Menu Expand
Robbins and Cotran Pathologic Basis of Disease, Professional Edition

Robbins and Cotran Pathologic Basis of Disease, Professional Edition

Vinay Kumar | Abul K. Abbas | Nelson Fausto | Jon C. Aster

(2014)

Additional Information

Book Details

Abstract

Dependable, current, and complete, Robbins and Cotran Pathologic Basis of Disease, 9th Edition is the perennially best-selling text that you’ll use long after your medical student days are behind you. A world-class author team headed by Drs. Vinay Kumar, Abul Abbas, and Jon Aster, delivers the latest, most essential pathology knowledge in a readable, interesting manner, ensuring optimal understanding of the latest basic science and clinical content. High-quality photographs and full-color illustrations highlight new information in molecular biology, disease classifications, new drugs and drug therapies, and much more.

  • Rely on uniquely authoritative and readable coverage, ideal for USMLE or specialty board preparation, as well as for course work.
  • Simplify your study with an outstanding full-color, highly user-friendly design.
  • Stay up to date with the latest information in molecular and genetic testing and mechanisms of disease.
  • Consult new Targeted Therapy boxes online that discuss drug therapy for specific diseases.
  • Gain a new perspective in key areas thanks to contributions from new authors at the top of their fields.
  • Consult this title on your favorite e-reader, conduct rapid searches, and adjust font sizes for optimal readability.

Table of Contents

Section Title Page Action Price
Front Cover cover
IFC_professional IFC1
IFC_regular IFC2
End sheet 3 IFC3
Robbins & Cotran Pathologic Basis of Disease, 9/e i
Copyright Page iv
Dedication v
Contributors vii
Preface: A New Chapter xi
Acknowledgments xiii
Table Of Contents xv
General Pathology 1
1 The Cell as a Unit of Health and Disease 1
Chapter Contents 1
The Genome 1
Noncoding DNA 1
Histone Organization 3
Micro-RNA and Long Noncoding RNA 4
Micro-RNA (miRNA) 4
Long Noncoding RNA (lncRNA) 5
Cellular Housekeeping 6
Plasma Membrane: Protection and Nutrient Acquisition 7
Passive Membrane Diffusion. 9
Carriers and Channels. 9
Receptor-mediated and fluid-phase uptake (Fig. 1-7). 9
Cytoskeleton and Cell-Cell Interactions 10
Cell-Cell Interactions. 11
Biosynthetic Machinery: Endoplasmic Reticulum and Golgi 12
Waste Disposal: Lysosomes and Proteasomes 13
Cellular Metabolism and Mitochondrial Function 14
Energy Generation. 14
Intermediate metabolism. 14
Cell Death. 15
Cellular Activation 15
Cell Signaling 15
Signal Transduction Pathways 16
Modular Signaling Proteins, Hubs, and Nodes. 18
Transcription Factors. 18
Growth Factors and Receptors 18
Epidermal Growth Factor and Transforming Growth Factor-α. 19
Hepatocyte Growth Factor. 19
Platelet-Derived Growth Factor. 19
Vascular Endothelial Growth Factor. 20
Fibroblast Growth Factor. 20
Transforming Growth Factor-β. 20
Interaction with the Extracellular Matrix 20
Components of the Extracellular Matrix. 21
Collagens. 23
Elastin. 23
Proteoglycans and hyaluronan (Fig. 1-14). 23
Adhesive glycoproteins and adhesion receptors 24
Maintaining Cell Populations 25
Proliferation and the Cell Cycle 25
Stem Cells 26
Regenerative Medicine 28
Concluding Remarks. 29
Suggested Readings 29
Genetics and Epigenetics 29
Cellular Housekeeping 29
Cellular Metabolism and Mitochondrial Function 29
Cellular Activation 29
Maintaining Cell Populations 29
2 Cellular Responses to Stress and Toxic Insults: 31
