Muir's textbook of pathology. PDF
Preview Muir's textbook of pathology.
Muir’s Textbook of Pathology BookPower (formerly ELST) is a registered charity which makes available low-priced,unabridged editions of British publishers’ textbooks to students in developing countries. BookPower is grateful to the many individuals,trusts and organisations which have provided funding to cover the costs of its operation.These include: Grocers Company The Tanner Trust The Unwin Charitable Trust The Ryklow Charitable Trust The Arimathea Charitable Trust Coutts Charitable Trust Below is a list of some other medical books published under the BookPower imprint: Browse An Introduction to the Symptoms and Signs of Surgical Disease Hodder Arnold Cook and Zumla Manson’s Tropical Diseases Saunders Giesecke Modern Infectious Disease Epidemiology Hodder Arnold Lakhani Basic Pathology Hodder Arnold Leppard An Atlas of African Dermatology Radcliffe Medical Press McMinn The Concise Handbook of Human Anatomy Manson Publishing Struthers and Westran Clinical Bacteriology Manson Publishing Muir’s Textbook of Pathology Fourteenth Edition Edited by DAVID A LEVISON MD FRCPath Professor of Pathology,University of Dundee,and Honorary Consultant Pathologist, Ninewells Hospital and Medical School,Dundee,UK ROBIN REID BSc(Hons) MBChB FRCPath Consultant Pathologist,Western Infirmary,Glasgow,and Honorary Senior Lecturer in Pathology,University of Glasgow,Glasgow,UK ALASTAIR D BURT BSc(Hons) MBChB MD(Hons) FRCPath FI Biol Professor of Pathology and Dean of Clinical Medicine,Newcastle University, Royal Victoria Infirmary,Newcastle-upon-Tyne,UK DAVID J HARRISON BSc(Hons) Ed MD MRCPath FRCPath FRCPEd FRCSEd Professor of Pathology and Director of the Edinburgh Cancer Research Centre, University of Edinburgh,Edinburgh,UK STEWART FLEMING MBChB BSc(Hons) MD(Hons) FRCPath Professor of Cellular and Molecular Pathology,University of Dundee, Ninewells Hospital,Dundee,UK with Hodder Arnold Sponsored by AstraZeneca Hodder Arnold,an imprint of Hodder Education,part of Hachette Livre UK 338 Euston Road,London NW1 3BH © 2008 Edward Arnold (Publishers) Ltd All rights reserved.No part of this publication may be reproduced or transmitted in any form or by any means,electronically or mechanically,including photocopying,record- ing or any information storage or retrieval system,without either prior permission in writing from the publisher or a licence per- mitting restricted copying.In the United Kingdom such licences are issued by the Copyright Licensing Agency:Saffron House, 6–10 Kirby Street,London EC1N 8TS. Whilst the advice and information in this book are believed to be true and accurate at the date of going to press,neither the authors nor the publisher can accept any legal respon- sibility or liability for any errors or omissions that may be made.In particular (but without limiting the generality of the preceding disclaimer) every effort has been made to check drug dosages;however it is still possible that errors have been missed.Furthermore, dosage schedules are constantly being revised and new side-effects recognized.For these reasons the reader is strongly urged to consult the drug companies’ printed instruc- tions before administering any of the drugs recommended in this book. First published in Great Britain 1924 Second edition 1929 Third edition 1933 Fourth edition 1936 Fifth edition 1941 Sixth edition 1951 Seventh edition 1958 Eighth edition 1964 Ninth edition 1971 Tenth edition 1976 Eleventh edition 1980 Twelfth edition 1985 Thirteenth edition 1992 Fourteenth edition 2008 ELBS edition first published 1964 ELBS edition of ninth edition 1971 ELBS edition of tenth edition 1976 ELBS edition of eleventh edition 1980 ELBS edition of twelfth edition 1984 ELBS edition of thirteenth edition 1992 BookPower edition of fourteenth edition first published 2008 ISBN 978 0 340 81024 8 Typeset in 10/12 Berling by Charon Tec Ltd (A Macmillan Company) www.charontec.com Printed and bound in India CONTENTS Contributors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x SECTION 1 MECHANISMS OF DISEASE: CELLULAR AND MOLECULAR 1 Applications of pathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 2 Normal cellular functions,disease and immunology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 3 Clinical genetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 4 Cell injury,inflammation and repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 5 Cancer and benign tumours . