1. Giemsa stain…routinely used for cytologic examination of blood (= blood film)
The number of neutrophils are increased in this field…acute inflammation
RBCs

2. Protein exudated into alveolar spaces…pink material
Inflammatory cells in alveolar spaces
Blood vessels in the alveolar walls are dilated
bronchopneumonia

3. Acute inflammation
transcytosis
Dilated venule
margination

4. Acute inflammation margination Dilated vessels
Neutrophils + pink material (exudated proteins)

5. Exudate composed of pink fibrin + neutrophils…acute inflammation

6. Gram stain..positive cocci inside phagocytes
in a background of inflammatory cells

7. High power of blood vessel wall showing fibrin, extravasated RBCs and neutrophils
Fibrinoid necrosis (vasculitis)

8. Acute inflammation mainly neutrophils and some macrophages
And some pink material (proteins)

9. Pitting edema

10. Congested epiglottis
(laryngeal edema)

11. Right lung
Serous pleural effusion

12. Serosanguinous pleural effusion

13. Chylous peritoneal effusion (chylous ascites)
…commonly due to lymphatic obstruction due to lymphoma, TB…etc
Milky (cholesterol content…etc.)

14. Sticky material (fibrin)
…fibrinous pericardial effusion

15. Fibrin

16. Pus on colonic mucosa (infectious colitis…etc.)
…suppurative inflammation

17. Suppurative pericardial effusion

18. Pus in brain coverings…suppurative inflammation (pyogenic (bacterial) meningitis)

19. Bronchopneumonia
…like in slide 2

20. Gallbladder mucosa
Neutrophils in mucosa
…acute cholecystitis

21. Bronchopneumonia
…like in slide 2 & 19

22. Abscess (liquefactive necrosis)…abscessizing pneumonia

23. Abscesses (abscessizing pneumonia)

24. Bacterial colonies
neutrophils

25. Abscess in lung…note the disturbed alveolar architecture

26. Bacterial colonies
neutrophils

27. May be benign as in peptic ulcer disease (affects duodenum mainly, or stomach, and mainly caused by H.pylori)
And may be malignant (underlying cancer)
Ulcer in gastric mucosa
Ulcer is a disruption of whole mucosal thickness that is repaired by fibrosis. microscopically we see in the bottom collagen, in the middle granulation tissue and on the top we find fibrin, neutrophils and necrotic debris

28. Malignant ulcer elevated by cancer

29. Ulcers in larynx due to mechanical pressure by tube due to prolonged intubation for mechanical ventilation

30. Fibrin and necrotic debris
Ulcer of squamous mucosa
Granulation tissue

31. Remember that in DM: neuropathy (loss of pain sensation), vascular problem (ischemia) and decreased immunity…ulcers are difficult to repair
Transmetatarsal amputation
Skin ulcer

32. Below knee amputation
Large ulcer with wet gangrene

33. endometrium
Plasma cell…once you see it in endometrium it means chronic endometritis…it causes menstrual problems

34. Chronic inflammation under synovium and it is so severe that it forms lymphoid follicles…seen in rheumatoid arthritis (an autoimmune joint disease)

35. Chronic inflammatory cells in the interstitium in between the alveoli
…this is chronic interstitial pneumonia

36. This is yellowish to whitish thickening in bronchiolar walls
…this is fibrosis (the end result of chronic inflammatory conditions

37. This is myocardium
This is area of previous infarction (necrosis due to ischemia)…now it is being repaired by granulation tissue which will be followed by fibrosis

38. Granulation tissue Inflammatory cells Thin-walled blood vessels
fibroblast

39. Severe interstitial fibrosis
Large area of fibrosis
Distorted alveoli

40. Adhesions (fibrosis) between viscera
Occur due to chronic infections…etc. inside abdomen
Also in recurrent operations
May affect mechanically the organs and cause intestinal obstruction
Treated by adhesolysis

41. Granulation tissue
Immature collagen + fibroblasts
This is a closed blood vessel
Re-epithelialized part of epidermis

42. Surrounding fibrosis (pale areas…because abscesses heal by fibrosis)
An abscess (liquefactive necrosis)

43. Caseating necrosis in hilar lymph node

44. Silicotic nodule…a fibrosis nodule seen in silicosis
Lung tissue

45. Miliary TB
…when TB spreads in the lung and other organs (small granular deposits)

46. Caseating granuloma Caseating necrosis
Epithelioid histiocytes and chronic inflammatory cells

47. Caseating granuloma Caseating necrosis
Epithelioid histiocytes and chronic inflammatory cells

48. Epithelioid histiocyte

49. We see non-caseating granulomas in sarcoidosis…etc.
They can occur in TB
Langhans MNGCs can be seen in diseases other than TB
…and in TB we can find foreign body-type giant cells
Langhans multinucleated giant cells
Non-caseating granulomas

50. Noncaseating granulomas in lung

51. Reference: WebPath