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General Pathology

General Pathology. Basic Principles of Cellular and Organ Pathology Inflammation - III. http://www1.lf1.cuni.cz/~jdusk/. Jaroslava Dušková Inst. Pathol. ,1st Med. Faculty, Charles Univ. Prague. Inflammation. Definition: complex reaction of organism to damage

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General Pathology

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  1. General Pathology Basic Principles of Cellular and Organ Pathology Inflammation - III http://www1.lf1.cuni.cz/~jdusk/ Jaroslava Dušková Inst. Pathol. ,1st Med. Faculty, Charles Univ. Prague

  2. Inflammation Definition: complex reaction of organism to damage (aim: homeostasis maintenance)

  3. Inflammation Sense defensive– agent elimination reparative – damage reparation

  4. Time view acute subacute chronic Inflammation - Classification:

  5. According to the dominant phase: alterative EXSUDATIVE proliferative Inflammation - Classification:

  6. According to the dominant phase: alterative exsudative PROLIFERATIVE Inflammation - Classification:

  7. Type of granulation tissue: nonspecific „specific“ GRANULOMATOUS Inflammation - Classification:

  8. Def.: Accumulation of macrophages transformed into epithelioid and multinucleated giant cells Granuloma

  9. infected macrophage intracellular parasites Macrophage activation mature Th clone creation interferon receptor interferon receptor interferon γ cytokins & bactericid subst. secretion activated macrophage

  10. Granuloma - composition • MACROPHAGES • lymphocytes • fibrous deposits of collagen • central necrosis

  11. fibrosis hyalinosis dystrophic calcification progressive necrosis cavity formation spread with generalisation or metastatic foci Granuloma - development

  12. TUBERCULOSIS sarcoidosis syphilis leprosy Lyme borreliosis inf. scleroma (rhinoscleroma) Granulomatous Inflammatory Diseases 1.

  13. lymphogranuloma venereum (inguinale) anthropozoonoses : brucelosis, listeriosis, tularemia,….. cat scratch disease (Afipia felis) mycoses: histoplasmosis, coccidiodomycosis… parasites: leishmaniasis, schistosomiasis, toxoplasmosis… large antigen antibody complexes: rheumatoid arthritis Granulomatous Inflammatory Diseases 2.

  14. Mycobacterium tuberculosis (Koch 1882) Mycobacterium bovis acidoresistance M. avium,intracellulare, Kansasii atypical mycobacterioses TUBERCULOSIS

  15. killing 30% patients with  AIDS killing 2–3 mill. people per year next 10 years : 90 millions infected 30 millions deaths dev. countries - 26% preventable deaths TUBERCULOSIS

  16. countries with combined therapy – deaths lowered by70% death rate in  Europe lowered to 1/10 12,5 / 100 000  Asia 40x more 500 / 100 000 95% patients unable to pay for therapy TUBERCULOSIS

  17. portae invasionis respiratory tract gastrointestinal tract skin types of disease (clinicoepidemiol. view) open tbc closed TUBERCULOSIS

  18. Type of infection childhood (primary, preimmune) adult (postprimary, immune) TUBERCULOSIS

  19. Morphological features primary infect (Ghon focus) & primary complex caseification isolated organ metastasis tubercle, exsudate, cavity early and late generalisation – milliary spread TUBERCULOSIS

  20. Type of infection childhood (primary, preimmune) adult (postprimary, immune) TUBERCULOSIS

  21. Terms –Forms– Locations: phtisis gallopans scrofulosis meningitis basillaris lupus vulgaris mallum Potti, cold absces TUBERCULOSIS

  22. etiology ????? Pathogenesis: changed Th and Ts ratio modified immune reaction SARCOIDOSIS

  23. morphology similar to tbc (and important dif. dg.) forms : localised generalised SARCOIDOSIS m. Besnier–Boeck–Schaumann

  24. Treponema pallidum (F.Schaudin 1905) argyrophilia Syphilis acquisita Syphilis congenita Syphilis

  25. Stages (1) : I. ulcus durum + bubo indolens II. exanthema syphiliticum, angina syphilitica, condylomata lata Syphilis acquisita

  26. Stages (2): III. gumma Late syphilis (quarterly, meta–) neurosyphylis paralysis progressiva tabes dorsalis panaortitis syphilitica Syphilis acquisita

  27. Forms: fetus maceratus (hepatosplenomegalia) hepatitis pericellularis pericholangitis syphilitica, pancreatitis pneumonia alba pseudogummata osteochondritis et periostitis syphilitica coryza et exanthema syphiliticum Syphilis congenita

  28. Trias Hutchinsoni: keratitis parenchymatosa labyrinthitis Hutchinson´s teath gummata periostitis syphilitica tibiae paralysis progressiva infantilis, iuvenilis panaortitis syphilitica Syphilis congenita tarda

  29. 700 000 new cases/year more than 10 mil. cases in the world mostly warm climates related to living conditions zoonosis - armadillo (Dasypus novemcinctus) primates, cultivation on a nude mice CURABLE !!!! (combination of antibiotics) LEPROSY

  30. Mycobacterium leprae (Hanseni) 1873 Port of entry respiratory tract Intracellular parasitism macrophages, later Schwann cells Reduced genom (comparing to Mycobacterium tbc) LEPROSY

  31. Classification: lepromatous (in nonimmune. Virchow lepra cell) tuberculoid (granulomatous, immune patients) indeterminate (early stage) borderline (combined) LEPROSY

  32. Rhinoscleroma –infectious scleroma • Klebsiella rhinoscleromatis • chronic granulomatose inflammation • Mikulicz cells – macrophages • scaring • curable - antibiotics

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