Chapter Contents 31
Introduction to Pathology 31
Etiology or Cause. 32
Pathogenesis. 32
Morphologic Changes. 32
Functional Derangements and Clinical Manifestations. 32
Overview: Cellular Responses to Stress and Noxious Stimuli 32
Adaptations of Cellular Growth and Differentiation 34
Hypertrophy 34
Mechanisms of Hypertrophy 34
Hyperplasia 35
Physiologic Hyperplasia 36
Pathologic Hyperplasia 36
Mechanisms of Hyperplasia 36
Atrophy 36
Mechanisms of Atrophy 37
Metaplasia 37
Mechanisms of Metaplasia 38
Overview of Cell Injury and Cell Death 38
Causes of Cell Injury 39
Oxygen Deprivation. 39
Physical Agents. 39
Chemical Agents and Drugs. 39
Infectious Agents. 39
Immunologic Reactions. 39
Genetic Derangements. 39
Nutritional Imbalances. 40
Morphologic Alterations in Cell Injury 40
Reversible Injury 40
Necrosis 41
Patterns of Tissue Necrosis 43
Mechanisms of Cell Injury 44
Depletion of ATP 45
Mitochondrial Damage 46
Influx of Calcium and Loss of Calcium Homeostasis 46
Accumulation of Oxygen-Derived Free Radicals (Oxidative Stress) 47
Generation of Free Radicals. 47
Removal of Free Radicals. 48
Pathologic Effects of Free Radicals. 49
Defects in Membrane Permeability 49
Mechanisms of Membrane Damage. 49
Consequences of Membrane Damage. 49
Damage to DNA and Proteins 50
Reversible vs Irreversible Injury. 50
Clinicopathologic Correlations: Selected Examples of Cell Injury and Necrosis 50
Ischemic and Hypoxic Injury 50
Mechanisms of Ischemic Cell Injury 50
Ischemia-Reperfusion Injury 51
Chemical (Toxic) Injury 51
Apoptosis 52
Causes of Apoptosis 52
Apoptosis in Physiologic Situations 52
Apoptosis in Pathologic Conditions 53
Morphologic and Biochemical Changes in Apoptosis 53
Mechanisms of Apoptosis 53
The Intrinsic (Mitochondrial) Pathway of Apoptosis 53
The Extrinsic (Death Receptor-Initiated) Pathway of Apoptosis 56
The Execution Phase of Apoptosis 56
Removal of Dead Cells 56
Clinicopathologic Correlations: Apoptosis in Health and Disease 57
Examples of Apoptosis 57
Growth Factor Deprivation. 57
DNA Damage. 57
Protein Misfolding. 57
Apoptosis Induced by the TNF Receptor Family. 58
Cytotoxic T Lymphocyte-Mediated Apoptosis. 58
Disorders Associated with Dysregulated Apoptosis 58
Necroptosis 58
Autophagy 60
Intracellular Accumulations 61
Lipids 62
Steatosis (Fatty Change) 62
Cholesterol and Cholesterol Esters 62
Proteins 63
Hyaline Change 63
Glycogen 63
Pigments 64
Exogenous Pigments 64
Endogenous Pigments 64
Pathologic Calcification 65
Dystrophic Calcification 65
Metastatic Calcification 65
Cellular Aging 66
DNA Damage. 66
Cellular Senescence. 67
Defective Protein Homeostasis. 67
Deregulated Nutrient Sensing. 67
Suggested Readings 68
Hypertrophy 68
Cell Death 68
Apoptosis 68
Necroptosis 68
Autophagy 68
Aging 68
3 Inflammation and Repair 69
Chapter Contents 69
Overview of Inflammation: Definitions and General Features 69
Historical Highlights 71
Causes of Inflammation 71
Recognition of Microbes and Damaged Cells 72
Acute Inflammation 73
Reactions of Blood Vessels in Acute Inflammation 73
Changes in Vascular Flow and Caliber 73
Increased Vascular Permeability (Vascular Leakage) 74
Responses of Lymphatic Vessels and Lymph Nodes 74
Leukocyte Recruitment to Sites of Inflammation 75
Leukocyte Adhesion to Endothelium 75
Leukocyte Migration Through Endothelium 76
Chemotaxis of Leukocytes 77
Phagocytosis and Clearance of the Offending Agent 78
Phagocytosis 78
Phagocytic Receptors. 78
Engulfment. 78
Intracellular Destruction of Microbes and Debris 79