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 SECTION 2 SYSTEMIC PATHOLOGY 6 The cardiovascular system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 7 The respiratory system. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159 8 The lymphoreticular system and bone marrow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189 9 The gastrointestinal system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221 10 The liver,gallbladder and pancreas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 260 11 The nervous systems and the eye. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 280 12 The locomotor system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 330 13 The kidneys and urinary tract. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 373 14 The female reproductive system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 401 15 The breasts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 420 16 The male reproductive system. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 438 17 The endocrine system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 449 18 The skin. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 474 19 Infections. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 508 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 547 To download electronic files of the illustrations used in this book,go to the Muir’s Textbook of Pathologyhomepage, www.muirspathology.com.Access to the files is password protected. Your username is:student99 Your password is:pathology Contributors David AnsellMA MB BChir FRCPath Philip S Hasleton MD FRCPath Consultant Histopathologist,Department of Histopathology, Professor of Pathology, Department of Histopathology, City Hospital,Nottingham,UK Manchester Royal Infirmary,Manchester,UK Jonathan N Berg MB ChB MSc MD FRCP(Ed) C Simon HerringtonMA MB BS DPhil MRCP FRCPath Senior Lecturer in Clinical Genetics,University of Dundee Professor and Consultant in Pathology,Bute Medical School, and Honorary Consultant in Clinical Genetics, Ninewells University of St Andrews,St Andrews,UK Hospitaland Medical School,Dundee,UK Robert Jackson Alastair D BurtBSc(Hons) MD(Hons) FRCPath FIBiol Department of Pathology,Royal Infirmary,Glasgow,UK Professor of Pathology and Dean of Clinical Medicine, Frederick D Lee Newcastle University, Royal Victoria Infirmary, Professor of Pathology, Department of Pathology, Royal Newcastle-upon-Tyne,UK Infirmary,Glasgow,UK Francis A CareyBSc(Hons) MB BCh BAO MD FRCPath Andrew HS LeeMRCP FRCPath Consultant and Professor of Pathology, Department of Consultant Histopathologist, City Hospital, Nottingham, Pathology, Ninewells Hospital and Medical School, UK Dundee,UK David A LevisonMD FRCPath FRCP(Ed) Henry J DargieMB ChB FRCP FESC FRSE Professor of Pathology,University of Dundee,and Honorary Consultant Cardiologist,Honorary Professor,University of Consultant Pathologist, Ninewells Hospital and Medical Glasgow,Glasgow,UK School,Dundee,UK Ian O Ellis BMedSci BM BS MRCPath George BM Lindop BSc(Hons) MBChB FRCP(Glas) Professor of Cancer Pathology and Honorary Consultant FRCPath Pathologist, Faculty of Medicine and Health Sciences, Senior Consultant Pathologist, Sheikh Khalifa Hospital, Department of Histopathology, City Hospital Campus, Abu Dhabi,UAE Nottingham University Hospitals NHS Trust Nottingham, UK Sebastian B LucasFRCP FRCPath Christopher W Elston MD FRCPath Professor, Department of Histopathology, King’s College Professor of Tumour Pathology and Consultant London School of Medicine,St Thomas’ Hospital,London, Histopathologist (Retired),City Hospital,Nottingham,UK UK Alan T Evans BMedBiol(Hons) MD(Hons) FRCPath The late D Gordon MacDonald Consultant Dermatopathologist,Department of Pathology, Professor,Department of Oral Pathology,Glasgow Dental NinewellsHospital and Medical School,Dundee,UK Hospital,Glasgow,UK Stewart FlemingMBChB BSc(Hons) MD(Hons) FRCPath Anne Marie McNicol BSc MD MRCP(UK) FRCP Professor of Cellular and Molecular Pathology, University Glas FRCPath of Dundee,Ninewells Hospital,Dundee,UK Reader, University Department of Pathology, Glasgow Royal Infirmary University NHS Trust,Glasgow,UK Alan K FoulisBSc MD MRCPath FRCP(Ed) Department of Pathology,Royal Infirmary,Glasgow,UK Allan R McPhadenBSc(Hons) MBChB,MD,MRCPath Department of Pathology, Glasgow Royal