Pathology of Tissues Flashcards
Includes the ff: a) Inflammation b) Retrogressive Changes= Organ/Tissue smaller than normal b.1) Developmental defects: AAHA b.2) Atrophy c) Degenerative changes= Tissue have abnormalities d) Tumors e) Grading f) Broder's Classification (Grading) g) TNM system h) Cellular death h.1) Types of necrosis i) Somatic death j) Postmortem Lividity vs. Ecchymosis k) Postmortem Clot vs. Antemortem Clot l) Organ Weights
Inflammation came from the _________ word “_______”, meaning to set afire.
Latin, Inflammare
Five cardinal signs of inflammation
- rubor (redness)
- calor (heat)
- tumor (swelling)
- dolor (pain)
- Functio laesa (loss of function)
a sign of inflammation which occurs when blood flow increases to the site of injury.
Rubor (redness)
Capillary permeability leads to fluid extravasation
Tumor (swelling)
Pressure affects sensory nerves
functio laesa (loss of function)
Vascular and exudative
PMNs —(tissue)—> Macrophages
Acute inflammation
Intergrade between acute and chronic
Subchronic inflammation
Vascular and fibroblastic
Monocytes —(tissue)—> Macrophages
Chronic inflammation
Types of Inflammation according to Characteristics of Exudate:
1) Fibrinous
2) Catarrhal
3) Hemorrhagic
4) Suppurative/ purulent
5) Serous
Serum/secretions from serosal mesothelial cells (3P’s)
Pulmonary TB
Serous inflammation
Fibrinogen
Diphtheria, rheumatoid pericarditis
Early stage of pneumonia
Fibrinous inflammation
Hypersecretion of mucosa
Catarrhal inflammation
Blood + exudates
Bacterial infections and other infections
Hemorrhagic inflammation
type of inflammation that involves
_____: creamy fluid component of PMNs & necrotic tissue debris
Abcess: ____
Pustule: ____
Suppurative/ purulent inflammation
____ = pus
are fluids, CELLS, or other cellular substances that are slowly discharged from BLOOD VESSELS usually from inflamed tissues.
Exudates
are fluids that pass through a membrane or squeeze through tissue or into the EXTRACELLULAR SPACE of TISSUES.
Transudates
Incomplete/defective development of a tissue/organ
Ex. amastia (breast aplasia)
Aplasia
Failure to form an opening
Atresia
Failure of an organ to reach its matured size
Hypoplasia
Complete non-appearance of an organ
Agenesia
Natural
Ex. Thymus, brain, sex organs
Physiologic atrophy
The following are types of this atrophy:
1) Vascular atrophy
2) Pressure atrophy
3) Atrophy of disuse
4) Exhaustion atrophy
5) Endocrine atrophy
Pathologic atrophy
A brownish tissue discoloration caused by lipofuscin (“ageing” pigment) deposition in certain organs—e.g., heart, liver, and others—which may occur in older individuals.
Organs affected by this condition are small and flabby.
Brown atrophy
Increased tissue size due to increased cell size
*Physiologic: ásize of uterus
*Pathologic: Systemic hypertension
Hypertrophy
Increased tissue size due to increased cell number
*Physiologic: Glandular proliferation of the female breast, ásize of uterus (preg.)
*Pathologic: Skin warts due to HPV
Hyperplasia
Ex. Enlargement of one kidney
Compensatory hyperplasia
Ex. Endometrial hyperplasia
Pathologic hyperplasia
Phenytoin-induced
Congenital hypertrophy
Examples of Degenerative Changes= Tissues have abnormalities
1) Metaplasia
2) Dysplasia
3) Anaplasia/ dedifferentiation
4) Neoplasia/ tumor
Reversible
One adult cell type ↔ Another adult cell type
Metaplasia
Reversible
One type of adult cell ↔ Changes in structural components
Dysplasia
Irreversible
Criterion toward malignancy
Adult cell More primitive cells (release tumor markers)
Anaplasia/ Dedifferentiation
Continuous abnormal proliferation of cells w/o control (no purpose/function)
Ex. Leukemia
Neoplasia/tumor
Study of neoplasm
Oncology
Parts of a tumor
- Parenchyma = active elements (tumor cells)
- Stroma = CT framework
Types of tumor according to capacity to produce death:
1) Benign (Ex. mole)
2) Malignant
Types of tumor according to histologic characteristics:
1) Medullary
2) Scirrhous
Type of tumor
cells (parenchyma) > supporting tissues (stroma)
Medullary
supporting tissues (stroma) > cells (parenchyma)
Scirrhous
“-oma” meaning
Benign
Terms for Malignant tumor:
“-sarcoma” = _____________
“-carcinoma” = _____________
“SaMe CarE”
“-sarcoma” = mesenchymal/CT
“-carcinoma” = epithelial tissues
Give at least 2 malignant cancer examples
Leukemia
Lymphoma
Identify if benign or malignant:
1) Squamous cell papilloma
2) Squamous cell carcinoma
1) Squamous cell papilloma= benign
2) Squamous cell carcinoma= malignant
Identify if benign or malignant:
Hepatoma/ hepatocarcinoma
Malignant
Identify if benign or malignant:
Melanoma/ melanocarcinoma
Malignant
Fallopian tube pregnancy
Ectopic pregnancy
Grading of tumor is based on:
Aggressiveness/level of malignancy
Differentiated cells = resemble normal cells
Undifferentiated cells = younger cells
refers to histological classification of differentiation in squamous cell carcinoma.