Reactive Oxygen Species. 79
Nitric Oxide. 80
Lysosomal Enzymes and Other Lysosomal Proteins. 80
Neutrophil Extracellular Traps 81
Leukocyte-Mediated Tissue Injury 81
Other Functional Responses of Activated Leukocytes 82
Termination of the Acute Inflammatory Response 82
Mediators of Inflammation 82
Vasoactive Amines: Histamine and Serotonin 83
Arachidonic Acid Metabolites 83
Prostaglandins 84
Leukotrienes 85
Lipoxins 85
Pharmacologic Inhibitors of Prostaglandins and Leukotrienes 85
Cytokines and Chemokines 86
Tumor Necrosis Factor (TNF) and Interleukin-1 (IL-1) 86
Chemokines 87
Other Cytokines in Acute Inflammation 88
Complement System 88
Other Mediators of Inflammation 89
Platelet-Activating Factor (PAF) 89
Products of Coagulation 89
Kinins 89
Neuropeptides 89
Morphologic Patterns of Acute Inflammation 90
Serous Inflammation 90
Fibrinous Inflammation 90
Purulent (Suppurative) Inflammation, Abscess 91
Ulcers 91
Outcomes of Acute Inflammation 92
Summary of Acute Inflammation 93
Chronic Inflammation 93
Causes of Chronic Inflammation 93
Morphologic Features 93
Cells and Mediators of Chronic Inflammation 94
Role of Macrophages 94
Role of Lymphocytes 96
Other Cells in Chronic Inflammation 96
Granulomatous Inflammation 97
Systemic Effects of Inflammation 99
Tissue Repair 100
Overview of Tissue Repair 100
Cell and Tissue Regeneration 101
Cell Proliferation: Signals and Control Mechanisms 101
Mechanisms of Tissue Regeneration 101
Liver Regeneration 102
Repair by Connective Tissue Deposition 102
Steps in Scar Formation 103
Angiogenesis 104
Deposition of Connective Tissue 105
Remodeling of Connective Tissue 105
Factors That Influence Tissue Repair 105
Selected Clinical Examples of Tissue Repair and Fibrosis 106
Healing of Skin Wounds 106
Healing by First Intention 106
Healing by Second Intention 107
Wound Strength 108
Fibrosis in Parenchymal Organs 109
Abnormalities in Tissue Repair 109
Suggested Readings 110
General Mechanisms of Inflammation 110
Acute Inflammation: Vascular Reactions 110
Acute Inflammation: Role of Leukocytes 110
Mediators of Inflammation 111
Chronic Inflammation: Role of Macrophages and Other Cells 111
Sepsis 111
Tissue Repair: Regeneration and Fibrosis 111
4 Hemodynamic Disorders, Thromboembolic Disease, and Shock 113
Chapter Contents 113
Edema and Effusions 113
Increased Hydrostatic Pressure 114
Reduced Plasma Osmotic Pressure 114
Sodium and Water Retention 114
Lymphatic Obstruction 114
Clinical Features 115
Hyperemia and Congestion 115
Hemostasis, Hemorrhagic Disorders, and Thrombosis 116
Hemostasis 116
Platelets 117
Coagulation Cascade 118
Factors That Limit Coagulation. 120
Endothelium 121
Hemorrhagic Disorders 121
Thrombosis 122
Endothelial Injury 122
Alternations in Normal Blood Flow 123
Hypercoagulability 123
Heparin-Induced Thrombocytopenia (HIT) Syndrome 124
Antiphospholipid Antibody Syndrome 124
Fate of the Thrombus 125
Clinical Features 126
Venous Thrombosis (Phlebothrombosis). 126
Arterial and Cardiac Thrombosis. 126
Disseminated Intravascular Coagulation 127
Embolism 127
Pulmonary Embolism 127
Systemic Thromboembolism 127
Fat and Marrow Embolism 128
Air Embolism 128
Amniotic Fluid Embolism 129
Infarction 129
Factors That Influence Development of an Infarct. 130
Shock 131
Pathogenesis of Septic Shock 131
Stages of Shock 133
Clinical Consequences. 134
Suggested Readings 134
Fluid Dynamics 134
Hemostasis and Bleeding 134
Thrombosis and Thromboembolism 135
Unusual Forms of Embolic Disease 135
Septic Shock 135
5 Genetic Disorders 137
