Medicine and Surgery

Gross and microscopic features and prognostic and predictive factors of cancers of the esophagus, stomach, colon, pancreas, and lung. Clinical-pathologic correlations and pathologic staging. Role of the Pathologist in the diagnostic work-up of GI tract malignant tumors. Role of the Pathologist in the GI Unit. Gross and microscopic features and prognostic and predictive factors of endocrine neoplasms. Clinical-pathologic correlations and pathologic staging. Gross and microscopic features of the most relevant diseases of the breast: inflammatory pathology; fibrocystic disease; nodular lesions of the breast; benign and malignant neoplasms. Prognostic and predictive factors in breast cancer. Indications to intraoperative diagnosis and biopsy. Clinical-pathologic correlations and pathologic staging. Role of the Pathologist in the diagnostic work-up of breast tract malignant tumors. Role of the Pathologist in the Breast Unit. Gross and microscopic features of the most relevant diseases of the female genital tract: Inflammatory and neoplastic pathology of the cervix uteri; endometriosis; endometrial polyps; hyperplasia and neoplasms of the endometrium; tumors of the myometrium; ovarian cysts; neoplasms of the ovary. Prognostic and predictive factors in cancer of the female genital tract cancer. Clinical-pathologic correlations and pathologic staging. Role of the Pathologist in the diagnostic work-up of cancers of the female genital tract. Role of the Pathologist in the Gyneco Unit. Gross and microscopic features of the most relevant diseases of head and neck: Neoplasms of the salivary glands, nose and paranasal sinuses, oropharynx and nasopharynx; keratosis and laryngeal nodule; neoplasms of the larynx. Clinical-pathologic correlations and pathologic staging. Prognostic and predictive factors in head and neck cancer. Role of the Pathologist in the diagnostic work-up of head and neck cancers. Macroscopic and microscopic features of the most relevant diseases of soft and calcified tissue pathology: Framing of soft tissue tumors; non-neoplastic osteopathies (osteomyelitis, osteonecrosis, metabolic osteopathies, Paget's disease); tumor-like and tumor-like lesions (benign and malignant) of the skeleton. Clinical-radiological and pathologic correlations, pathologic staging Principles of exfoliative and needle aspiration cytodiagnostics; indications and interpretation of: needle biopsy; incisional biopsy, excisional biopsy. Indications to intraoperative diagnosis. Grading and staging of neoplasms. Know how to discuss on examination (oral)concrete examples of diagnostics of thyroid, lung, myocardium, liver, digestive tract, kidney and urinary tract. Know how to perform the macroscopic examination of the various organs and apparatuses. Know how to interpret the main histopathological pictures. Know how to interpret pathological reports. Know how to discuss the value of the epicrisis as a moment of diagnostic synthesis of autopsy. Know how to discuss what are the correct relationships between the Clinician and the Pathologist. Know how to discuss on professional role of the pathologist and understand indications, implementation methods, and limitations of the main diagnostic procedures , including immunohistochemistry and molecular techniques. Content delivered and learning assessed in the Integrated Pathology I course: Gross and microscopic pictures, etiology pathogenesis of: Pulmonary edema Acute respiratory distress syndrome Pulmonary thromboembolism Emphysema Chronic obstructive and restrictive diseases Atelectasis Pulmonary hypertension Pneumonias and bronchopneumonias Lung tumors Lung tumors Pleural tumors Thymomas Myocardial hypertrophy Ischemic heart disease Cardiomyopathies Valvulopathies Endocarditis and pericarditis Aneurysms and vasculitis Major congenital heart diseases Myocardial hypertrophy Content delivered and learning assessed in the Integrated Pathology II course: Gross and microscopic pictures, etiology pathogenesis of: Glomerular diseases - Acute glomerulonephritis - Rapidly progressive glomerulonephritis - Membranous glomerulonephritis - Minimal lesion diseases - Focal segmental sclerosis - Membranoproliferative glomerulonephritis - IgA nephropathy - Chronic glomerulonephritis Interstitial and tubular diseases - Acute tubular necrosis - Tubulointerstitial nephritis Vascular diseases - Atherosclerosis - Benign nephrosclerosis - Malignant hypertension - Isolated arterial stenosis - Thrombotic microangiopathies Obstructive uropathies Tumors of the kidney - Benign - Malignant Urinary tract - Inflammatory pathology - Benign and malignant tumors of the bladder and ureters Male genital tract Tumors of the testis Prostate pathology - Prostatic hyperplasia - Tumors of the prostate Content delivered and learning assessed in Integrated Pathology IV course. Gross and microscopic pictures, etiology pathogenesis of: Lymphadenitis Lymphoproliferative diseases Myeloid neoplasms Splenomegaly Clinical indications and technical features of bone marrow fine needle aspiration and biopsy Systemic connectivities Content delivered and learning assessed in the Integrated course of diseases of the Nervous System: Diseases of the central nervous system: cerebrovascular disease (ischemia and infarction); intracranial hemorrhages (intracerebral and subarachnoid); infections (meningitis); cerebral and meningeal tumors, primary and metastatic; neurodegenerative diseases (Alzheimer disease; frontotemporal lobar degenerations; Parkinson disease).