Broder’s Classification (Grading)
Explain Broder’s Classification (Grading).
Grade Differentiated cells Undifferentiated cells
I 75%-100% 0-25%
II 50%-75% 25-50%
III 25-50% 50-75%
IV 0-25% 75%-100%
Treatment depends on the grading:
Grade I to Grade IV
Surgery ————> Radiation
is based on tumor size, extent of spread to lymph nodes, +/- metastases
Staging
is a system for classifying a malignancy. It is primarily used in solid tumors and can be used to assist in prognostic cancer staging.
UICC TNM
Grading + staging
is a system to describe the amount and spread of cancer in a patient’s body, using TNM.
AJCS Staging system
TNM stands for:
Tumor, Nodes, Metastases
Applicable to all forms of neoplasia
TNM system
1’ tumor
#: denotes the size of tumor and its local extent
Tis = carcinoma in situ
Ta = non-invasive
Tx = cannot be evaluated
T0 = free of tumor
T1 = lesion <2 cm (T1a = <0.5 cm | T1b = <1 cm | T1c = <2 cm)
T2 = lesion 2-5 cm (invasion in muscle)
T3 = skin and/or chest wall involved by invasion (T3a = deep muscle | T3b = through organ)
T4 = tumor invasion/fixation (T4a = adjacent organ | T4b = fixation to bladder or colonic wall, in breast, edema)
T
Regional lymph node involvement
High # denotes increasing extent of involvement
Nx = not evaluable
N0 = no axillary nodes involved
N1 = 1 mobile regional (axillary) node involved
N2 = multiple, mobile regional nodes involved
N3 = fixed regional lymph node involved
N4 = beyond regional lymph node involvement
N
Metastasis
M0 = no evidence of metastases
M1 = distant metastases are present
Mx = distant metastases not evaluable
M
Compound tumors
Greek: Monstrous tumors
May contain hair, teeth, bones
w/ heartbeat
Teratomas
Programmed cell death (cellular suicide)
Apoptosis
Physiologic cell death
Ex. normal sloughing off of skin cells
Necrobiosis
Pathologic cell death
Necrosis
Most common
Tombstone formation
“MyLKS”
Myocardium
Lungs
Kidneys
Spleen
Coagulation necrosis
Types of Necrosis
1) Coagulation necrosis
2) Liquefactive/colliquative necrosis
3) Caseous/caseation necrosis
4) Gangrenous necrosis
5) Fat necrosis
6) Fibrinoid necrosis
Fatty degeneration can occur in
Liver
is limited to small blood vessels. Typically, it involves small arteries, arterioles, and glomeruli affected by autoimmune diseases (e.g., systemic lupus erythematosus) or malignant hypertension.
The walls of necrotic vessels or glomeruli are impregnated with fibrin and appear homogeneously red in routine hematoxylin-eosin (H&E)–stained slides.
Fibrinoid necrosis
Type of necrosis
Pus formation
Brain & spinal cord
Liquefaction/colliquative necrosis
Type of necrosis
Yellow, cheesy, crumbly material
TB, syphilis, tularemia, lymphogranuloma inguinale
Caseous/caseation necrosis
Type of necrosis
Sulfide gas production
a. Dry gangrene = arterial occlusion
b. Wet gangrene = venous occlusion
Gangrenous necrosis
Type of necrosis
Chalky white precipitates
Pancreatic degeneration
Fat necrosis
deals with the irreversible cessation of the vital functions of the brain, heart, and lungs.
Somatic death
Under somatic death
“CRC”: circulatory, respiratory, CNS failure
1’ changes
During somatic death
“ARLP DPA”: Algor mortis, Rigor mortis, Livor mortis, Postmortem clotting, Dessication, Putrefaction, Autolysis
2’ changes
After somatic death
Postmortem cooling
Cooling: 7’F/hr
Algor mortis (1st)
Stiffening
1st: neck & head (2-3 hrs)
Persists for 3-4 days
Rigor mortis (2nd)
Lividity/suggillations
Purplish discoloration
After 10-12 hrs, it does not blanch on pressure or shift when the body is moved
Livor mortis
is a plurifocal staining of the skin, usually in the form of a more or less intense purple discoloration, due to the gravitational settling of blood in vessels after the circulation has ceased.
Postmortem lividity (hypostasis, livor mortis)
Disappears on pressure (reappears when pressure is released)
Oozing of blood (incision)
Postmortem Lividity
Opposite of postmortem lividity
No oozing of blood (incision)
Ecchymosis
Settling of RBCs from plasma
Chicken fat
Currant jelly
Assumes the shape of the vessel
Rubbery consistency
Postmortem Clot
Not readily detachable from the blood vessels
No chicken fat
Seldom assumes the shape of blood vessels
Granular & friable
Antemortem Clot
Drying & wrinkling of the anterior chamber of the eye
Dessication
Invasion of intestinal microorganisms
is the decomposition of the body carried out by the microbial action.
Putrefaction
Self digestion of cells
Lysosome: suicide sac of the cell, releases lysozyme
Autolysis
Organ Weights
Liver: 1,100 – 1,600g
Brain: 1,150 – 1,450g
Right lung: 300-400g
Left lung: 250-350g
Heart: 250-300g
Spleen: 60-300g
Thyroid: 10-50g
Adrenals: 4g or so each