Chapter Contents 137
Genes and Human Diseases 137
Mutations 138
Mendelian Disorders 140
Transmission Patterns of Single-Gene Disorders 140
Autosomal Dominant Disorders 140
Autosomal Recessive Disorders 141
X-Linked Disorders 142
Biochemical and Molecular Basis of Single-Gene (Mendelian) Disorders 142
Enzyme Defects and Their Consequences 142
Defects in Receptors and Transport Systems 143
Alterations in Structure, Function, or Quantity of Nonenzyme Proteins 144
Genetically Determined Adverse Reactions to Drugs 144
Disorders Associated with Defects in Structural Proteins 144
Marfan Syndrome 144
Pathogenesis. 144
Clinical Features. 145
Ehlers-Danlos Syndromes (EDS) 145
Disorders Associated with Defects in Receptor Proteins 147
Familial Hypercholesterolemia 147
Normal Process of Cholesterol Metabolism and Transport 147
Disorders Associated with Defects in Enzymes 149
Lysosomal Storage Diseases 149
Tay-Sachs Disease (GM2 Gangliosidosis: Hexosaminidase α-Subunit Deficiency) 151
Clinical Features. 152
Niemann-Pick Disease Types A and B 152
Niemann-Pick Disease Type C 153
Gaucher Disease 153
Clinical Features. 154
Mucopolysaccharidoses (MPS) 154
Clinical Features. 155
Glycogen Storage Diseases (Glycogenoses) 155
Disorders Associated with Defects in Proteins That Regulate Cell Growth 157
Complex Multigenic Disorders 158
Chromosomal Disorders 158
Normal Karyotype 158
Commonly Used Cytogenetic Terminology 159
Structural Abnormalities of Chromosomes 159
Cytogenetic Disorders Involving Autosomes 161
Trisomy 21 (Down Syndrome) 161
Other Trisomies 163
Chromosome 22q11.2 Deletion Syndrome 163
Cytogenetic Disorders Involving Sex Chromosomes 164
Klinefelter Syndrome 165
Turner Syndrome 166
Hermaphroditism and Pseudohermaphroditism 167
Single-Gene Disorders with Nonclassic Inheritance 168
Diseases Caused by Trinucleotide-Repeat Mutations 168
Fragile X Syndrome and Fragile X Tremor/Ataxia 169
Fragile X Tremor/Ataxia. 171
Mutations in Mitochondrial Genes—Leber Hereditary Optic Neuropathy 171
Genomic Imprinting 172
Prader-Willi Syndrome and Angelman Syndrome 172
Gonadal Mosaicism 174
Molecular Genetic Diagnosis 174
Diagnostic Methods and Indications for Testing 174
Laboratory Considerations 174
Indications for Analysis of Inherited Genetic Alterations 174
Indications for Analysis of Acquired Genetic Alterations 175
PCR and Detection of DNA Sequence Alterations 175
Molecular Analysis of Genomic Alterations 176
Fluorescence in Situ Hybridization (FISH) 177
Multiplex Ligation-Dependent Probe Amplification (MLPA) 177
Southern Blotting 177
Cytogenomic Array Technology 177
Array-Based Comparative Genomic Hybridization (Array CGH). 177
SNP Genotyping Arrays. 178
Polymorphic Markers and Molecular Diagnosis 178
Polymorphisms and Genome-Wide Analyses 179
Epigenetic Alterations 180
RNA Analysis 180
Next-Generation Sequencing 180
Bioinformatics 180
Clinical Applications of NGS DNA Sequencing 181
Future Applications 182
Acknowledgment 182
Suggested Reading 182
Molecular Basis of Single Gene Disorders—General 182
Disorders Associated with Defects in Structural Proteins 182
Disorders Associated with Defects in Receptor Proteins 182
Disorders Associated with Defects in Enzymes 182
Cytogenetic Disorders Affecting Autosomes 182
Cytogenetic Disorders Affecting Sex Chromosomes 182
Diseases Caused by Trinucleotide Mutations 183
Diseases Caused by Genomic Imprinting 183
6 Diseases of the Immune System 185
Chapter Contents 185
The Normal Immune Response 186
Innate Immunity 186
