Types of Necrosis

Question 1

What are the types of necrosis?

Answer 1

coagulative, liquefactive, caseous, gangrenous, fat, and ulceration

Question 2

Grossly what does tissue affected with coagulative necrosis look like?

Answer 2

solid, cell and tissue is identifiable, and delayed autolysis (decrease in pH)

Question 3

Microscopically, what does coagulative necrosis look like?

Answer 3

cytoplasm (homegeneous hypereosinophilic), and pyknotic nuclear change

Question 4

What causes coagulative necrosis?

Answer 4

hypoxia, cell membrane injury, and toxins

Question 5

What tissues does coagulative necrosis usually effect?

Answer 5

liver, kidney, muscle, and individual neurons

Question 6

How would coagulative necrosis resolve?

Answer 6

by fibrosis or scarring

Question 7

Grossly what does liquefactive necrosis look like?

Answer 7

liquid debris and fluid, the cell and tissue is unidentifiable, cavitation or focal loss of structure

Question 8

What causes liquefactive necrosis?

Answer 8

hypoxia and bacteria

Question 9

What tissues are usually effected by liquefactive necrosis?

Answer 9

CNS

Question 10

What happens to CNS tissues during liquefactive necrosis?

Answer 10

enzymatic destruction, high lipid content, abscess early

Question 11

Can liquefactive necrosis be resolved?

Answer 11

it depends on how severe it is; if small it’ll be healed by astrocytes, if large it will turn into a fluid filled cyst

Question 12

Grossly, what does caseous necrosis look like?

Answer 12

solid/semisolid tissue, cells and tissue are unidentifiable, coagulation of debris, looks like cream cheese

Question 13

What are causes of caseous necrosis?

Answer 13

bacteria

Question 14

Will caseous necrosis resolve?

Answer 14

unlikely - the lesion creates for a good environment for bacteria to hide out in

Question 15

What is gangrenous necrosis caused by?

Answer 15

coagulative necrosis + saprophytic bacteria

Question 16

What are the types of gangrenous necrosis?

Answer 16

wet and dry

Question 17

What is the difference between wet and dry gangrenous necrosis?

Answer 17

wet has a good blood supply and has bacteria, dry is usually on a distal extremity, mummification, and lacks bacteria

Question 18

Grossly, what does fat necrosis look like?

Answer 18

nodular, firm, and yellow-brown

Question 19

What is a secondary lesion caused by fat necrosis?

Answer 19

saponification

Question 20

What is saponification?

Answer 20

the creation of soapy, salted, crusty, and chalky material from fat

Question 21

How can fat necrosis resolve?

Answer 21

either by fibrosis or scarring

Question 22

In the pancreas, what must be intact in order for it to heal and return to normal function?

Answer 22

if the basement membrane is intact

Question 23

If the basement membrane is not intact in the pancreas, what will happen?

Answer 23

fibrosis

Question 24

What cell type does ulceration necrosis happen on?

Answer 24

epithelial cells on the epithelial surface

Question 25

Is the basement membrane affected by ulceration necrosis?

Answer 25

yes, but it is not in erosion

Question 26

What is somatic death?

Answer 26

death of body

Question 27

What is clinical death?

Answer 27

absence of blood flow, breathing

Question 28

What is brain death?

Answer 28

no CNS activity in the neocortex

Question 29

What is the appearance of necrosis in the cytoplasm?

Answer 29

hypereosinophilic, homogeneous, smudged, swollen then shrunken, pale, and unnattached from the basement membrane

Question 30

If a cell is hypereosinophilic, what color does that make it?

Answer 30

pinker

Question 31

What are the fates of necrotic areas?

Answer 31

liquefied, calcified, phagocytosis, and encapsulated

Question 32

In general, what does necrosis look like grossly?

Answer 32

pale, sharp line of demarcation, and friable

Question 33

What is a line of demarcation?

Answer 33

the line of transition between necrotic cell and normal cell

Question 34

What does it mean when something is friable?

Answer 34

it has lost its tensile strength

Question 35

What is pyknosis?

Answer 35

when you cannot distinguish between structures and the nucleus

Question 36

What is karyorrhexis?

Answer 36

when the nucleus is centrally fragmented

Question 37

What is karyolysis?

Answer 37

when the nucleus is fragmented around the periphery of the cell

Question 38

What are common differentials for pulmonary nodules?

Answer 38

abcess, granuloma, neoplasia, hyperplasia