Clinical and Surgical Pathology

A.Y. 2021/2022
Overall hours
Learning objectives
The course provides students with the tools to learn the pathological basis of organ and apparatus diseases and to be able to integrate macroscopic changes, histological and cytological modifications and molecular alterations into the clinical picture. The course introduces the main diagnostic procedures in surgical pathology, the professional tasks, responsibilities and fields of activity of the pathologist. Teaching approach is strictly integrated with that applied in the pathology modules of the System Disease courses
Expected learning outcomes
At the end of the course, the student is expected to:
-be acquainted with the most important diagnostic tools (exfoliative and aspirative cytology, histology, cytology, frozen section) and techniques (immunohistochemistry and molecular pathology) of the surgical pathology;
-be aware of the possible applications of such tools in preventive medicine (cytological and molecular screening), in clinical diagnostics and in the evaluation of prognostic and predictive parameters;
-be able to properly interpret and integrate in the clinic the information provided by the pathology report for an appropriate therapeutic decision-making process.
Course syllabus and organization

Single session

More specific information on the delivery modes of training activities for academic year 2021/22 will be provided over the coming months, based on the evolution of the public health situation.
Course syllabus
Lecture 1. Preneoplastic and pre-invasive lesions: A way to understand the development of tumours
The concept of preneoplastic and preinvasive lesions
Dysplasia and progression
Models of cancer development
The clinical relevance of preneoplastic and preinvasive lesions
Examples from different organs
Lecture 2. Inflammatory disorders of the skin
Histopathology of the skin: elementary lesions. Epidermal and dermal changes in inflammatory disorders. Psoriasiform dermatitis (psoriasis). Spongiotic dermatitis (eczematous dermatitis). Interface dermatitis (Lichen, LES). Bullous dermatitis (Penphigus, Bullous Penphigoid). Panniculitis.
Lecture 3. Non-melanocytic tumours of the skin
Benign and malignant tumours of the epidermis
Adnexal tumours: principles of classification; clinical and pathological criteria of malignancy
Tumours of the dermis: mesenchymal tumours and lymphoproliferative disorders of the skin
Lecture 4. Melanocytic tumours of the skin
Melanocytic nevi and dysplastic nevus
Melanoma: epidemiology, risk factors, pathogenesis, clinical-pathological classification, morphological changes. The pathology report: prognostic and predictive parameters
Lecture 5. Head and neck pathology
Tumors of the oral cavity and oropharynx: from precursor lesions to invasive cancer
Benign and malignant tumors of the salivary glands
Odontogenic tumours and maxillofacial bone tumors
Lecture 6. Breast pathology - part 1
Clinical presentation of breast diseases
Inflammatory disorders of the breast
Benign epithelial lesion of the breast: nonproliferative and proliferative changes
Carcinoma of the breast: epidemiology, risk factors, pathogenesis
Lecture 7. Breast pathology - Part 2
Histological classification of breast tumours
Molecular classification of breast tumours
The pathology report: grading, staging, prognostic and predictive parameters
Updated guidelines in breast cancer patient clinical handling
Lecture 8. Breast pathology - Part 3
The sentinel lymph-node procedure: how, when, why
Lecture 9. Novelties on specific types of neuroendocrine tumours
Neuroendocrine tumours of the lung
Neuroendocrine tumours of the GI tract and pancreas
Differences in biopsy and surgical resection samples when dealing with neuroendocrine tumours. The issue of heterogeneity in neuroendocrine tumours: from morphology to the molecular landscape
Lecture 10. Pathology of the female genital tract: the cervix
Acute a chronic cervicitis. Cervical polyps
Cervical cancer: epidemiology, risk factors and pathogenesis; premalignant lesions: cervical cancer screening; classification and morphological changes, evolution, staging and prognostic factors. HPV testing
Lecture 11. Pathology of the female genital tract: uterus
