Patho Lab - Cell Injury

1.3 to 1.5 cm

Normal left ventricular artery thickness

2 to 2.8 cm

Left ventricular hypertrophy thickness

Increase in the TRANSVERSE diameter of myocytes

Microscopic findings in left ventricular hypertrophy

Increase sytemic pressure due to hypertension

Cause of left ventricular hypertrophy in the case where the patient who’s hypertensive, diabetic, and has a history of cardiomegaly died due to hypovolemic shock secondary to a vehicular accident

Increase in workload

Most common stimulus for cardiac muscle hypertrophy

hypertrophy, hyperplasia, atrophy, metaplasia

Four adaptive changes in cell injury

Physiologic hypertrophy

Physiologic/Pathologic & Hypertrophy/Hyperplasia:

• Hormonal: uterus - pregnancy; breast - lactation

Physiologic hypertophy

Physiologic/Pathologic & Hypertrophy/Hyperplasia:

• Functional: skeletal muscles - exercise

Pathologic hypertrophy

Physiologic/Pathologic & Hypertrophy/Hyperplasia:

• Heart - hypertension and faulty valves

Physiologic hyperplasia

Physiologic/Pathologic & Hypertrophy/Hyperplasia:

• Hormonal: increased functional capacity, breast during puberty/pregnancy, uterus during pregnancy

Pathologic hyperplasia

Physiologic/Pathologic & Hypertrophy/Hyperplasia:

• Excess hormones or growth factors

  • e.g. endometrial, benign prostatic, viral infections

F: do not divide

T/F: heart muscle divides and undergoes hypertrophy as a compensatory mechanism when injured

Fibrosis, fibrous

Repair in ventricular hypertrophy takes the form of _______; patient with old MI has ______ scar formation

T

T/F: increase resistance in the outflow track, where lipid deposition in the wall occludes blood flow, can also cause hypertrophy

Biventricular hypertrophy

Both right and left ventricles hypertrophied

left ventricular hypertrophy; hypertrophy (increase in cell size)

Pathologic condition and cellular adaptive change associated with this specimen

Chronic cervicitis with squamous metaplasia

Gross findings of this condition are:

• Mucopurulent cervical discharge with a reddened and edematous cervix

Chronic cervicitis with squamous cell metaplasia; reversible

Diagnose and identify metaplasmic change

Chronic cervicitis with squamous cell metaplasia; reversible

Diagnose and identify metaplasmic change

Chronic cervicitis with squamous cell metaplasia

2: Nabothian cyst

4: Endocervical glands

6: Squamous metaplasia of glands

Diagnose and identify labeled microscopic features

Chronic cervicitis with squamous cell metaplasia

1: lymphocytes & plasma cells

2: Nabothian cyst

3: squamous lining epithelium

4: endocervical glands

6: squamous metaplasia of glands

Diagnose and identify labeled microscopic features

Metaplasia: squamous to columnar

Morphological change in BARRETT ESOPHAGUS

Myositis ossificans

Connective tissue metaplasia that is a repair mechanism and not a true adaptation, associated with extraosseous bone formation

Metaplasia: columnar to squamous

Morphological change in bronchi of heavy smokers

Metaplasia

Reprogramming of stem cells; change of differentiated cell type

Columnar to squamous

Most common type of epithelial metaplasia

Chronic cervicitis with squamous metaplasia

Diagnose

Cellular swelling

Earliest manifestation of almost all forms of injury to cells

hydrophobic change or vacuolar degeneration

other term for cellular swelling

cellular injury

This condition causes pallor, increased turgor, increased weight of affected organ

cellular swelling of the kidneys

gross findings of this condition includes swollen tubules, granular cytoplasm, and displaced nuclei of tubules

Cellular swelling of the kidneys

1: glomerulus

2: swollen tubules

Reversible

Diagnose, identify the pointed structures, and identify if reversible or irreversible

cellular swelling of kidneys

diagnose

cellular swelling of kidneys

diagnose

1. plasma membrane alterations

2. mitochondrial changes

3. accumulation of myelin figures

4. dilation of endoplasmic reticulum

5. nuclear alterations

ultrastructural changes of reversible cell injury

cellular swelling of kidneys

1: displaced nucleus

2: glomerulus

3: swollen tubules

4: granular cytoplasm

diagnose and identify the pointed structure

coagulation necrosis in renal infarct

(image shows wedge-shaped kidney infarct)

diagnose

coagulation necrosis in renal infarct, coagulative necrosis, irreversible

diagnose, type of cell injury, reversible/irreversible

coagulation necrosis in renal infarct, coagulative necrosis, irreversible

diagnose, type of cell injury, reversible/irreversible

coagulation necrosis in renal infarct, coagulative necrosis, irreversible

diagnose, type of cell injury, reversible/irreversible

1. coagulative

2. caseous

3. liquefactive

4. fibrinoid

5. gangrenous

6. enzymatic fat

six types of necrosis

caseous necrosis

necrosis often seen in tuberculosis infection

enzymatic fat necrosis

necrosis often seen in pancreatitis

caseous necrosis

A friable yellow-white necrotic area and cellular outlines cannot be discerned

coagulative necrosis

Necrosis that has a firm structure and affected tissue and has maintained cellular outline

cellular swelling of kidney, coagulative necrosis in renal infarct

Displaced nuclei is associated with ______, while absence of nuclei is ______ in kidney injuries

enzymatic fat necrosis of omentum

cell injury with gross findings of chalky white appearance

saponification

this mechanism requires both fatty acids and calcium

pancreatic lipase

release of these enzymes leads to fat necrosis in the momentum

dystrophic calcification

calcification expected to develop in the omentum

dystrophic

deposition of calcium at sites of cell injury and necrosis, serum calcium is normal

metastatic

deposition of calcium in normal tissue caused by hypercalcemia

hyperparathyroidism, vitamin d deficiency, renal failure

conditions that leads to metastatic calcification

enzymatic fat necrosis of omentum

1: necrotic fat cells

2: normal adipocytes

diagnose and identify pointed structure

enzymatic fat necrosis of omentum

1: necrotic fat cells

2: normal adipocytes

diagnose and identify pointed structures

enzymatic fat necrosis of omentum

1: necrotic fat cells

2: normal adipocytes

Diagnose and identify pointed structure

enzymatic fat necrosis of omentum

identify pointed structure

chronic cholecystitis with cholesterolosis

condition with gross findings of subserosal fibrosis, thickened walls, and dense fibrous adhesions

endogenous lipids

abnormal metabolism of _______ are the nature of intracellular accumulation in chronic cholecystitis with cholesterolosis

chronic cholecystitis with cholesterolosis

in a tissue section, accumulation of lymphocytes, rokitansky-aschoff sinuses, cholesterol laden macrophages, and fibrosis is indicative of

chronic cholecystitis with cholesterolosis

3: rokitansky-aschoff sinuses

4: lymphocytes, eosinophils, plasma cells

6: chronic inflammation

diagnose and identify pointed structures

chronic cholecystitis with cholesterolosis

2: endogenous lipid/foamy microphage/cholesterolosis

diagnose and identify pointed structure

chronic cholecystitis with cholesterolosis

diagnose