Trans 1- Cell adaptation Flashcards
the study (logos) of disease (pathos)
Pathology
Disease is due to cellular abnormalities:
o Altered ability to proliferate
o Dysfunction
o Disturbed homeostasis
Cells react to adverse stimuli by:
o Cellular adaptation § Hypertrophy § Hyperplasia § Atrophy § Metaplasia o Reversible injury o Irreversible injury and cell death o Apoptosis o Necrosis
Types of cellular adaptation
Hypertrophy
Hyperplasia
Atrophy
Metaplasia
response to hormonal or
endogenous influences
physiologic
response of the cell to injurious
stimuli which enable them to escape injury
pathologic
are continuously cycling
skin cells
are stable and will go to G1 if needed.
“Prometheus and his liver regeneration.”
Hepatocytes
are permanent cells and non-dividing. They cannot regenerate.
Heart muscles and Neurons
- Increase in the number of cells
* Encountered in cells which are capable of dividing
Hyperplasia
Hyperplasia is encountered where
epithelium
blood cells
connective tissues
In hyperplasia, these are PHYSIOLOGIC if normal stressor
o Breasts in pregnancy
o Menstrual endometrium
In hyperplasia, these are PATHOLOGIC if normal stressor
o ACTH from pituitary adenoma
o High estrogen
• Increase in the size of cells due to an increase in the
cellular contents
• Encountered in cells which are not capable of or have
limited capacity to divide
Hypertrophy
Hypertrophy is encountered where
in myocytes and skeletal muscles
In hypertrophy, these are PHYSIOLOGIC if normal stressor
Skeletal Muscles with Exercise
In hypertrophy, these are PATHOLOGIC if normal stressor
Hypertensive cardiomegaly
Histological Comparisons between Pregnancy and Normal Uterus
Pregnancy has bigger cells compared to the Normal Uterus
A normal heart weighs
250 g
- Decrease in the size of a previously normal cell
* Not hypoplasia, Cells under hypoplasia never developed to begin with.
Atrophy
In atrophy, these are PHYSIOLOGIC if normal stressor
non-pregnant uterus and
brain in senility
In atrophy, these are PATHOLOGIC if normal stressor
loss of stimulus (blood, innervation, endocrine, disuse, mechanical compression
Poliio virus affects
anterior motor neurons
Gyri become smaller, sulci become wider
Atrophy Normal Brain
More fat rather than beefy-looking
Skeletal Muscle Atrophy
Renal atrophy due to atherosclerosis or incidental cancer
renal atrophy
Change of Epithelium from one to another in an abnormal
location (Chronic cervicitis, Chronic bronchitis, Barrett Esophagus).
Gastro-esophageal junction demarcation is not clear.
Due to reflux.
Metaplasia
from squamous epithelium of normal esophagus to the glandular type along the gastroesophageal junction
Glandular metaplasia
• Not an adaptive response
• Limbo/grey area between normal and neoplastic tissue
• Alteration in the size, shape and organization of the
cellular components of a tissue
• Disorganized, haphazard cellular growth
• Like metaplasia, reflects persistence of injurious
influences and may regress
• Pre-neoplastic, step before cancer.
Dysplasia
Normal cellular constituent
water, lipids, proteins, carbohydrates
may be acquired or congenital in origin (ex. lysosomal storage diseases)
enzymatic defects
foreign material engulfed by macrophages, cell cannot degrade the substance nor transport it to other sites (ex. carbon particles, silica)
Exogenous deposition
accumulations that appear as rounded, eosinophilic
droplets in the cytoplasm
protein
homogenous, glassy, pink appearance
mallory hyaline
Steatosis (fatty change) resulting from abnormal
metabolism
fat
Fat accumulation is frequent in liver but also occurs in
heart, muscle and kidney
major organ in fat metabolism
liver
Fat appearance
Gross: with progressive accumulation, the liver
enlarges and becomes increasingly yellow
In extreme instances, it may weigh 2 to 4 times
normal and be bright yellow, soft and greasy
Microscopic: small vacuoles around nucleus ->
join together to create cleared spaces, pushing
the nucleus to the cell’s periphery -> cells may
rupture and the enclosed fat globules will
coalesce to form fatty cysts
exogenous deposition of pigments
§ phagocytosed by dermal macrophages
tattoo
most common, air pollutant
carbon
accumulations blacken the organ (e.g. of the lungs, lymph nodes)
athracosis
Picked up by macrophages in alveoli and
transported to regional lymph nodes
carbon
Wear-and-tear pigment
Lipofuscin
§ Yellow brown, finely granular cytoplasmic, often
perinuclear pigment
§ From lipid peroxidation and free radical injury
Lipofuscin
may be pathologic (as in melanoma) or
physiologic
melanin
Endogenous source is hemolysis
iron
elevated circulating iron, asymptomatic
hemosiderosis
symptomatic
Hemochromatosis
accumulation of copper in vital organs
Wilson’s disease
Copper deposits in the cornea manifests as
Kayser-Fleischer ring
bile-stained liver; also presents with nodularities which are hallmarks of liver cirrhosis
Cholestasis
Bile deposition in brain
kernicterus
results to deposition of bile in different parts of the body
Hyperbilirubinemia
- Controlled breakdown of cells in response to DNA damage or as part of normal growth and development
- Greek: “falling off” or falling away”
- Chromatin condensation and fragmentation
- No inflammation
- Ultrastructurally, clumping chromatin is better visualized
apoptosis
catalytically active cysteine aspartic acid proteases (caspases)
initiation
Apoptosis mechanism
o Intra and extracellular pathways
o Caspases cleave DNA
o DNA fragments are phagocytosed
Stimuli: Hypoxia toxins
Coagulation Necrosis
Stimuli: Physiologic and pathologic factors
Apoptosis
Histologic Appearance: Cellular Swelling
Coagulation Necrosis
Histologic Appearance:
Single cells
Chromatin condensation
Apoptotic bodies
Apoptosis
DNA breakdown: Random, diffuse
Coagulation Necrosis
DNA breakdown: Internucleosomal
Apoptosis
Mechanisms:
ATP depletion
Membrane injury
Free radical change
Coagulation necrosis
Mechanisms:
Gene activation
Endonucleases
Proteases
Apoptosis
Tissue reaction: Inflammation
Coagulation Necrosis
Tissue reaction:
No inflammation
Phagocytosis of apoptotic bodies
Apoptosis
Uncontrolled breakdown of cells due to injury
necrosis
- Most common form
- Protein is denatured, less enzymatic breakdown
- More eosinophilic cytoplasm, less basophilic nucleus
- Preserved architecture
- Most organs
- e.g. Acute myocardial infarction
Coagulative Necrosis
o More enzymatic breakdown
o Occurs in lipid-rich, low-protein tissue (e.g. brain)
o Architecture is lost
Liquefactive necrosis
o Can be enzymatic (as in pancreatitis) or traumatic
o Gross appearance: soapy white deposits
Fat necrosis
o “Cheesy” appearance (resembling cream cheese or
kesong puti); classic description of tuberculosis
§ Not evident for all cases of TB
o Architecture not distinct microscopically; presents with
granuloma
Caseous necrosis
o With pus
o e.g. renal abscess, brain abscess
Suppurative necrosis
o Complication of coagulative, caseous, or liquefactive
necrosis
o Normal serum calcium and calcium metabolism
Dystrophic
o Hypercalcemia
o Abnormal calcium metabolism
Metastatic