Components of Innate Immunity 186
Cellular Receptors for Microbes, Products of Damaged Cells, and Foreign Substances 187
Toll-Like Receptors. 187
NOD-Like Receptors and the Inflammasome. 188
Other Receptors for Microbial Products. 188
Reactions of Innate Immunity 188
Adaptive Immunity 188
Cells of the Immune System 189
Lymphocyte Diversity 190
T Lymphocytes 190
B Lymphocytes 191
Dendritic Cells 191
Macrophages 192
Natural Killer Cells 192
Innate Lymphoid Cells (ILCs) 193
Tissues of the Immune System 193
Generative Lymphoid Organs 193
Peripheral Lymphoid Organs 193
Lymphocyte Recirculation 194
Major Histocompatibility Complex (MHC) Molecules: The Peptide Display System of Adaptive Immunity 194
Cytokines: Messenger Molecules of the Immune System 196
Overview of Lymphocyte Activation and Immune Responses 196
Display and Recognition of Antigens 196
Cell-Mediated Immunity: Activation of T Lymphocytes and Elimination of Intracellular Microbes 197
Humoral Immunity: Activation of B Lymphocytes and Elimination of Extracellular Microbes 198
Decline of Immune Responses and Immunologic Memory 199
Hypersensitivity: Immunologically Mediated Tissue Injury 200
Classification of Hypersensitivity Diseases 200
Immediate (Type I) Hypersensitivity 201
Activation of TH2 Cells and Production of IgE Antibody 202
Sensitization and Activation of Mast Cells 202
Mediators of Immediate Hypersensitivity 203
Preformed Mediators. 203
Lipid Mediators. 203
Cytokines. 203
Late-Phase Reaction 204
Development of Allergies 204
Systemic Anaphylaxis 204
Local Immediate Hypersensitivity Reactions 205
Antibody-Mediated (Type II) Hypersensitivity 205
Opsonization and Phagocytosis 205
Inflammation 205
Cellular Dysfunction 205
Immune Complex–Mediated (Type III) Hypersensitivity 207
Systemic Immune Complex Disease 207
Local Immune Complex Disease (Arthus Reaction) 208
T Cell–Mediated (Type IV) Hypersensitivity 208
CD4+ T Cell–Mediated Inflammation 208
Activation of CD4+ T Cells. 208
Responses of Differentiated Effector T Cells. 209
Clinical Examples of CD4+ T Cell–Mediated Inflammatory Reactions. 210
CD8+ T Cell–Mediated Cytotoxicity 211
Autoimmune Diseases 211
Immunologic Tolerance 212
Central Tolerance 212
Peripheral Tolerance 213
Mechanisms of Autoimmunity: General Principles 214
Role of Susceptibility Genes 215
Association of HLA Alleles with Disease. 215
Association of Non-MHC Genes with Autoimmune Diseases. 215
Role of Infections 216
General Features of Autoimmune Diseases 217
Systemic Lupus Erythematosus (SLE) 218
Spectrum of Autoantibodies in SLE 218
Other Autoantibodies. 219
Etiology and Pathogenesis of SLE 219
Genetic Factors. 219
Immunologic Factors. 220
Environmental Factors. 221
A Model for the Pathogenesis of SLE. 221
Mechanism of Tissue Injury. 221
Clinical Features. 225
Chronic Discoid Lupus Erythematosus. 225
Subacute Cutaneous Lupus Erythematosus. 226
Drug-Induced Lupus Erythematosus 226
Rheumatoid Arthritis 226
Sjögren Syndrome 226
Etiology and Pathogenesis 226
Clinical Features. 227
Systemic Sclerosis (Scleroderma) 228
Etiology and Pathogenesis 228
Clinical Features. 229
Inflammatory Myopathies 231
Mixed Connective Tissue Disease 231
Polyarteritis Nodosa and Other Vasculitides 231
IgG4-Related Disease 231
Rejection of Tissue Transplants 231
Mechanisms of Recognition and Rejection of Allografts 231
Recognition of Graft Alloantigens by T and B Lymphocytes 231
T Cell–Mediated Reactions 233
Antibody-Mediated Reactions 233
Rejection of Kidney Grafts 233
Methods of Increasing Graft Survival 234
