Practical of Cell Injury Third Year 5th October 2015

Liver cell necrosis: Nuclear changes normal pyknosis karyorrhexis karyolysis

Here, there is a wedge-shaped firm pale area of coagulative necrosis (infarction) in the renal cortex of the kidney. Diagnosis : Coagulative necrosis of kidney

Microscopically, the renal cortex has undergone anoxic injury at the left so that the cells appear pale and ghost-like normal renal parenchyma at the far right Diagnosis : coagulative necrosis of renal tissue

Two large infarctions (areas of coagulative necrosis) are seen in this sectioned spleen & are often wedge-shaped with a base on the organ capsule. Diagnosis : infarction ( coagulative necrosis) of spleen

Here is myocardium in which the cells are dying Here is myocardium in which the cells are dying. Preserved cell membrane with loss of internal structure, including nucleus & cross striation with eosinophilic cytoplasm. Prominent contraction bands Diagnosis : Coagulative necrosis ( Myocardial Infarction)

slide on the right: microscopical feature of liquefactive necrosis of the brain demonstrates many macrophages & edema at the right which are cleaning up the necrotic cellular debris. Slide on the left this infarct in the brain is organizing and being resolved, the liquefactive necrosis leads to resolution with cystic spaces

Caseous necrosis- the hilar lymph node is replaced by cheesy white material of caseous necrosis, this type of necrosis is usually due to pulmonary tuberculosis microscopically :the area of necrosis is seen as eosinophilic granular area surrounded by epithelioid cells & a peripheral rim of lymphocyte to form the granuloma characteristic of pulmonary TB 8

Fat necrosis of the mesentery: multiple chalky white patches on the surface of mesentery due to enzymatic digestion of mesenteric fat secondary to acute pancreatitis 9

Slide on left: gross: soft, chalky white areas with foci of hemorrhage seen on the cut surfaces of inflamed pancreas Diagnosis : acute pancreatitis with fat necrosis & calcification slide on the right: Microscopically, fat necrosis is seen here. Though the cellular outlines vaguely remain, the fat cells have lost their peripheral nuclei and their cytoplasm has become a pink amorphous mass of necrotic material.

The deposition of immune complexes in an artery is called vasculitis with circumferential bright pink area of fibrinoid necrosis with protein infiltration & inflammation ( Fibrinoid necrosis)

Apoptotic body appears as dense eosinophilic core

Blackish discoloration of the finger- dry gangrene, the gangrenous area is separated from normal tissue by a zone of hyperemia 13

Below knee amputation of right leg with swelling blackish-discoloration with edema & large irregular ulcer over the ankle Diagnosis: wet gangrene in a diabetic patient

A. Normal brain of a young adult. B A. Normal brain of a young adult. B. Atrophy of the brain in an old male with atherosclerotic disease. Atrophy of the brain is due to aging and reduced blood supply. Note that loss of brain substance narrows the gyri and widens the sulci. The meninges have been stripped from the right half of each specimen to reveal the surface of the brain. 15

Hypertrophic cardiomyopathy is an example of pathological hypertrophy due to increase demand, this ultimately results in increase in the size of the organ

hypertrophy of cardiac muscle in response to increased demand

Endometrial hyperplasia is an example of hormone-induced hyperplasia due to hyperestrogenism.

Endometrial hyperplasia-there is hyperplasia of the both glandular & stromal elements.

Metaplasia of normal columnar (left) to squamous epithelium (right) in a bronchus

Metaplasia is a change of one adult type of epithelium into another type, here the epithelium lining the respiratory tract is changed into squamous one ( squamous Metaplasia) 21

Barrett esophagus: Metaplastic transformation (arrow) of the normal esophageal stratified squamous epithelium (Lt) to mature columnar epithelium

Microscopically: liver showing accumulation of lipid vacuoles in the cytoplasm of hepatocytes with the displacement of the nuclei to the periphery Diagnosis : fatty changes of liver

The yellow-brown granular pigment seen in the hepatocytes here is lipochrome (lipofuscin) which accumulates over time in cells (particularly liver and heart) as a result of Lipofuscin pigment "wear and tear" with aging.

Slide on the right The golden brown coarsely granular material in macrophages in this alveolus is hemosiderin with congestion of alveolar capillaries Diagnosis: heart failure cells Slide on the left side : A Prussian blue reaction is seen in this iron stain of the liver to demonstrate large amounts of hemosiderin that are present in hepatocytes and Kupffer cells.

Slide on the left: The black streaks seen between lobules of lung beneath the pleural surface are due to anthracotic pigment Slide on the right: showing black small pigments within the cytoplasm of macrophages in hilar LN Diagnosis: (carbon particles) anthracotic pigment

Dystrophic calcification affecting aortic valve, which appears as multiple whitish nodules on the surface of the valve cusps

At the far left is an artery with calcification in its wall At the far left is an artery with calcification in its wall. There are also irregular bluish-purple deposits of calcium in the submucosa. Diagnosis: dystrophic calcification at the base of gastric ulcer .

Dystrophic calcification of dead parasite in the lung

There is basophilic to purple color deposit on the alveolar wall Metastatic calcification in the lung of a patient with a very high serum calcium level (hypercalcemia).