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SECTION 2 CELL INJURY

SECTION 2 CELL INJURY. Cellular Swelling Fatty Change Hyaline Change Amyloid Change Mucoid Change Pathologic Pigmentation Pathologic Calcification. Reversible. Degeneration. Irreversible. Cell Death. Reversible Cell Injury. Degeneration.

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SECTION 2 CELL INJURY

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  1. SECTION 2 CELL INJURY

  2. Cellular Swelling Fatty Change Hyaline Change Amyloid Change Mucoid Change Pathologic Pigmentation Pathologic Calcification • Reversible Degeneration • Irreversible Cell Death

  3. Reversible Cell Injury Degeneration Intracellular &/or extracellular abnormal accumulation: • Excess amounts of various normal substances (water,lipids,proteins,pigments) • Abnormal substances (exogenous, endogenous)

  4. (1) Cellular Swelling (hydropic degeneration) Intracellular accumulation • Sodium • Water

  5. (2) Cellular Swelling Morphology the organs NE: • Cloudy swelling • Increase in the weight the cells LM: • Large • Small & fine granules in the cytoplasm Ballooning change Swelling • Endoplasmic reticulum • Mitochondria EM：

  6. ATP Water & sodium within the cells Injurious agents Mechanism Mitochondria damage Cellular swelling

  7. Fatty Change (1) Steatosis Intracellular abnormal accumulation: • Triglycerides Often occurred in the liver and the heart

  8. Fatty Change (2) Morphology • Large • Yellow • Soft • Greasy NE: Fat vacuoles LM: • Round, clear vacuoles • Orange-red color by staining with Sudan Ⅲ or Oil Red O (Frozen tissue sections!) Liposomes EM： • Membrane-bound inclusions

  9. (1) Fatty Change of the Liver NE • Mild fatty change: Not affect the gross appearance • With progressive accumulation: • Large • Yellow • Soft • Greasy Fatty Liver: Severe & diffuse fatty change

  10. (2) Fatty Change of the Liver LM Fat vacuoles Small , in the cytoplasm around the nucleus Displacing the nucleus to the cell periphery Fatty cysts

  11. (3) Fatty Change of the Liver Mechanism

  12. Fatty Change of the Myocardium NE • Mild fatty change: Not affect the gross appearance • With progressive accumulation: Tigered effect Apparent bands of yellowed myocardium alternating with bands of dark,red-brown,uninvolved myocardium

  13. Hyaline Change (1) A descriptive morphologic term A homogeneous, translucent, pink appearance in HE staining Intracellular or extracellularabnormal accumulation: • Proteins

  14. Hyaline Change (2) • Hyaline change in arteriolosclerosis • e.g. Hypertension, Diabetes • Hyaline change in connective tissues e.g. Old scars • Hyaline change within the cytoplasm e.g. Nephrotic syndrome, Russell bodies, Mallory body

  15. Amyloidosis Extracellular abnormal accumulation: • Amyloid

  16. Physicochemical characteristics of amyloid • +Iodine--- a brown color--- +H2SO4 --- blue • Staining: Congo red--- red, HE--- homogeneous pink • EM: nonbranching fibrils 7.5-10 nm wide • X-ray: a pleated –sheet structure (rendering protein very resistant to enzymatic degradation, contributing to its accumulation in tissues)

  17. Mucoid Change Extracellular abnormal accumulation: • Mucopolysaccharide (Glycosaminoglycans, Hyaluronic Acid)

  18. Pathologic Pigmentation Intracellular & extracellular abnormal accumulation: Colored substances • Exogenous • Endogenous

  19. Pathologic Pigmentation • Exogenous • Endogenous • Carbon • Hemosiderin • Lipofuscin • Melanin

  20. Pathologic Calcification (1) • Except for the bones and teeth • Pathologic conditions Intracellular & extracellular abnormal accumulation: • Calcium salts

  21. Pathologic Calcification (2) • Dystrophic Calcification In areas of necrosis No calcium metabolic derangements • Metastatic calcification In normal tissues Some calcium metabolic derangements

  22. Irreversible Cell Injury Cell Death 1. Necrosis A sequence of morphologic changes that follow cell death in living tissue 2. Apoptosis A distinctive and important mode of cell death regulated by genes

  23. (1) Necrosis Two essentially concurrent processes to produce the morphologic changes : 1.Enzymatic digestion of the cell 2. Denaturation of proteins Autolysis Heterolysis

  24. (2) Necrosis • Basic pathologic changes • Types of necrosis • Sequences of necrosis

  25. (3) Necrosis Basic Pathologic Changes Pyknosis • Nuclear changes Karyorrhexis Karyolysis • Cytoplasm Increased eosinophilia

  26. (4) Necrosis Types of Necrosis • Coagulative necrosis • Liquefactive necrosis • Caseous necrosis • Fat necrosis • Gangrene • Fibrinoid necrosis

  27. Coagulative Necrosis • A mass of coagulated, pink-staining, homogeneous cytoplasm • Preservation of the basic structure outline of the coagulated cell or tissue for several days • In solid organs (kidney, heart, spleen )

  28. Liquefactive Necrosis • Liquefaction of necrotic cells • Condition: Presence of more abundant proteolytic enzymes • Most often in suppurative inflammation & in the brain

  29. Caseous Necrosis • A distinctive form of coagulative necrosis • Cheese-like • An amorphous coarsely granular eosinophilic debris • Most often in foci of TB

  30. Fat Necrosis • A special type of liquefactive necrosis • Focal areas of fat destruction • Calcium soaps • Enzymatic fat necrosis(acute pancreatitis) • Nonenzymatic fat necrosis (following direct trauma to adipose tissue & extracellular liberation of fat)

  31. Gangrene • Extensive tissue necrosis • Secondary bacterial infection • Dry gangrene • Wet gangrene • Gas gangrene

  32. Fibrinoid Necrosis • A type of connective tissue necrosis • Loss of normal structure • A homogeneous,bright pink-staining necrotic material that resembles fibrin microscopically

  33. (5) Necrosis Consequences of Necrosis • Autolysis & inflammation • Dissolution & absorption • Sloughing Ulcer, Cavity, Sinus, Fistula • Organization & encapsulation • Calcification

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