism 385
Infectious Diseases
Osteomyelitis 386
Chronic Osteomyelitis 387
Infectious Arthritis 388
Tuberculous Arthritis 389
Noninfectious Arthritic Diseases
Osteoarthritis 390
Osteoarthritis: Clinical Manifestations 391
Rheumatoid Arthritis 392
Rheumatoid Arthritis: Clinical Manifestations 393
Paget Disease
Paget Disease 394
Paget Disease: Clinical Manifestations 395
Tumors of the Skeletal System
Fibrous Dysplasia 396
Aneurysmal Bone Cysts 397
Enchondroma 399
Osteochondroma 400
Giant Cell Tumor 401
Osteosarcoma 402
Chondrosarcoma 403
Ewing Sarcoma 404
Soft Tissue Disorders
Compartment Syndrome 405
Collagen-Vascular Disease 406
Benign Soft Tissue Tumors 408
Malignant Soft Tissue Tumors 409


Chapter 12: Endocrine System

Introduction 411
Hypothalamus
Endocrine Function I 413
Endocrine Function II 414
Pituitary Gland
Anatomy of Hypophysis 415
Acidophil Adenoma 416
Basophil Adenoma 417
Chromophobe Adenoma 418
Hypopituitarism 419
Diabetes Insipidus 420
Thyroid Gland
Physiology of Thyroid Hormones 421
Hyperthyroidism 422
Congenital Hypothyroidism and Myxedema 423
Goiter 425
Thyroiditis 426
Thyroid Adenomas 428
Thyroid Carcinoma 428
Parathyroid Glands
Hyperparathyroidism 430
Hypoparathyroidism 431
Adrenal Cortex
Anatomy and Hyperplasia 432
Adrenogenital Syndrome 433
Hyperaldosteronism 434
Acute Adrenal Cortical Insufficiency 435
Chronic Adrenal Cortical Insufficiency 436
Adrenal Medulla
Pheochromocytomas 437
Endocrine Pancreas
Hyperinsulinism 438
Insulin-Dependent Diabetes Mellitus 439
Non?Insulin-Dependent Diabetes Mellitus 440


Chapter 13: Nervous System

Introduction 441
Neurologic Disorders of Infancy and Childhood
Cranial Hemorrhage 444
Brain Malformations 445
Spinal Dysraphism 446
Hydrocephalus 447
Hypotonia 448
Brain Tumors in Children 449
Neurocutaneous Syndromes 450
Pathologic Basis of Common Problems in Neurology
Headache/Giant Cell Arteritis and Polymyalgia Rheumatica 451
Causes of Vertigo 452
Causes of Seizures 453
Differential Diagnosis of Coma 454
Cerebrovascular Disease
Diagnosis of Stroke 455
Atherosclerosis, Thrombosis, and Embolism 456
Stenosis or Occlusion of the Carotid Artery 457
Collateral Circulation With Occlusion of the Internal Carotid Artery 458
Occlusion of the Middle and Anterior Cerebral Arteries 459
Lacunar Infarction 460
Ischemia in Vertebrobasilar Territory: Clinical Manifestations Related to Site 461
Cardiac Sources of Cerebral Emboli 462
Uncommon Etiologic Mechanisms in Stroke 463
Intracerebral Hemorrhage 464
Intracerebral Hemorrhage: Clinical Manifestations Related to Site 465
Vascular Malformations 466
Congenital Intracranial Aneurysms 467
Hypoxic Brain Damage and Brain Death 468
Central Nervous System Trauma
Epidural Hematoma 469
Acute and Chronic Subdural Hematoma 470
Cervical Spine Injury: Incomplete Spinal Cord Syndromes 472
Brain Tumors
Gliomas 473
Tumors Metastatic to the Brain 474
Meningiomas 475
Pituitary Tumors 476
Craniopharyngiomas 477
Tumors of the Pineal Region 478
Acoustic Neuromas 479
Neurofibromatosis 480
Intraventricular Tumors 481
Degenerative Disorders of the Central Nervous System
Alzheimer Disease: Pathology 482
Normal-Pressure Hydrocephalus 483
Chorea 484
Parkinson Disease and Related Disorders 485
Infectious Diseases
Bacterial Meningitis 486
Parameningeal Infections 488
Neurosyphilis 489
Tuberculosis of the Brain and Spine 490
Poliomyelitis 491
Herpes Zoster 493
Herpes Simplex Encephalitis and Rabies 494
Slow Virus Infections and Spongiform Encephalopathies 495
Demyelinating Disorders of the Central Nervous System
Multiple Sclerosis: Central Nervous System Pathology 496
Disorders of the Spinal Cord, Nerve Root, and Plexus
Acute Spinal Cord Syndromes: Pathology, Etiology, and Diagnosis 497
Tumors of the Spinal Column 498
Tumors of the Spinal Cord 499
Syringomyelia 501
Subacute Combined Degeneration 502
Cervical Disc Herniation 503
Lumbar Disc Herniation: Clinical Manifestations 504
Disorders of the Motor Neuron, Peripheral Nerve, Neuromuscular Junction, and
Skeletal Muscles
Diseases of the Motor-Sensory Unit: Regional Classification 505
Primary Motor Neuron Disease 506
Peripheral Neuropathies: Metabolic, Toxic, and Nutritional 507
Mononeuritis Multiplex With Polyarteritis Nodosa 508
Myasthenia Gravis 509
Guillain-Barré Syndrome 510
Duchenne Muscular Dystrophy 512
Polymyositis/Dermatomyositis 513

Index 515