Irreversiblecellinjury 15thseptpatho121 090915142909 Phpapp02

PATHOLOGY LABDATE: - 15 T H SEPT

RAVI A PATEL

CELL INJURY-2IRREVERSIBLE CELL INJURY

& INFLAMMATORY CELLS

GEOGRAPHY OF THE SLIDES SHOWN IN THE PATHO LAB- 9:00 AM 15TH SEPT

TABLE#1

TABLE #2

1 2 3 4

5678

9 10 11 12

13 14 15

Slides of Irreversible Cell injury

Slides ofInflammatory cells

Reversible injury slides

LUNG ABSCESS

TYPE OF NECROSIS:- LIQUEFACTIVE

HALL MARK:-

Grossly:- Purulent Exudate(PUS)

Microscopically:- Complete destruction of the tissue and loss of the architecture(We can see Cell debris, infiltrates of lymphocytes, and Fibres)-

Though alveoli and other pulmonary structures can be differentiated depending on the level of lung absess

TYPE OF INFLAMMATION:-CAN BE ACUTE OR CHRONIC

LEVELS OF LUNG ABSCESS

MINIMAL:- We can appreciate the Pulmonary struct.

MODERATE:- Most of the pulmonary parenchyma are involved in the necrosis

LATENT:- We can rarely appreciate the Pulmonary structures(Most of the tissue has been destroyed)

***Commonest cause is aspiration of infected particles****

NORMAL LUNG TISSUE

Organ : Lung

Alveolar sac

Alveolar duct

1

LPO

HPO

GRANULAR DEBRIS

NEUTROPHIL AND OTHER INFLAMMATORY CELLS

MYOCARDIAL INFARCTION

TYPE OF NECROSIS:- COAGULATIVE

HALLMARK:- The necrosed Cells appear more eosinophilic(Dark pinkish)

Infiltrates and PMNs become prominent(Neutrophils Spec)

PYKNOSIS:- Nuclear condensationKARYOLYSIS:- Nuclear DissolutionKARYORRHEXIS:- Fragmentation of nucleus into granules

Type Of inflammation:- Acute

MYOCARDIAL INFARCTION

Kidneys and Heart have only one blood supply unlike other organs

Because of this reason these organs are very sensitive to oxygen deprivation and due to this they usually undergo infarction in any ischemic conditions…..

When we think of infarction its Most commonly HEART AND KIDNEYS

2

Notice that the Architecture of the Myocardium is still preservedBut the Structures within the cells (Nucleus And cytoplasmic) are not clear..

Karyorrhexis

The nucleus seems to have undergone Pyknosis

MI is Acute type of InflammationSo there are a lot of PMNs

Acute Pancreatitis

Type of Necrosis:- Enzymatic Fat Necrosis

Hallmark:- Necrotic fat cells have cloudy appearance

The necrotic area is surrounded by inflammatory reactions

Type of inflammation:- Acute

Notice the Architecture being still intact

Noramal PancreasNo

Islet of Langerhans

3

Site of Necrosis

Necrotic Tissue Cloudy appearacedue to Autodigestion by Lipase

Inflammatory Reaction

Pulmonary Tuberculosis

Type of Necrosis:- Caseous( Coagulative+Liqufaction)

Hallmark:- Chessy appearance

GranulomaEpitheliod cells(they are simply modified macrophages)Giant Cells:-(Many macrophages combine and form Giant cell)

Two types---Langhans and Foreign body Giant cells

CAUSE:- Mycobacterium tuberculosis

Type of inflammation:- Chronic

4

GRANULOMA

Surrounding the Granuloma we can see inflammatory reaction

TB of the Lymph nodes

Type of Necrosis:- Caseous

HALLMARK:- Purple color- Epithelioid cellsPink Color:- Granuloma

M. Tuberculosis if not removed from the lungs is taken up by the lymph…

Through Lympho-Heamtogenous distribution M. Tuberculosis is spread to different organs

5

PINK COLOREDGRANULOMA IS THESITE OF NECROSIS

PURPLE COLORED ARE THE EPITHELIOD CELLS

Tuberculosis of Intestines

Type of Necrosis:- Caseous

Hallmark:- In intestines there is Tunica muscularis which helps in differentiating lung and intesting TB

GranulomaEpithelioid cellsGiant cells

6Site of necrosis(Granuloma)

Inflammatory ReactionWhere epithelioid cells are visible

ACUTE APPENDICITIS

HALLMARK:- PMNs(NEUTROPHILS)

MOST COMMON CAUSE:- Enterococcus feacalis

NORMAL APPENDIX

Organ : Appendix4 layers 1. Mucosa 2. Submucosa 3. Tunica

muscularis 4. Tunica serosa

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3

4

7

Tunica Muscularis

IMPT HALL MARK OF ACUTE APPENDICITISPMNs SPECIALLY NEUTROPHILS

TUBERCULOID LEPROSY-SKIN

It is a Chronic type of Inflammation

Cause:- Infection by Mycobacterium leprae

Hallmark:-

Granuloma in DermisFoamy cells or Leprae cells in DermisEpithelioid cells

NORMAL SKIN

8

Foam cells or Leprae cells

Granuloma in the Dermis Epithelioid cells

Giant cells

Renal infarction

Kidney and Heart have only one main blood supply

Because of this reason these organs are very sensitive to oxygen deprivation and due to this they usually undergo infarction in any ischemic conditions…..

Hallmark:-

The cells look more eosinophilic,karyolysis And karyorrhexis can be seen

When we think of infarction its Most commonly HEART AND KIDNEYS

Normal Kidney

Renal infarction which we couldnot see during our Demo slides

Notice that the structures of Glomerulus and the tubules are still intact

But due to protein degeneration which took place due to the ischaemic infarction the nucleus are fragmented and infiltrates of the PMNs can be seen(This make it more eosinophilic)

Inflammatory cells

Cells elevated in different kinds of infections

Bacterial infection:- NeutrophilsNeutrophils contain Myeloperixidase which helps in the O2 dependant pathogen destruction by forming free radicals(Neutrophils will convert into monocytes after their action due to their short life span)

Viral Infection:-LymphocytesLymphocytes will release interferons which in turn will help makes the process of virus recognizition through receptors more effective

Parasitic infection:-EosinophilsThere are granules in Eosinophils which contains neurotoxins,and eosionophil peroxidase– neurotoxins are harmful to parasites

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10

11

12

13

•Organ- Liver•Pathology::- Fibrosis due to liver cirrhosis

•Precursor cells leading to fibrosis:- Fibroblasts

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GIANT CELLS Foreign body Giant cell

TYPICAL LANGHAN’S CELL

HORSE SHOE SHAPED

Nucleus are arranged on the Periphery so the the infection doesNot spread further

TYPICAL FOREIGN BODY GIANT CELL

NUCLEUS ARE SCATTERED

15

HPO

LPO

TYPICAL PLASMA CELL

CART/WHEEL SHAPE NUCLES

RUSSLE BODIES

SLIDE MADE FROM BLOOD TISSUE

PATHOLOGY:- MULTIPLE MYELOMA

PLASMA CELLS CONTINUE TO BE IN G-2 PHASE SO WE SEE SO MANY PLASMA CELLS IN BLOOD DURING THIS CODITION

Thanking to the entire Universe