Transplantation of Other Solid Organs 236
Transplantation of Hematopoietic Stem Cells 236
Immunodeficiency Syndromes 237
Primary Immunodeficiencies 237
Defects in Innate Immunity 237
Defects in Leukocyte Function 237
Deficiencies Affecting the Complement System 238
Defects in Adaptive Immunity 238
Defects in Lymphocyte Maturation 238
Severe Combined Immunodeficiency 239
X-Linked Agammaglobulinemia (Bruton Agammaglobulinemia) 240
DiGeorge Syndrome (Thymic Hypoplasia) 241
Other Defects in Lymphocyte Maturation 241
Defects in Lymphocyte Activation and Function 241
Hyper-IgM Syndrome 241
Common Variable Immunodeficiency 241
Isolated IgA Deficiency 242
X-Linked Lymphoproliferative Syndrome 242
Other Defects in Lymphocyte Activation 242
Immunodeficiencies Associated with Systemic Diseases 242
Wiskott-Aldrich Syndrome 242
Ataxia Telangiectasia 242
Secondary Immunodeficiencies 243
Acquired Immunodeficiency Syndrome (AIDS) 243
Epidemiology 244
Etiology: The Properties of HIV 245
Structure of HIV 245
Pathogenesis of HIV Infection and AIDS 245
Life Cycle of HIV 246
Infection of Cells by HIV 246
Viral Replication 247
Mechanism of T-Cell Depletion in HIV Infection 248
HIV Infection of Non–T Cells 249
B Cell Function in HIV Infection. 249
Pathogenesis of Central Nervous System Involvement 250
Natural History of HIV Infection 250
Primary Infection, Virus Dissemination, and the Acute Retroviral Syndrome 250
Chronic Infection: Phase of Clinical Latency 252
AIDS 252
Clinical Features of AIDS 252
Opportunistic Infections. 252
Tumors. 253
Kaposi Sarcoma. 253
Lymphomas. 254
Other Tumors. 255
Central Nervous System Disease. 255
Effect of Antiretroviral Drug Therapy on the Clinical Course of HIV Infection. 255
Amyloidosis 256
Properties of Amyloid Proteins 257
Physical Nature of Amyloid. 257
Chemical Nature of Amyloid. 257
Pathogenesis and Classification of Amyloidosis 258
Primary Amyloidosis: Plasma Cell Disorders Associated with Amyloidosis. 258
Reactive Systemic Amyloidosis. 259
Heredofamilial Amyloidosis. 259
Hemodialysis-Associated Amyloidosis. 260
Localized Amyloidosis. 260
Endocrine Amyloid. 260
Amyloid of Aging. 260
Clinical Features. 262
Suggested Readings 262
Innate Immunity 262
Cell-Mediated Immunity 262
Humoral Immunity 263
Immune Regulation 263
Immediate Hypersensitivity, Allergy 263
Other Hypersensitivity Reactions 263
Immunological Tolerance 263
Mechanisms of Autoimmunity: General 263
Systemic Lupus Erythematosus 263
Sjogren Syndrome, Systemic Sclerosis, and Other Systemic Autoimmune Diseases 264
Rejection of Transplants 264
Primary Immunodeficiency Diseases 264
HIV and Aids 264
Amyloidosis 264
7 Neoplasia 265
Chapter Contents 265
Nomenclature 266
Benign Tumors. 266
Malignant Tumors. 266
Mixed Tumors. 266
Characteristics of Benign and Malignant Neoplasms 267
Differentiation and Anaplasia 268
Metaplasia and Dysplasia. 270
Local Invasion 271
Metastasis 272
Pathways of Spread 273
Seeding of Body Cavities and Surfaces. 273
Lymphatic Spread. 273
Hematogenous Spread. 274
Epidemiology of Cancer 275
The Global Impact of Cancer 275
Environmental Factors 276
Age 278
Acquired Predisposing Conditions 278
Genetic Predisposition and Interactions Between Environmental and Inherited Factors 279
Molecular Basis of Cancer: Role of Genetic and Epigenetic Alterations 280
Cellular and Molecular Hallmarks of Cancer 282
Self-Sufficiency in Growth Signals: Oncogenes 283
Proto-oncogenes, Oncogenes, and Oncoproteins 284
Growth Factors. 285
Growth Factor Receptors. 285