Infirmary, David I GrahamMBBch PhD FRCPath FRCP(G) FRS(Ed) Glasgow,UK Emeritus Professor of Neuropathology, University Department of Neuropathology, Institute of Neurological Sarju Mehta BSc(Hons) MBBS MRCP(UK) Sciences,Southern General Hospital NHS Trust,Glasgow,UK Consultant in Clinical Genetics, Department of Clinical Genetics,Addenbrooke’s Hospital,Cambridge,UK David J Harrison BSc(Hons) Ed MD FRCPath FRCP(Ed) FRCS(Ed) Wolter J Mooi MD PhD Professor of Pathology and Director of the Edinburgh Cancer Professor of Pathology, Department of Pathology, Vrye Research Centre,University of Edinburgh,Edinburgh,UK Universiteit Medical Centre,Amsterdam,the Netherlands Contributors viii Ian AR MoreBSc PhD MD FRCP FRCPath Fiona Roberts BSc MBChB MD FRCPath Department of Pathology, Western Infirmary, Glasgow, Consultant Ophthalmic Pathologist, Department of UK Pathology, University of Glasgow, Western Infirmary, Glasgow,UK James AR NicollBSc MD FRCPath Professor of Neuropathology, Division of Clinical R Stuart C RodgerMB FRCP Neurosciences, University of Southampton and Honorary Consultant Nephrologist, Honorary Clinical Senior Consultant Neuropathologist, Southampton University Lecturer in Medicine, Renal Unit, University of Glasgow, Hospitals NHS Trust,Southampton,UK Western Infirmary,Glasgow,UK Sarah E Pinder MBChB,FRCPath Paul Van der ValkMD PhD Department of Histopathology, Addenbrooke’s Hospital, Professor of Pathology, Department of Pathology, Vrye Cambridge,UK Universiteit Medical Centre,Amsterdam,the Netherlands Robin ReidBSc(Hons) MBChB FRCPath Consultant Pathologist, Western Infirmary, Glasgow, and Honorary Senior Lecturer in Pathology, University of Glasgow,Glasgow,UK Prevailing a head ix preface This is the Fourteenth Edition of Muir’s Textbook of to appreciate that undergraduate education is just the Pathology,building upon the work of previous editions.It is beginning – a window on the exciting and challenging different in a number of ways from previous editions,but world of disease.We have also included in most chapters, we think it is similar enough to retain the traditional values several case histories which illustrate and add to the infor- of its predecessors.We trust we have produced a text that mation provided in the main text,in an attempt to empha- will be useful both to undergraduate medical students and size the fundamental relevance of pathology to clinical to postgraduates who are interested in having a better medicine. By adopting this format of special study topics understanding of disease upon which to base either their and case studies integrated into, but clearly distinguished clinical practice or their research,or both. from,the core text,we are adopting the approach taken to This edition differs in the balance between general and medical education in many medical schools. We strongly systematic pathology from most earlier editions, with the support the move in the UK to more integrated teaching of general section being relatively shorter.This is deliberate;it the disciplines in medicine.We,not unexpectedly,believe is not meant to suggest that we think an understanding of that the best doctors are knowledgeable about disease the basic sciences is any less important to clinical practice processes, and we hope that this belief is reflected in the than it used to be – quite the contrary.What we have tried level at which we have pitched the text. to do is to focus on the most clinically relevant basic science It will be noted for this edition of the book that for the and we have included some of that in the systematic chap- first time ever the majority of the editors are not based in ters where its relevance is hopefully easier to appreciate. Glasgow. However,three of us are Glasgow graduates,and We have also introduced into almost every chapter one we all acknowledge our debt to, and the inspiration we or two special study topics where the information provided have drawn from,our predecessors in Glasgow Pathology. is rather more than most medical educators would include We are honoured to have had the opportunity to edit this in the core curriculum of a medical undergraduate course. latest edition of ‘Muir’ and hope that we have done justice This is intended to interest and stimulate the best students to the task. David A Levison Robin Reid Alastair D Burt David J Harrison Stewart Fleming 2008
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