Endometrial changes in the menstrual cycle. Functional disorders of the endometrium. Endometriosis and adenomiosis. Endometrial hyperplasia. Malignant tumours of the endometrium and of the endometrial stroma. Endometrial carcinoma: epidemiology, risk factors and pathogenesis, morphological changes, evolution and prognostic factors. Tumours of the myometrium
Lecture 12. Pathology of the female genital tract: the ovary
Nonneoplastic and functional cysts of the ovary. Ovarian tumours: epidemiology, risk factors and pathogenesis; histological classification: epithelial tumours, germ cell tumours, sex cord-stromal tumours of the ovary; evolution, staging and prognostic factors
Lecture 13. Neoplastic diseases of the kidney and urinary bladder
Principles of classification of tumours of the kidney
Benign lesions (renal papillary adenoma, angiomyolipoma, oncocytoma)
Renal cell carcinoma: epidemiology, risk factors, morphological changes and evolution
Tumours of the ureters and urinary bladder: epidemiology, risk factors, morphological changes, evolution and staging
Lecture 14. Pathology of the prostate
Acute and chronic prostatitis
Nodular prostatic hyperplasia (benign prostatic hyperplasia)
Pre-neoplastic lesions of the prostate (atypical adenomatous hyperplasia and prostatic intraepithelial neoplasia)
Prostatic cancer: epidemiology, risk factors, diagnostic approach, morphological changes, grading, evolution and staging
Lecture 15. Pathology of the testis
Reduce fertility: pathological changes of the testis in azospermia and olygospermia
Tumours of the testis: epidemiology, risk factors, histological classification, morphological changes, evolution and staging. The diagnostic report
Lecture 16. Pathology of the adrenal gland and paraganglia
The two components of adrenal gland: differences in origin and disease development
Pathology of adrenal cortex: hyperplasia, adenoma, carcinoma
Lecture 17. Soft tissue and bone pathology
Soft tissue tumours: epidemiology, histological classification, pathogenesis, diagnostic approach, grading, staging and prognostic factors
Bone tumours: epidemiology, histological classification, pathogenesis, diagnostic approach, grading, staging and prognostic factors
Lecture 18. Pathology of the mediastinum
Anatomical and clinical considerations
Pathology of the anterior-superior mediastinum: pathology of the thymus (hyperplasia, thymoma, thymic carcinoma); lymphoid lesions and tumours of germ cell origin
Pathology of the middle mediastinum: cysts, lymphoid lesions and lymph node metastasis
Pathology of the posterior mediastinum: neurogenic tumours
Lecture 19. Tumours of the paediatric age
Epidemiology, principle of classification
Tumors of the CNS
Tumors of the mediastinum
Tumors of the abdomen (neuroblastoma, nefroblastoma)
Soft tissue tumors of the childhood
Haematopoietic tumors of the childhood
Lecture 20. Transplantation pathology
Assessment of death
Assessment of the risk of transplantation
Italian CNT (Centro Nazionale Trapianti)
The role of the pathologist in transplantation pathology
Liver, kidney and incidentalomas evaluation
Acute and chronic rejection
Lectures 21-22. Journal Club
Oral presentation and collegial discussion of specific journal articles and reviews related to the previous lectures
Lecture 23-24. The pathology report
Digital pathology, examples of pathologic reports and review of the main topics discussed in the previous lectures
Prerequisites for admission
To take the Clinical and Surgical Pathology exam, students must have already passed all the exams of the first and second year (Fundamentals of Basic Sciences, Cells, Molecules and Genes 1 and 2, Human Body, Functions and Mechanisms of Diseases).
Teaching methods
Teaching Resources
Robbins and Cotran. PATHOLOGIC BASIS OF DISEASE (9th Edition)
Assessment methods and Criteria
Student assessment is based on an oral examination concerning the topics discussed during the lectures.
MED/08 - PATHOLOGY - University credits: 4
Lessons: 48 hours
Educational website(s)
By appointment
Virtual or in my office at IEO
Monday 12.00-13.00 (by appointment)
Interhospital Pathology Division, Science and Technology Park, Via Fantoli 16/15, 20138 Milano