Downstream components of the receptor tyrosine kinase signaling pathway. 286
RAS Mutations. 286
Oncogenic BRAF and PI3K Mutations. 286
Alterations in Nonreceptor Tyrosine Kinases. 287
Transcription Factors. 288
MYC Oncogene. 288
Cyclins and Cyclin-Dependent Kinases. 288
Insensitivity to Growth Inhibition: Tumor Suppressor Genes 290
RB: Governor of Proliferation. 292
TP53: Guardian of the Genome. 293
Other Tumor Suppressor Genes. 296
APC: Gatekeeper of Colonic Neoplasia. 296
E-Cadherin. 297
CDKN2A. 297
TGF-β Pathway. 298
PTEN. 298
NF1. 298
NF2. 298
WT1. 298
PATCHED (PTCH). 298
VHL. 299
STK11. 299
Growth-Promoting Metabolic Alterations: The Warburg Effect 300
Autophagy. 301
Evasion of Programmed Cell Death (Apoptosis) 301
Biochemical Pathways That Lead To Programmed Cell Death. 302
Limitless Replicative Potential: The Stem Cell–Like Properties of Cancer Cells 303
Angiogenesis 305
Invasion and Metastasis 306
Invasion of Extracellular Matrix 306
Vascular Dissemination and Homing of Tumor Cells 308
Molecular Genetics of Metastasis Development 309
Role of Stromal Elements in Metastasis 309
Evasion of Host Defense 310
Tumor Antigens 310
Antitumor Effector Mechanisms 312
Immune Surveillance and Escape 312
Genomic Instability 314
Hereditary Nonpolyposis Colon Cancer Syndrome. 314
Xeroderma Pigmentosum. 314
Diseases with Defects in DNA Repair by Homologous Recombination. 314
Cancers Resulting from Mutations Induced by Regulated Genomic Instability: Lymphoid Neoplasms. 315
Cancer-Enabling Inflammation 315
Dysregulation of Cancer-Associated Genes 316
Chromosomal Changes 316
Chromosomal Translocations. 316
Deletions. 317
Gene Amplification. 318
Chromothrypsis. 318
Epigenetic Changes 319
Noncoding RNAs and Cancer 320
Molecular Basis of Multistep Carcinogenesis 320
Carcinogenic Agents and Their Cellular Interactions 321
Steps Involved in Chemical Carcinogenesis 322
Direct-Acting Carcinogens 322
Indirect-Acting Carcinogens 323
Molecular Targets of Chemical Carcinogens. 323
Promotion of Chemical Carcinogenesis 324
Radiation Carcinogenesis 324
Ultraviolet Rays 324
Ionizing Radiation 325
Microbial Carcinogenesis 325
Oncogenic RNA Viruses 325
Human T-Cell Leukemia Virus Type 1. 325
Oncogenic DNA Viruses 326
Human Papillomavirus. 326
Epstein-Barr Virus. 327
Hepatitis B and C Viruses. 328
Helicobacter pylori 329
Clinical Aspects of Neoplasia 329
Local and Hormonal Effects 330
Cancer Cachexia 330
Paraneoplastic Syndromes 330
Grading and Staging of Tumors 332
Laboratory Diagnosis of Cancer 332
Histologic and Cytologic Methods. 332
Immunohistochemistry. 334
Flow Cytometry. 334
Circulating Tumor Cells. 334
Molecular and Cytogenetic Diagnostics. 334
Molecular Profiles of Tumors: The Future of Cancer Diagnostics 335
Tumor Markers 337
Suggested Readings 338
Cancer Epidemiology 338
Cancer “Evolution” 338
Hallmarks of Cancer 338
Oncogenes 338
Tumor Suppressor Genes 338
Cancer Cell Metabolism 339
Autophagy 339
Evasion of Apoptosis 339
Cancer Stem Cells 339
Angiogenesis 339
Invasion and Metastasis 339
Evasion of Host Defense 339
Cancer Enabling Inflammation 339
Chromosomal Aberrations 339
Epigenetics and Cancer 339
Non-coding RNAs 339
Environmental Carcinogens 339
Microbial Carcinogenesis 339
Cancer Cachexia and Paraneoplastic Syndromes 340
Cancer Diagnostics 340
8 Infectious Diseases 341
Chapter Contents 341
General Principles of Microbial Pathogenesis 341
How Microorganisms Cause Disease 342
Routes of Entry of Microbes 342
Skin 342
Gastrointestinal Tract 342