Basic knowledge of gross and microscopic anatomy, physiology and general pathology. Knowledge of content delivered in the course Institutions of Human Pathology: Meaning of macroscopic and microscopic examinations. Histochemistry, immunohistochemistry and electron microscopy techniques and their role in anatomopathological diagnosis. Main techniques of molecular pathology, both in situ and by nucleic acid extraction

P.Gallo, G. d’Amati ed. :Anatomia Patologica, La Sistematica, Ultima edizione, EDRA.

Obbligatoria, in presenza

1) Practical exam. It precedes the written exam. To give the written exam you MUST pass the practical one. You will be asked to interpret 3 clinico-pathologic cases (gross and/or histologic or cytologic findings). Each correct answer gives you 1 point (maximum: 3 points for 3 correct answers). Answers which are partially correct are scored 0.5. If you do not answer or if your interpretation is completely wrong, the score is 0. If you pass the practical exam with a total score of 3 to 2.5, you will receive a “bonus” of 2 points or 1 point respectively, which will be added to the score of your written exam. The results of your practical exams will be scored as follows: •3 = (with a 2 point bonus) •2,5 = (with a 1 point bonus) •2 to 1,5= you are admitted to the written exam, with NO bonus bonus •<1,5 = You are not admitted to the written exam. In case you do not want to give the written exam right after the practical one, you can keep your score until the end of the session (and not more!) 2) Written exam. It consists of 30 multiple choice quiz. Each correct answer is scored 1. Wrong answers are scored 0. The minimum score required to pass the exam is 18. 3)Oral exam. It is OPTIONAL. You can ask for the oral exam to improve your score if you have a minimum score of 18. Keep in mind that your score may improve, but the opposite is also possible.The exams modalities are the same for Anatomic Pathology I and II. The final score is a mean value of the scores obtained at the ongoing and final exams

