6. Abnormal accumulation of substances in the cell

Question 1

What are the 4 Mechanisms of Abnormal Accumulation of Substances in cells?

{Morphogenesis of Intracellular & Stromal Degeneration)

Answer 1

1. Infiltration = Pathologically INCREASED Reabsorption of Cells / Abnormal Factors in ECM
2. Decomposition = Disintegration of Membranous Structures of Cells
3. Pathological Synthesis = Synthesis of Amyloid / Alcoholic Hyaline / Glycogen in Henle’s Loop (DM)
4. Transformation INTO other Chemical Substances instead of Normal

Question 2

What is Hyaline?

Answer 2

Acellular, Proteinaceous Substances

Appears Glassy + Pink = Stained w/ Hematoxylin & Eosin (HE)

E.g Hyaline Cartilage = Transparent, Glossy Articular Joint Cartilage

Question 3

What are Hyaline Casts?

Answer 3

Acellular Casts

Made up of Protein Matrix

Presence of OCCASIONAL Cast = Normal

Presence INCREASES = Renal Disease

Question 4

What is Hyaline-Drop Degeneration / Dystrophy?

Answer 4

Occurs in = Kidney / Liver + Myocardium

Characterised by Aggregation of Small Protein INTO Cytoplasm of Cells

Organs affected DON’T have Specific Macro Changes

Question 5

What Causes Hyaline-Drop Degeneration / Dystrophy?

Answer 5

• a-1-antitrypsin deficiency = CAUSES Protein Accumulation in Hepatocyte Cytoplasm
• Alcoholic Hepatitis
• Viral Hepatitis

Question 6

What Happens in Hyaline-Drop Degeneration?

Answer 6

Hyaline seen as Eosinophilic Deposits

IN Cytoplasm of Epithelial Cells of Proximal Renal Tubules

Occurs in Diseases w/ Proteinuria = Glomerulonephritis Kidney Amyloidosis / Diabetic Nephropathy

Question 7

What are the 3 Specific Intracellular Protein Accumulations?

Answer 7

1. Mallory Bodies = Protein Accumulation in Hepatocytes
2. Russell Bodies = Protein Accumulation in Plasma Cells
3. Lewy Bodies = Protein Accumulation in Nerve Cells

Question 8

1| What are Mallory Bodies?

Answer 8

Cytoplasm of Hepatocytes shows eosinophilic deposits of intermediate filaments of CYTOKERATIN.

In Alcoholic + Viral Hepatitis; a-1-antitrypsin deficiency

Question 9

2| What are Russell Bodies?

Answer 9

Pink Hyaline Inclusions

IN Cytoplasm of Plasma Cells

Represent Synthesised Igs

Seen in Chronic Infections

Question 10

3| What are Lewy Bodies?

Answer 10

a. Brainstem LBs = Brainstem Nuclei + Diencephalon; SPHERICAL INTRANEURONAL CYTOPLASMIC Inclusions w/ Hyaline Eosinophilic CORES / Concentric LAMELLAR BANDS / NARROW PALE HALOS
b. Cortical LBs = Cerebral Limbic Cortex + Amygdala

Occurs in Lewy Body Dementia + Parkinson’s Disease

Question 11

What are the 3 Groups of Intracellular Carbohydrate Degeneration?

AND Their Staining?

Answer 11

1. Polysaccharides = Glycogen; Best Carmine’s + PAS Reaction (Dark Pink)
2. Mucopolysaccharides; Best Carmine’s + PAS Reaction (Red)
3. Glycoproteides = Mucin / Mucoids; Haile Staining (Blue)

Question 12

What are Glycogen Accumulations?

Answer 12

EXCESSIVE Intracellular Deposits of Glycogen

Question 13

Which Patient’s have Glycogen Accumulations?

Answer 13

Those with Abnormal Glucose / Glycogen Metabolism

E.g = Diabetes Mellitus

Question 14

What are the Morphological Features of Glycogen Accumulation?

{Testing for Glycogen Accumulation}

Answer 14

1. Formalin Fixative = Water Sol. CAUSES Dissolution of Glycogen FROM Cells
2. HE Staining + Formalin Fixation = Glycogen (Clear Vacuoles in Cytoplasm)
3. PAS Reaction w/ PAS Control AFTER Alcohol Fixation = PAS Reaction (Red); PAS Control w/ Amylase (Redness Disappears)

Question 15

How do we see Glycogen Accumulation in Diabetes Mellitus?

Answer 15

Red Granules in:

(i) Epithelial Cells of Loop of Henle
(ii) Lumen of Kidney Canals
(iii) Cytoplasm & Nuclei of Hepatocytes

Armani-Ebstein Cells = GA in Epithelial Cells of Kidney Tubules