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A BIASED PRESENTATION OF HUMAN PATHOLOGY
FROM THE FILES OF RICHARD J. REED, M.D.
NEW ORLEANS, LA 70125.
Note: the collection of material, particularly with regard to expositions of skin pathology, owes much to my
association with various conferences, including: 1.) meetings of the Louisiana Dermatologic Society, 2.) meetings of the Ochsner Dermatologic
Clinicopathologic Skin Conference, 3.) meetings of the Zola Cooper Clinicopathologic Skin Conference, and 4.) various collaborative efforts with residents in
pathology and dermatology at Charity Hospital, New Orleans, La. The availability of the material expresses a long-standing interest in the morphology of
disease and in attempts to inculcate peculiar concepts in the minds of students of disease.
Special thanks to William Weems for his efforts, patience, support, dedication, and
competence.
INTRODUCTION: Here, pathological images, particularly those of the skin, will be discussed. Interpretations will be based primarily on morphology. Both
inflammatory and neoplastic diseases will be selected for display.
On this site, the approach to inflammatory disease will owe much to empiricism; reactions patterns will be emphasized. Morphologic features will be
correlated with rather general concepts of the nature of inflammation. Emphasis will be on the site in which antigens and antibodies interact with only
secondary attention to the distribution of lymphoid cells along dermal vessels. Dermal vessels are mere conduits allowing for the egress and ingress of
formed elements. Vascular permeability must be affected for either to occur. Where it occurs is in large part an expression of hemodynamic effects and is
closely associated with injury to vessels. Among the injurious agents. the most common are antigens, antibodies, and their combinations (i.e., immune
complexes). The proposed reaction patterns will attempt to incorporate these principals (i.e., hemodynamics, antigens, antibodies, and antigen-antibody
complexes) in the sequence leading to tissue injury. To all this, the system of antigen presenting cells will be added.
The approach to neoplasia is essentially morphological. For the elaboration of basic principles, melanocytic neoplasia will serve as the model. The choice
is simple; it reflects an abundance of available archival material, all related to neoplasms of the melanocytic system. Some of the concepts and the
related terminology which, herein, will be promoted have been much abused by critics. These areas of controversy are concerned mostly with the definition
of transitional phenomena. If an observer is concerned with transitional patterns, he will be obligated to adopt a relevant taxonomy. If one is not
available, then efforts will be required to develop names in which virtual image of transitional phenomena are embodied. The embodiments become “intensions”
and “intensions” provide the basis for the utility of pathologic diagnoses in prognostications and therapy.
Among others, a navigation bar in the border has several external links. Most of the links are to material which is relevant to melanocytic neoplasia but one
(BWEEMS) sends the browser to a site with more general presentations of dermatopathology.
Click “Consults" to go to discussion of a case of minimal deviation lentigo maligna melanoma.
COMMENTS TO: rjreedpathology@netscape.net
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