Interactive teaching

Main professional activities of the pathologist: exfoliative and needle aspiration cyto-diagnostics; biopsy; intraoperative and definitive histopathologic examination; pathologic grading and staging of malignancies; autopsy diagnostics. Know how to discuss concrete examples of thyroid, lung, myocardial, liver, digestive tract, kidney, and urinary tract diagnostics. Gross and microscopic features and prognostic and predictive factors of cancers of the esophagus, stomach, colon, pancreas, and lung. Clinical-pathologic correlations and pathologic staging. Role of the Pathologist in the diagnostic work-up of GI tract malignant tumors. Role of the Pathologist in the GI Unit. Gross and microscopic features and prognostic and predictive factors of endocrine neoplasms. Clinical-pathologic correlations and pathologic staging. Gross and microscopic features of the most relevant diseases of the breast: inflammatory pathology; fibrocystic disease; nodular lesions of the breast; benign and malignant neoplasms. Prognostic and predictive factors in breast cancer. Indications to intraoperative diagnosis and biopsy. Clinical-pathologic correlations and pathologic staging. Role of the Pathologist in the diagnostic work-up of breast tract malignant tumors. Role of the Pathologist in the Breast Unit. Gross and microscopic features of the most relevant diseases of the female genital tract: Inflammatory and neoplastic pathology of the cervix uteri; endometriosis; endometrial polyps; hyperplasia and neoplasms of the endometrium; tumors of the myometrium; ovarian cysts; neoplasms of the ovary. Prognostic and predictive factors in cancer of the female genital tract cancer. Clinical-pathologic correlations and pathologic staging. Role of the Pathologist in the diagnostic work-up of cancers of the female genital tract. Role of the Pathologist in the Gyneco Unit. Gross and microscopic features of the most relevant diseases of head and neck: Neoplasms of the salivary glands, nose and paranasal sinuses, oropharynx and nasopharynx; keratosis and laryngeal nodule; neoplasms of the larynx. Clinical-pathologic correlations and pathologic staging. Prognostic and predictive factors in head and neck cancer. Role of the Pathologist in the diagnostic work-up of head and neck cancers. Macroscopic and microscopic features of the most relevant diseases of soft and calcified tissue pathology: Framing of soft tissue tumors; non-neoplastic osteopathies (osteomyelitis, osteonecrosis, metabolic osteopathies, Paget's disease); tumor-like and tumor-like lesions (benign and malignant) of the skeleton. Clinical-radiological and pathologic correlations, pathologic staging Principles of exfoliative and needle aspiration cytodiagnostics; indications and interpretation of: needle biopsy; incisional biopsy, excisional biopsy. Indications to intraoperative diagnosis. Grading and staging of neoplasms. Know how to discuss on examination (oral)concrete examples of diagnostics of thyroid, lung, myocardium, liver, digestive tract, kidney and urinary tract. Know how to perform the macroscopic examination of the various organs and apparatuses. Know how to interpret the main histopathological pictures. Know how to interpret pathological reports. Know how to discuss the value of the epicrisis as a moment of diagnostic synthesis of autopsy. Know how to discuss what are the correct relationships between the Clinician and the Pathologist. Know how to discuss on professional role of the pathologist and understand indications, implementation methods, and limitations of the main diagnostic procedures , including immunohistochemistry and molecular techniques. Content delivered and learning assessed in the Integrated Pathology I course: Gross and microscopic pictures, etiology pathogenesis of: Myocardial hypertrophy Atherosclerosis Ischemic heart disease Cardiomyopathies Valvulopathies Endocarditis and pericarditis Aneurysms and vasculitis Major congenital heart diseases Myocardial hypertrophy Pulmonary edema Acute respiratory distress syndrome Pulmonary thromboembolism Emphysema Chronic obstructive and restrictive diseases Atelectasis Pulmonary hypertension Pneumonias and bronchopneumonias Lung tumors Lung tumors Pleural tumors Thymomas Content delivered and learning assessed in the Integrated Pathology II course: Gross and microscopic pictures, etiology pathogenesis of: Glomerular diseases - Acute glomerulonephritis - Rapidly progressive glomerulonephritis - Membranous glomerulonephritis - Minimal lesion diseases - Focal segmental sclerosis - Membranoproliferative glomerulonephritis - IgA nephropathy - Chronic glomerulonephritis Interstitial and tubular diseases - Acute tubular necrosis - Tubulointerstitial nephritis Vascular diseases - Atherosclerosis - Benign nephrosclerosis - Malignant hypertension - Isolated arterial stenosis - Thrombotic microangiopathies Obstructive uropathies Tumors of the kidney - Benign - Malignant Urinary tract - Inflammatory pathology - Benign and malignant tumors of the bladder and ureters Male genital tract Tumors of the testis Prostate pathology - Prostatic hyperplasia - Tumors of the prostate Content delivered and learning assessed in Integrated Pathology IV course. Gross and microscopic pictures, etiology pathogenesis of: Lymphadenitis Lymphoproliferative diseases Myeloid neoplasms Splenomegaly Clinical indications and technical features of bone marrow fine needle aspiration and biopsy Systemic connectivities Content delivered and learning assessed in the Integrated course of diseases of the Nervous System: Diseases of the central nervous system: cerebrovascular disease (ischemia and infarction); intracranial hemorrhages (intracerebral and subarachnoid); infections (meningitis); cerebral and meningeal tumors, primary and metastatic; neurodegenerative diseases (Alzheimer disease; frontotemporal lobar degenerations; Parkinson disease).

