Pracs review: cellular injury and adaptation

Question 1

Acute Appendicits

Gross photo showing a resected vermiform appendix with serosal vascular congestion, acute hemorrhage, and fibrinous exudates (arrows)

Answer 1

• Presence of an acute inflammatory process
• The appendix can be seen as a tubular organ
• In the specimen, the serosa is covered with exudates or purulent (infected/ pus-filled) secretions due to the accumulation of neutrophils during infection

Question 2

Normal uterus

Answer 2

Gravid Uterus

Question 3

TB lung. Formalinized specimen of lung with tuberculosis

Answer 3

Presence of white caseous granulomas in TB. The image shows a cross-section of a lung infected with TB, containing multiple white granulomas (arrows). Dark areas of anthracosis are also present in this lung.

• Chronic caseating granulomatous lesions can be seen in tuberculosis
• Caseous means cheese-like, referring to the friable yellow-white appearance of the area of necrosis which is often enclosed within a distinctive inflammatory border. This appearance is characteristic of a localized infection induced inflammation known as a granuloma

Question 4

LUNG ANTHRACOSIS

Answer 4

Anthracotic Pigments. The black streaks and dots between lobules of lung beneath the pleural surface are due to anthracotic pigment accumulation, as seen in this image. This anthracosis of the lung is not necessarily harmful, and is caused by pollution, most notable in highly urbanized and industrialized areas.

Question 5

HEPATIC STEATOSIS (FATTY LIVER)

Answer 5

Fatty liver is a reversible cell injury caused by the accumulation of triglycerides via steatosis, which is the abnormal retention of lipids intracellularly

Question 6

Answer 6

Anthracosis of the Lungs

Question 7

MALARIA (LIVER)

Answer 7

Hemozoin pigments in malarial infection. The hemozion pigments characteristic (arrows) of malaria are caused by the release of hematin from ruptured RBC

Question 8

Squamous Metaplasia of the Lungs in LPO

Answer 8

Squamous Metaplasia of the Lungs in HPO.

Question 9

CELLULAR SWELLING AND NECROSIS (KIDNEY)

Answer 9

• The characteristic features of a normal kidney are viable epithelial cells, centrally located nuclei, and visible lumen.
• In a kidney with cellular swelling, a mild cell injury, there is a decrease in lumen size but still recognizable, retention of nucleus but pushed towards the lumen, more fluid and presence of granularity in the cytoplasm, and increased eosinophilia

Question 10

BILE NEPHROSIS (KIDNEY)

Answer 10

• In a normal kidney, the lumen of renal tubules is visible and unobstructed. However, in bile nephrosis, the renal tubules contain yellow-golden brown pigments within their lumen due to retention of conjugated billirubin and bile salts in the plasma, which are further filtered-out in the glomerulus.

Question 11

Chronic Passive Congestion of the Lungs

Note the presence of reddish brown hemosiderin (blue arrows) in the alveolar spaces, as compared to a normal lung (inset).SC (septal cells), AS (alveolar sac), C (capillaries)

Answer 11

Chronic Passice Congestion (CPC) of the Lungs . Notice a more pronounced lung septal wall with Heart Failure Cells in alveolar spaces. Macrophages contain brown colored hemosiderin.

Question 12

FAT NECROSIS (ACUTE PANCREATITIS)

Answer 12

The pancreas is characterized histologically by acinar spaces grouped into lobules. The vitalized part of healthy pancreas is the one with visible nuclei and darker contrast (yellow arrow).

• In fat necrosis, the histological features are pale pink/ eosinophilic appearance and less visible nuclei as compared to the healthy part (red arrows).
• Fat necrosis is secondary to saponification of calcium within the pancreas.

Question 13

Caseous necrosis in tuberculosis of the lungs

Answer 13

• In tuberculosis (TB), the alveolar spaces are obliterated – one can just see a solid lung parenchyma made up of nodules.
• Granulomas are lesions in chronic TB
• Caseous necrosis are seen in some areas

Question 14

Amyloidosis of the Liver

Answer 14

• The characteristic features of a normal liver are 1) hepatocytes arranged in sinusoids, and 2) reddish-slightly brown cytoplasm
• On the other hand, amyloidosis is characterized by dense pink, waxy material, which affects almost all hepatocytes.

Question 15

Fatty Liver with corresponding histological features

Answer 15

Question 16

Answer 16

FATTY LIVER

Question 17

Answer 17

FATTY CHANGE seen in REVERSIBLE cell injury

Question 18

Answer 18

FATTY CHANGE, LIVER (gross, formalinized)

Question 19

Answer 19

TUBERCULOSIS, LUNG

Question 20

Answer 20

GRANULOMA, TB, LUNG

Question 21

Answer 21

LANGHAN’S GIANT CELL FORMATION

Question 22

Answer 22

Cellular swelling, Kidney

Question 23

Answer 23

FAT NECROSIS, PANCREAS

Question 24

Answer 24

AMYLOIDOSIS, LIVER

Question 25

Answer 25

BROWN ATROPHY

**lipofuscin

Question 26

Answer 26

80 Bile nephrosis, Kidney