Accumulation

Question 1

Definition of Tissue Accumulation

Answer 1

deposition of substance , either endogenous or exogenous in tissues

Question 2

Types of Tissue Accumulation

Answer 2

1- Protein: Amyloidosis
2- Hyaline: Hyalinosis
3- Pigment
4- Pathological calcification

Question 3

Def of Amyloidosis

Answer 3

It is the extracellular deposition of abnormal protein.

Question 4

Chemical Nature of Amyloid

Answer 4

Amyloid light chain (AL) protein
Amyloid-associated (AA) protein

Question 5

Amyloid light chain (AL) protein is produced by?

Answer 5

Produced by plasma cells from Ig light chain

Question 6

Amyloid-associated (AA) protein is Produced by ?

Answer 6

by the liver during inflammation from proteolysis of SAA (serum amyloid-associated)

Question 7

Classification of Amyloidosis

Answer 7

Localized Amyloidosis
Generalized (Systemic) Amyloidosis

Question 8

Define Localized Amyloidosis and give examples

Answer 8

Limited to a single tissue or organ e.g. tongue (macroglossia).

Question 9

Generalized (Systemic) Amyloidosis includes

Answer 9

Primary n secondary

Question 10

Primary amyloidosis
Does it have a cause?
Where is it found?
The precursor protein is

Answer 10

There is no definite cause (idiopathic)
Found in multiple myeloma ( tumor of plasma cell)
The precursor protein is AL type

Question 11

Secondary amyloidosis Is seen secondary to?
The precursor protein is

Answer 11

• Chronic inflammatory conditions e.g. tuberculosis & Rheumatoid arthritis.
• Some solid tumors e.g. renal cell carcinoma, Hodgkin Lymphoma
• The precursor protein is AA type

Question 12

Pathogenesis of Amyloidosis

Answer 12

1- Production of large amount of normal protein.
2- gen mutation produce mutant proteins

Question 13

Amyloidosis Gross picture?

Answer 13

The organ is enlarged, grey, firm and rubbery

Question 14

Amyloidosis Microscopic picture?
Site of deposition
By H&E staining
By Specific stain

Answer 14

extracellular in basement membranes > wall of BVs
Pale pink
Congo red stain It stains amyloid > apple green by polarized microscope

Question 15

the most specific stain for amyloid

Answer 15

Congo red stain

Question 16

Effect of amyloid accumulation in tissue

Answer 16

1. Pressure on cells
2. Direct toxicity to cells e.g. cardiac cells
3. Accumulation in vessel wall Leading to ischemia

Question 17

Complications of amyloidosis

Answer 17

1. Renal failure
2. Heart failure
3. Intestinal obstruction and malabsorption

Question 18

Hyalinosis def

Answer 18

Intracellular / extracellular deposition of hyaline material.

Question 19

Hyalinosis In H&E

Answer 19

Pale pink appearance

Question 20

Types of Hyalinosis

Answer 20

1- Extracellular hyalinosis
2- Intracellular hyalinosis

Question 21

Extracellular hyalinosis: seen in

Answer 21

• Old scar
• Wall of blood vessels in chronic disease e.g. DM

Question 22

Intracellular hyalinosis seen in?

Answer 22

• Mallory body (in liver cells in Alcoholic patient)
• Russel body ( in plasma cells e.g. rhinoscleroma)

Question 23

Difference between amyloidosis & Hyalinosis in desposition?

Answer 23

Extracellular deposition
Intracellular / Extracellular deposition

Question 24

Difference between amyloidosis & Hyalinosis in structure?

Answer 24

Has definite biochemical structure
It has no definite structure

Question 25

Difference between amyloidosis & Hyalinosis in stains?

Answer 25

Has special stains
No special stains

Question 26

Definition of pigments?

Answer 26

It is colored substances that can be exogenous (coming from outside the body), or
endogenous (synthesized within the body itself)

Question 27

Exogenous pigments types?

Answer 27

A - Carbon
B - Tattooing

Question 28

Carbon Exogenous pigments

Answer 28

in air pollution and cigarette smoking.
Black coloration of the tissues (anthracosis)

Question 29

localized, exogenous pigmentation of the skin.

Answer 29

Tattooing