Requirements: Basic knowledge of gross and microscopic anatomy and, physiology and general pathology Knowledge of content delivered in the course Institutions of Human Pathology: Meaning of macroscopic and microscopic examinations. Histochemistry, immunohistochemistry and electron microscopy techniques and their role in anatomopathological diagnosis. Main techniques of molecular pathology, with emphasis on FISH

Suggested textbooks: P.Gallo, G. d’Amati ed. :Anatomia Patologica, La Sistematica, Ultima edizione, EDRA. Robbins and Cotran: Pathologic Bases of Disease, latest edition

mandatory

1) Practical exam. It precedes the written exam. To give the written exam you MUST pass the practical one. You will be asked to interpret 3 clinico-pathologic cases (gross and/or histologic or cytologic findings). Each correct answer gives you 1 point (maximum: 3 points for 3 correct answers). Answers which are partially correct are scored 0.5. If you do not answer or if your interpretation is completely wrong, the score is 0. If you pass the practical exam with a total score of 3 to 2.5, you will receive a “bonus” of 2 points or 1 point respectively, which will be added to the score of your written exam. The results of your practical exams will be scored as follows: •3 = (with a 2 point bonus) •2,5 = (with a 1 point bonus) •2 to 1,5= you are admitted to the written exam, with NO bonus bonus •<1,5 = You are not admitted to the written exam. In case you do not want to give the written exam right after the practical one, you can keep your score until the end of the session (and not more!) 2) Written exam. It consists of 30 multiple choice quiz. Each correct answer is scored 1. Wrong answers are scored 0. The minimum score required to pass the exam is 18. 3)Oral exam. It is OPTIONAL. You can ask for the oral exam to improve your score if you have a minimum score of 18. Keep in mind that your score may improve, but the opposite is also possible.The exams modalities are the same for Anatomic Pathology I and II. The final score is a mean value of the scores obtained at the ongoing and final exams

Teaching methods: 1) Frontal lectures 2) Interpretative professionalizing educational activities in the classroom 3) Elective teaching activities in the anatomic pathology laboratories: How's life in the pathologist's lab? This consists of two afternoons in which students (3 or 4) attend the anatomic pathology laboratory and take part in macroscopic and microscopic examinations.

Bone and Soft Tissue Pathology Approach to the dignostics of bone pathology; osteogenic neoplasms and neoplastic-like lesions; chondrogenic neoplasms and neoplastic-like lesions; non-osteogenic neoplasms and neoplastic-like lesions; bone metastases Approach to the dignostics of soft tissue neoplastic pathology; classification according to the differentiation line; benign, malignant and border-line lesions: general concept and outline of differntial diagnosis; prognostic stratification in soft tissue tumours

The student must have a basic knowledge of the anatomy, histology and physio-pathology of the organs and apparatuses covered in the pathological anatomy course.

Robbins and Cotran, The Pathological Basis of Disease, 9th ed. Gallo d'Amati, Pathological Anatomy, 2nd ed.

Compulsory attendance, 66% attendance required to take the assessment tests

The achievement of the learning objectives of the integrated course is assessed by means of a practical test consisting of a guided discussion of macroscopic and microscopic images of high diagnostic relevance as a preliminary and/or supplemented by a written test of the multiple-choice quiz type (5 possible answers of which only one is correct) Students who have achieved the required percentage of attendance are admitted to the examinations.

The course is conducted through lectures and elective teaching activities (seminars interactive lectures and elective internships). Paradigmatic anatomo-clinical cases are discussed, as a means of understanding of the role of the histo-cytopathological investigation in the diagnosis of diseases and as training in understanding the histo-cytopathological report