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General Pathology (PATH 303) Lecture # 9

General Pathology (PATH 303) Lecture # 9 Pathological ccification. Pathological calcification. The amount of calcium in bones, cells and fluids changes constantly.

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General Pathology (PATH 303) Lecture # 9

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  1. General Pathology (PATH 303) Lecture # 9 • Pathological ccification

  2. Pathological calcification • The amount of calcium in bones, cells and fluids changes constantly. • In the blood its concentration fluctuates within a narrow range controlled by parathyroid gland. • Average = 10 mg/dl , 12 mg/dl (hypercalcemia, precipitation in tissues); 8 mg/dl (excitability); 6 mg/dl (tetany); 3 mg/dl (death)

  3. Pathological Calcification is non-osseous (other than bones) deposition of calcium in various tissues. Have two forms: • Dystrophic • Metastatic 1. Dystrophic or local calcification: • Calcification of dead and dying tissues. • The level of calcium in blood is usually normal. (There is no hypercalcemia). • Calcification occurs in two phases-initiation and propagation within the cells or extra-cellularly.

  4. Extracellular initiation occurs in small vesicles derived from degenerating cells- Ca has affinity for membrane lipids. • Initiation of intra-cellular calcification occurs in the mitochondria of dead or dying cells.

  5. Sites of calcification: • Dystrophic calcification is associated with lesion of chronic diseases in different tissues, e.g.: • Caseous necrosis in tuberculosis. Atherosclerosis. Dead parasitic lesions like trichinosis, Onchocercosis. Thrombosis. Tumours

  6. Gross appearance: • Calcium salts appear as white granules or grey, chalky masses. • Calcium deposits have firm consistency and gritty feelings on cutting like stones. Microscopic appearance: • Calcium salts appear as blue granules or masses with H& E. • Special stain Von Kossa gives a black color to Ca salts which maybe intracellular or extracellular.

  7. 2.Metastatic calcification: It is deposition of calcium salts in many tissues which may be normal. It is associated with disorders of calcium metabolism and there is hypercalcemia. • Causes: The common causes of metastatic calcification are: Contd…

  8. Hyperparathyroidism-A. Primary, due to neoplasm B. Secondary-nutritional or renal failure (uremia) 2. Hypervitaminosis-D (Vit.D Toxicosis). Increased absorption of Ca from intestine. Solanum and Trisetumplants have Vit. D analogue and cause toxicity. 3. Neoplasms: Lymphosarcoma and apocrine adenocarcinoma secrets parathyroid hormone- like peptides and cause hypercalcemia. 4. Calcinogenic bacteria: Tooth colonizing bacteria induce calcification and produce dental plaques.

  9. Sites of calcification: • Metastatic calcification may occur in organ throughout the body. It is commonly observed in: • Organs which secrete or excretes acids like stomach, kidneys and lungs. • Calculi or stones in salivary glands, intestine, urinary tract, gall bladder etc. • Corpora amylacea in mammary gland alveoli, thyroid and ventricles in brain.

  10. Gross and microscopic appearance is similar to dystrophic calcification. • Significance and results: Calcification is usually harmless. May cause hindrance to organs motility and inelasticity.

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