Concentric hypertrophy of left ventricular wall Note marked thickening of the left ventricular wall...

Concentric hypertrophy of left ventricular wall

Note marked thickening of the left ventricular wall and moderate thickening of the right ventricular wall

Normal myocardium Hypertrophied myocardium

Normal myocardium (left) compared to hypertrophied myocardium (right)

The muscle fibers are thicker and nuclei larger and darker in the hypertrophied myocardium.

The clear spaces between the fibers are processing artifacts.

Normal myocardium (left) compared to hypertrophied myocardium (right)

Arrow: Large dark nuclei found in hypertrophied cardiac muscle cells

Polyploidy is a common feature in cardiac hypertrophy. Also note the increased size (thickness) of the individual cardiac muscle cell on the right compared to normal cardiac myocytes (left)

Cardiac hypertrophy and congestive heart failure resulting in the dilation of the cardiac chambers

Note the marked dilation of both the left (1) and right (2) ventricular chambers

Normal physiologic hypertrophy.

Note the marked thickening of the uterine wall due to smooth muscle cell hypertrophy.

1: Open uterus 2: Cervix 3: Vagina 4: Both ovaries 5: Both kidneys

1: Kidneys 2: Ureters 3: Bladder (open) 4: Prostate (enlarged)

The bladder mucosa has multiple trabeculae and is hyperemic.

The ureters are dilated.

Note the nodularity of the tissue (1) and the engorgement of the gland.

Enlargement of the prostate leads to compression of the urethra (2) as it passes through the gland.

Hyperplastic Prostate

Note appearance of dilated glands

Normal prostate

The dilated glands (arrows) make up the major portion of the prostate tissue and there is compression of the stroma.

These glands exhibit hyperplasia of the glandular epithelium. The infolding of the glandular epithelial cells forms papillary projections (arrows) into the lumen of the gland.

Cystic dilation of the glands

Accumulation of secretory material inside the glands (arrows) and compression (thinning) of the lining epithelium.

Arrows: Papillary folds produced by hyperplastic epithelium projecting into the lumen of the gland

While these folds project into the lumen of the gland, there is no extension through the glandular basement membrane into the gland’s stroma.

Kidney of a patient with prostatic hyperplasia resulting in marked urinary retention and back-flow of the urine from the bladder into the ureters and renal pelvis. This increased pressure resulted in dilation of the renal pelvis (1) and pressure atrophy of the cortex (2). This change is called hydronephrosis.

Low power pictomicrograph showing full cortical and medullary thickness of the kidney

Arrow: dilated calyx containing RBCs

The cortex is thin and has severe lesions of degeneration and atrophy, which are difficult to appreciate at this magnification.

Transitional epithelium lining the renal calyx (1) and the junction (transitional zone) to a thicker hyperplastic epithelium (2).

Note the inflammatory cells and increased vascular response in the stromal tissue (3) lying beneath the normal transitional epithelium.

Junction of normal epithelium (1) with hyperplastic transitional epithelium

Note the inflammatory cells in the subepithelial tissue

In areas adjacent to the normal transitional epithelium, there are areas of epithelium (arrows) where the epithelial cells have the characteristics of normal squamous epithelium as found in the dermis. This is not normal for the renal pelvis. This adaptive change is referred to as squamous metaplasia.

Inflammatory cells in the subepithelial tissue

Arrows: Formation of keratinized epithelium (arrows)

Trachea of a smoker

Note that ciliated columnar epithelium has been replaced by squamous epithelium.

Atrophic testis

Black arrow: Vessels which are part of epididymis and vas deferens

Atrophic testis

1: Seminiferous tubules with viable cells; no visible spermatocytes

2: Acellular seminiferous tubules with pale pink hyaline appearance

Loss of testicular parenchymal tissue

Very few recognizable spermatic cells

Arrow: Focus of interstitial or Leydig cells. These cells are not affected by the hormone-induced atrophy process.

