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Practical Pathology Inflammation Dr : Hala El-sayed Mahmoud Lecturer of pathology
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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
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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
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REDNESS REDNESS HOTNESS HOTNESS SWELLING SWELLING PAIN PAIN LOSS OF FUNCTION LOSS OF FUNCTION CARDINAL SIGNS AND SYMPTOMS OF ACUTE INFLAMMATION
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TYPES OF ACUTE INFLAMMATION SUPPURATIVE INFLAMMATION INFLAMMATION NON-SUPPURATIVE
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Types: I- SUPPURATIVE INFLAMMATION I-Localized Supp. Inflamm. Abscess, furuncle, carbuncle II- Diffuse Supp. Inflamm. Cellulitis, Suppurative appendicitis, Suppurative cholecystitis, Suppurative peritonitis, Suppurative meningitis …etc.
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I- LOCALIZED SUPPURATIVE INFLAMMATION carbuncle furuncle Abscess
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Abscess
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II- DIFFUSE SUPPURATIVE INFLAMMATION Acute supp. appendicitis Diffuse sup.cholecystitis Suppurative meningitis Cellulitis
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Catarrhal inflammation: e.g.common coldCatarrhal inflammation: e.g.common cold Pseudo-membranous inflam.: e.g.diphtheriaPseudo-membranous inflam.: e.g.diphtheria Fibrinous inflammation: e.g. fibrinous pericarditis, fibrinous pleurisy, fibrinous peritonitis.Fibrinous inflammation: e.g. fibrinous pericarditis, fibrinous pleurisy, fibrinous peritonitis. Serous inflammation: e.g. burnsSerous inflammation: e.g. burns Haemorrhagic inflammationHaemorrhagic inflammation Gangrenous (necrotizing) inflammationGangrenous (necrotizing) inflammation Allergic inflammationAllergic inflammation NON-SUPPURATIVE INFLAMMATION
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Fibrinous pleurisy Fibrinous pericarditis Fibrinous peritonitis Haemorhagic pericarditis. Gangrenous inflammation Fibrinous pericarditis
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Gross Pathology Lesson2 Acute lung abscess Acute brain abscess. Chronic lung abscess Acute suppurative meningitis Fibrinous pericarditis. Healed serofibrinous inflammation
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Section in the lung shows an irregulr abscess cavity (3x2 cm). The lining is yellowish and necrotic. Diagnosis: Acute lung abscess
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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
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Adult brain showed diffuse yellowish suppurative exudate covering the meninges mainly at the base Diagnosis: Diffuse suppurative meningitis
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Swollen appendix with congested blood vessels and covered by diffuse yellowish suppurative exudate Diagnosis: Acute suppurative appendicitis
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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
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Lung specimen shows opaque whitish pleura with irregular surface. Diagnosis: Healed serofibrinous pleurisy (Pleural adhesions)
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Histopathology Slides for 1.Acute suppurative appendicitis
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Acute supp appendicitis
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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
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