Respiratory Tract 343
Urogenital Tract 343
Vertical Transmission 344
Spread and Dissemination of Microbes Within the Body 344
Release from the Body and Transmission of Microbes 345
Host-Pathogen Interactions 345
Host Defenses against Infection 345
Immune Evasion by Microbes 345
Injurious Effects of Host Immunity 347
Infections in People with Immunodeficiencies 347
Host Damage 348
Mechanisms of Viral Injury 348
Mechanisms of Bacterial Injury 349
Bacterial Virulence. 349
Bacterial Adherence to Host Cells. 349
Virulence of Intracellular Bacteria. 350
Bacterial Toxins. 350
Sexually Transmitted Infections 351
Spectrum of Inflammatory Responses to Infection 351
Suppurative (Purulent) Inflammation 352
Mononuclear and Granulomatous Inflammation 352
Cytopathic-Cytoproliferative Reaction 353
Tissue Necrosis 353
Chronic Inflammation and Scarring 353
Special Techniques for Diagnosing Infectious Agents 353
Viral Infections 354
Acute (Transient) Infections 354
Measles 355
Pathogenesis. 355
Mumps 355
Poliovirus Infection 356
West Nile Virus 356
Viral Hemorrhagic Fever 357
Latent Infections (Herpesvirus Infections) 357
Herpes Simplex Viruses 357
Varicella-Zoster Virus (VZV) 358
Cytomegalovirus 359
Congenital Infections. 359
Perinatal Infections. 360
Cytomegalovirus Mononucleosis. 360
CMV in Immunosuppressed Individuals. 360
Chronic Productive Infections 360
Transforming Viral Infections 360
Epstein-Barr Virus (EBV) 360
Pathogenesis. 360
Clinical Features. 362
Bacterial Infections 362
Gram-Positive Bacterial Infections 362
Staphylococcal Infections 362
Pathogenesis. 362
Bacterial Toxins. 363
Streptococcal and Enterococcal Infections 364
Pathogenesis. 364
Diphtheria 365
Listeriosis 366
Anthrax 366
Pathogenesis. 366
Nocardia 367
Gram-Negative Bacterial Infections 367
Neisserial Infections 368
Systemic Pathology: Diseases of Organ Systems 483
11 Blood Vessels 483
Chapter Contents 483
Vascular Structure and Function 483
Vascular Anomalies 485
Vascular Wall Response to Injury 485
Intimal Thickening: A Stereotyped Response to Vascular Injury 486
Hypertensive Vascular Disease 487
Blood Pressure Regulation 488
Pathogenesis of Hypertension 490
Pathogenesis of Secondary Hypertension. 490
Mechanisms of Essential Hypertension 490
Vascular Pathology in Hypertension 490
Arteriosclerosis 491
Atherosclerosis 491
Epidemiology. 491
Constitutional Risk Factors 492
Modifiable Major Risk Factors 492
Additional Risk Factors 493
Pathogenesis of Atherosclerosis 494
Endothelial Injury. 494
Hemodynamic Disturbances. 495
Lipids. 495
Inflammation. 496
Infection. 496
Smooth Muscle Proliferation and Matrix Synthesis. 496
Overview. 496
Consequences of Atherosclerotic Disease 499
Atherosclerotic Stenosis. 500
Acute Plaque Change. 500
Thrombosis. 501
Vasoconstriction. 501
Aneurysms and Dissection 501
Pathogenesis of Aneurysms. 501
Abdominal Aortic Aneurysm (AAA) 502
Clinical Features. 503
Thoracic Aortic Aneurysm 503
Aortic Dissection 504
Pathogenesis. 504
Clinical Features. 505
Vasculitis 505
Noninfectious Vasculitis 506
Immune Complex-Associated Vasculitis 506
Antineutrophil Cytoplasmic Antibodies 507
Antiendothelial Cell Antibodies 507
Giant Cell (Temporal) Arteritis 507
Pathogenesis. 508
Clinical Features. 508
Takayasu Arteritis 508
Clinical Features. 509
Polyarteritis Nodosa 509
Index 1345
A 1345
B 1349
C 1351
D 1356
E 1357
F 1360
G 1361
H 1363
I 1366
J 1370
K 1370
L 1370
M 1372
N 1375
O 1377
P 1378
Q 1382
R 1382
S 1383
T 1386
U 1389
V 1389
W 1390
X 1391
Y 1391
Z 1391
Inside Back Cover ibc1