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Path lab slides. Hemodynamic disorders & thrombosis.

Path lab slides. Hemodynamic disorders & thrombosis. Dr Abiodun Mark.A. What is going on with the organ?. Congested lungs. This is a gross photograph of lungs that are distended and red . The reddish coloration of the tissue is due to congestion .

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Path lab slides. Hemodynamic disorders & thrombosis.

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  1. Path lab slides.Hemodynamic disorders & thrombosis. Dr AbiodunMark.A

  2. What is going on with the organ?

  3. Congested lungs. • This is a gross photograph of lungs that are distended and red. • The reddish coloration of the tissue is due to congestion. • Some normal pink lung tissue is seen at the edges of the lungs (arrows).

  4. Identify the organ?What is the pathologic process here?

  5. NUTMEG LIVER. • This is a gross photograph of a liver demonstrating chronic passive congestion. • Note the accentuation of the centrilobular pattern evidenced by the dark-brown-staining areas in this tissue.

  6. Liver congestion. • This is a high-power photomicrograph of the central vein illustrating congestion and some loss of liver parenchymal cells. • A mild increase in connective tissue around the central vein is evident in this section.

  7. What can you see in this organ?

  8. Mural Thrombus. • This is a gross photograph of the heart from this case demonstrating the well-formed thrombus tightly attached to the myocardium near the apex of the left ventricle. • A thrombus is a solid mass resulting from the aggregation of blood constituents within the vascular system.

  9. More on mural thrombi. • This is a low-power photomicrograph of the thrombus (1) attached to the myocardium (2).

  10. More on mural thrombi 2. • This higher-power photomicrograph shows the border between the thrombus on the right (1) and the endocardium on the left (2). • There is a line of inflammatory cells at this interface (arrow).

  11. Identify the slide.

  12. This is a gross photograph of thrombosed coronary artery (arrows).

  13. Thrombosis of the coronary artery. • This is a low-power photomicrograph of thrombosed coronary artery. (A thrombus is a solid mass resulting from the aggregation of blood constituents within the vascular system) • (1) completely occludes the vessel. Note the layering of the thrombus. The fibrous cap is ruptured (arrow) and there is hemorrhage into the atherosclerotic plaque. Note the cholesterol crystals in the plaque.

  14. Identify the slide?

  15. Thrombus. • This is a higher-power photomicrograph of the thrombus. • Note the pale regions which contain primarily platelets (degranulated platelets) with some fibrin (1), and the red areas which contain RBCs, some leukocytes, and fibrin (2).

  16. Lines of Zahn. • These are "lines of Zahn" which are the alternating pale pink bands of platelets with fibrin and red bands of RBC's forming a true thrombus.

  17. Identify the slide?

  18. Pulmonary thromboembolus. • This pulmonary embolus is adherent to the pulmonary arterial wall. • If the patient survives, the thromboembolus will organize and, for the most part, be removed.

  19. Identify the slide.

  20. Infarction of many internal organs leads to a "pale" infarct from loss of hte blood supply, resulting in coagulative necrosis. • Shown here is a myocardial infarction from occlusion of a major coronary artery, here the left anterior descending artery

  21. Identify the organ?What is the pathologic process here?

  22. Splenic infarct. •  Here are splenic infarcts in a patient with infective endocarditis. •  These infarcts are typical of ischemic infarcts: they are based on the capsule, pale, and wedge-shaped. The remaining splenic parenchyma appears dark red.

  23. Petechial hemorrhages on the myocardium. • Here are petechial hemorrhages seen on the epicardium of the heart. • Petechiae (pinpoint hemorrhages) represent bleeding from small vessels and are classically found when a coagulopathy is due to a low platelet count. • They can also appear following sudden hypoxia.

  24. What form of embolus is this?

  25. Saddle embolus. • Autopsy photo from a patient who died suddenly from a large “saddle” embolus. •   The embolus is lodged at the bifurcation of the main pulmonary artery into the right and left pulmonary arteries, largely obstructing the flow of blood to the lungs.

  26. Identify the organ?What is the pathologic condition here?

  27. Skin eccymoses. • The blotchy areas of hemorrhage in the skin are called ecchymoses (singular ecchymosis)

  28. Identify the slide.

  29. Sample question. • A 5 yr old girl is brought to the emergency dept by her father because of nose bleed that just wont stop. The father says they have tilted the heads backwards and applied ice packs for several hours but noting has worked so far.She had been well except for a runny nose and a sore throat 12 days ago.Physical examination showed epitasis and a diffuse ecchymoses and petechiae. A bone marrow biopsy showed an increased number of megarkayocytes with immature forms. What group of lab studies would be most consistent with this disorder? • Platelet --? • BT---? • PTT---? • PT---?

  30. Quiz. • http://meds.queensu.ca/medicine/deptmed/hemonc/anemia/coag/CCLM.swf

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