L4: Cellular Accumulations Flashcards
What is the definition of hyalinosis (hyaline degeneration)?
Glassy Refractile Homogenous Structurless Transparent material with unknown nature that stains Red with Eosin.
What are the types of hyalinosis?
Intracellular hyalinosis
1. Corpora Amylacia: Prostate
2. Russell bodies: Plasma cells in Rhinoscleroma
3. Old thrombi
4. Mallory body “Apoptotic bodies”: in Alcoholic
hepatitis
5. Councilman body: in Viral hepatitis (Yellow fever)
Extracellular hyalinosis
A. Vascular:-
1. Artery: Atherosclerosis
2. Arteriole: Spleen in Old age, Hypertension
B. Extra-vascular:-
- Old scar
- Spleen capsule & trabeculae
What are the sites, examples, and M/E of mucinous & myxomatus degeneration?
Sites:-
- Epithelial “Mucinous - Mucoid”
- Connective tissue “Myxomatous”
Examples
- Catarrhal inflammation, Mucoid adenocarcinoma
- Myxoma “CT tumor”, Myxedema
M/E
- none
- Star-shaped cells separated by pale blue mucin
What is the definition of amyloidosis?
Abnormal deposition of protein substance in between cells and in blood vessels in different tissues and organs.
What is the morphology of amyloidosis?
N/E: Waxy Translucent
M/E: Homogenous Structurless Red material (Like Hyalinosis & Fibrinoid necrosis)
What are the stains of amyloidosis?
Gross stains
1) lodine: Brown
2) lodine with sulphoric acid: Blue
Microscopic stains
1) Congo red: When viewed under polarized light it gives Apple Green birefringence
What are the types of systemic amyloidosis?
1) Immunocyte dyscrasias with amyloidosis “Primary amyloidosis
2) Reactive systemic amyloidosis “Secondary amyloidosis”
3) Heredofamilial amyloidosis
Where is Immunocyte dyscrasias with amyloidosis “Primary amyloidosis” seen in and what is its site, and cause of diseases?
-Seen in: Multiple Myeloma (Plasma cell tumor).
- Site:
a) Early in Muscle - Heart - GIT “Alimentary tract”.
b) Late in: Solid organs.
-Cause of Death:
Heart failure - Renal failure
Where is Reactive systemic amyloidosis “Secondary amyloidosis” seen in and what is its site, and cause of diseases?
- Seen in Chronic inflammatory lesions with continuous breakdown (TB - Rheumatoid arthritis).
- Site: Early in Solid organs.
- Cause of Death: Renal failure.
Describe Heredofamilial amyloidosis
Familial Mediterranean Fever “FMF” characterized
by recurrent inflammations of Joints & Serous sacs.
What are examples of localized amyloidosis?
1) Senile Cardiac Amyloidosis
2) Senile Cerebral Amyloidosis “Alzheimer disease”
3) Medullary Thyroid Carcinoma MTC
4) Nodules in Skin - Tongue - Larynx - Lung - Urinary bladder
What is the N/E of any organ with amyloidosis?
V Size: Enlarged V Shape: Preserved V Surface: Smooth V Consistency: Firm V Color: Pale Greyish-brown V Edges: Sharp edges
What is Gout “Hyperuricemia”?
Disturbance of Purines in nucleoprotein metabolism.
What is the pathology of Gout “Hyperuricemia”?
In joints:-
- Recurrent attacks of acute arthritis.
- Chronic gouty Tophi: Joints - Eyelid - Cartilage of ear.
In kidney:-
- Urate stones
- Chronic renal failure
What is pathological calcification?
Deposition of Ca salts in tissues other than bone & teeth.
What is the N/E of pathological calcification?
Dull opaque - White - Hard - Finely granular surface.
What is the M/E of pathological calcification?
Dark blue with Hematoxylin.
What is the classification of calcification?
- Dystrophic calcification
- Metastatic calcification
- Stone formation (Urinary tract - Biliary tract - Duct of the salivary gland - Appendix).
Dystrophic calcification
Ca level:
Type of tissues:
Sites:
- Ca level: Blood Ca is normal
- Damaged tissues are more liable to Ca deposition (Hyalinosis & Necrosis).
- Sites:- Degenerated tissue: Old scar - Wall of chronic abscess and necrotic tissues
Metastatic Calcification
Ca level:
Type of tissues:
Pathogenesis (causes of hypercalcemia)
- Blood Ca is elevated
- Deposition in normal tissues
- Excess mobilization of Ca from bone:-
a) Bone destruction (Multiple myeloma - Secondary Bone tumors)
b) Hyperparathyroidism
c) Prolonged immobilization
- Excess mobilization of Ca from bone:-
- Excess absorption of Ca from intestine:-
a) Hypervitaminosis D
b) Increased Milk intake - Sarcoidosis
What is hemosiderosis?
Pathological accumulation of Hemosiderin (Localized - Generalized)
How does hemosiderosis take place?
Fe is absorbed from duodenum - Carried in plasma trans-ferritin, Stored as Fe or Apo-ferritin in macrophages in Liver - Spleen - BM.
What is the definition of localized hemosiderosis?
Local accumulation of hemosiderin.
What are the causes of localized hemosiderosis?
Occurs around areas of hemorrhage as in:-
a) Interstitial hemorrhage.
b) Chronic venous congestion of the lung.
What is the def of generalized hemosiderosis (hemochromatosis)?
Generalized increase of hemosiderin.
What are the causes of generalized hemosiderosis (hemochromatosis)?
Iron overload due to:-
1) Over-dose of iron intake.
2) Prolonged iron therapy.
3) Increased iron absorption.
4) Repeated blood transfusions.
5) Hemolytic anemias
What is the pathology of Generalized Hemosiderosis(Hemochromatosis)?
The pigment is deposited in Liver cells - Pancreas - Skin - Heart - Other organs:-
1) Skin: Bronzed color.
2) Pancreas: Diabetes mellitus.
3) Liver: Develops Pigmentary cirrhosis.
4) Heart: Fibrosis - Arrhythmia - Cardiomyópathy - Heart failure.
What is the N/E of Generalized Hemosiderosis(Hemochromatosis)?
The affected organs are Enlarged - Brown - Hard.
What are the types of pigments?
Types of pigments:-
- Exogenous:-
a) Inhalation: Pneumoconiosis due to Silica.
b) Ingestion: Melanosis coli - Chronic lead poisoning.
c) Inoculation: Tattooing - Endogenous:-
a) Melanin
b) Hemoglobin derived pigments
What are increased melanin pigments?
- Prolonged exposure to the sun: Stimulation of MSH (Melanocyte Stimulating Hormone)
- Addison’s disease.
- Chloasma of pregnancy: Pigmentation around Nipple - Face - Vulva during pregnancy.
- Tumors; Melanoma.
- Chronic irritation
What are decreased melanin pigments?
- Albinism: Partial or Complete absence of tyrosinase.
- Leukoderma (Congenital).
- Vitiligo (Acquired).