1: Seminiferous tubule with remnants of spermatocytes; no mature sperm present

2: Remnants of spermatic tubules which have completely atrophied and lost all spermatogenic cells

3: Eosinophilic Leydig cells present between the atrophic tubules

Atrophy of the tubules extending to the Rete testis (arrow)

Kidneys and abdominal aorta

Narrowing of the left renal artery at its ostium from the aorta. This narrowing causes reduced blood pressure in the kidney whose artery is affected. Result: characteristic Goldblatt’s hypertension syndrome

Note that the kidney with the narrowed artery is atrophied compared to the kidney with the normal vessel.

Patient had blockage of one ureter leading to increased pressure in the renal pelvis

This increased pressure caused hydronephrosis (arrow) in one kidney.

Increased pressure caused decreased blood flow, which caused atrophy.

Two kidneys from the same patient

One kidney (1) is relatively normal, although increased in size due to compensatory hypertrophy. The other kidney (2) is very small with only rudamentary nodules of kidney parenchyma. This kidney never developed and therefore this process represents hypoplasia.

Normal patient Geriatric patient (80+)

Decreased size, narrowed gyri, widened sulci

Lung with severe metastatic calcification

This lung tissue had a rough, firm appearance with open airways.

Lung with metastatic calcification

Large, open alveolar spaces

Pleural space is curved surface at the top

1: Blood vessel cut in longitudinal section

2: Several of the alveoli are filled with pink-staining proteinaceous fluid indicative of pulmonary edema

3: The alveolar septa and the wall of the blood vessel have a purplish appearance due to massive deposition of mineral (primarily calcium) in these tissues.

1: Calcium deposits in the vascular wall. The smooth muscle has been almost completely replaced by calcium deposits.

2: Proteinaceous material (from edema) within some of the alveoli

1: Pulmonary alveoli with extensive calcium deposits in the septa

2: Protein accumulations in the alveoli

Heart with dystrophic calcification of the aortic valve (arrow)

Arrow: Aortic Valve

Nodularity and thickening of this valve; would be extremely stiff and almost entirely immobile

This particular example of dystrophic calcification results is associated with a degenerative change of the aortic valve due to an unknown cause.

Aortic Valve

Nodularity and thickening of this valve due to fibrosis and dystrophic calcification

Liver (Contrast with normal dark red color)

Yellow color due to high fat content

Liver

Pale staining section

Pale, washed out appearance of the tissue

Numerous holes throughout

Arrows: Accumulations of inflammatory cells around portal tracts

Centrilobular areas of the liver

Gives appearance of fatty tissue, indicated by empty spaces

Arrows: Normal-appearing hepatocytes present

Arrows:Proliferation of bile ducts in the interlobular and perichordal regions

Liver parenchyma

Each individual cell is filled with a large, clear droplet which resembles space after lipid has been dissolved by tissue preparation. Note that each droplet is surrounded by a thin rim of eosinophilic cytoplasm. In many instances, the hepatocyte nucleus is seen as well.

The red body (arrow) is an acidophilic body associated with alcoholic hepatitis.

Red droplets: fat

Typical of fatty degeneration in the liver

Liver of patient with history of alcohol use

1: Clear vacuoles indicating fat droplets

2: Numerous red-staining granular deposits within the cytoplasm of hepatocytes. This is alcoholic hyalin.

3: RBCs

Liver stained with trichrome stain

Arrows: Connective tissue, which stains green Hepatic parenchymal cells are red

Note that many of the parenchymal cells have clear spaces indicating fatty degeneration.

The proliferation of scar tissue between the lobules is the result of cirrhosis.

Severe nodular cirrhosis

Note the extensive scarring of the capsule and the nodular projections through the uncut capsule in this tissue. The green color is due to the accumulation of bile pigment.

Severe nodular cirrhosis

Note the marked nodular pattern

The paler-staining areas between the round nodules represent fibrous connective tissue.