Practical Pathology Inflammation Dr : Hala El-sayed Mahmoud Lecturer of pathology

Practical PathologyInflammation

Dr : Hala El-sayed Mahmoud

Lecturer of pathology

• DEFINITION:• Inflammation is the reaction of vascularized

living tissue to local injury. It is a series of vascular and cellular reactions aiming to protect the body against the injurious agent .

• TYPES:• -Acute: sudden onset and short duration ( hours -

days) • -Chronic: gradual onset and long duration ( days -

years)

INFLAMMATION

ACUTE INFLAMMATION

• Caused by an irritant of short duration of action

• The tissue response is rapid i.e. sudden onset

• Inflammation lasts for days or weeks• Characterized by presence of fluid

exudate and cellular exudate mainly polymorph-nuclear leucocytes

• REDNESSREDNESS• HOTNESSHOTNESS• SWELLINGSWELLING• PAINPAIN• LOSS OF LOSS OF

FUNCTIONFUNCTION

CARDINAL SIGNS AND SYMPTOMS OF CARDINAL SIGNS AND SYMPTOMS OF ACUTE INFLAMMATIONACUTE INFLAMMATION

TYPES OF ACUTE INFLAMMATIONTYPES OF ACUTE INFLAMMATION

SUPPURATIVESUPPURATIVE INFLAMMATIONINFLAMMATION

NON-SUPPURATIVENON-SUPPURATIVE INFLAMMATIONINFLAMMATION

Types:Types:

I- SUPPURATIVE INFLAMMATIONI- SUPPURATIVE INFLAMMATION

I-Localized Supp. Inflamm.

Abscess, furuncle,

carbuncle

II- Diffuse Supp. Inflamm.

Cellulitis, Suppurative appendicitis, Suppurative cholecystitis, Suppurative peritonitis, Suppurative meningitis

…etc.

I- LOCALIZED SUPPURATIVE I- LOCALIZED SUPPURATIVE INFLAMMATIONINFLAMMATION

carbunclecarbunclefurunclefuruncle

AbscessAbscess

AbscessAbscess

II- DIFFUSE SUPPURATIVE INFLAMMATIONII- DIFFUSE SUPPURATIVE INFLAMMATION

Acute supp. appendicitisDiffuse sup.cholecystitis

Suppurative meningitis

Cellulitis

Cellulitis

• Catarrhal inflammation: Catarrhal inflammation: e.g.common colde.g.common cold

• Pseudo-membranous inflam.: Pseudo-membranous inflam.: e.g.diphtheriae.g.diphtheria

• Fibrinous inflammation: e.g. Fibrinous inflammation: e.g. fibrinous fibrinous pericarditis, fibrinous pleurisy, fibrinous peritonitis.pericarditis, fibrinous pleurisy, fibrinous peritonitis.

• Serous inflammation: Serous inflammation: e.g. burnse.g. burns

• Haemorrhagic inflammationHaemorrhagic inflammation

• Gangrenous (necrotizing) inflammationGangrenous (necrotizing) inflammation

• Allergic inflammationAllergic inflammation

NON-SUPPURATIVE NON-SUPPURATIVE INFLAMMATIONINFLAMMATION

NON-SUPPURATIVE NON-SUPPURATIVE INFLAMMATIONINFLAMMATION

Fibrinous pleurisy Fibrinous pericarditis

Fibrinous peritonitisHaemorhagic pericarditis.

Gangrenous inflammation

Fibrinous pericarditis

Gross PathologyLesson2

• Acute lung abscess

• Acute brain abscess.

• Chronic lung abscess

• Acute suppurative meningitis

• Fibrinous pericarditis.

• Healed serofibrinous inflammation

Section in the lung shows an irregulr abscess cavity (3x2 cm). The lining is yellowish and necrotic.

 Diagnosis:

Acute lung abscess

Section in the brain shows an irregulr abscess cavity (2x2 cm). The lining is yellowish and necrotic. The floor is perforated. The surrounding brain tissue shows hemorrhagic spots.

 Diagnosis:

Acute brain abscess

Adult brain showed diffuse yellowish suppurative exudate covering the meninges mainly at the base

Diagnosis:Diffuse suppurative meningitis

Swollen appendix with congested blood vessels and covered by diffuse yellowish suppurative exudate

Diagnosis:

Acute suppurative appendicitis

A closed adult heart. The visceral pericardium shows yellowish reticulated fibrin threads (having bread & butter appearance) .

The surface of the heart is pale brown and opaque.

Diagnosis:

Fibrinous pericarditis

Lung specimen shows opaque whitish pleura with irregular surface.

Diagnosis:

Healed serofibrinous pleurisy

(Pleural adhesions)

Histopathology Slides for

1. Acute suppurative appendicitis

Acute supp appendicitis

Transverse section in the appendix shows:

•The mucosal cells are partially shedded.

•The mucosa, submucosa, muscles layers and serosa show dilated congested capillaries, inflammatory oedema and infiltrated with excess polymorphs, pus cells and few macrophages.

•The lumen contains necrotis mucosal cells, fibrin, polymorphs and pus cells.

Diagnosis:

Acute diffuse suppurative appendicitis