Workshop 4 - Cellular injury 2 Flashcards
chronic reversible cell lesion
intracellular accumulation
3 types of substances
- accumulation in excess of normal cellular components
( lipids, protein, carbohydrates ) - accumulation of exogenous pigments
( carbon, Si )
and endogenous pigments
( bilirubin ) - accumulation of abnormal substances
- exogenous ( mineral substances )
-endogenous ( by abnormal metabolism )
Fat intracellular accumulations
( disturbances in fat metabolism )
what are lipids and whats their role?
categories of lipids
Lipids are nutritive substances
with energy role in cell metabolism
categories :
-
triglycerides / neutral fats
( steatosis, obesity ) -
cholesterol and **cholesterol esters **
( ATPs ) -
phospholipids-PL
( storage diseases )
Fat intracellular accumulations
( disturbances in fat metabolism )
Steatosis ( fatty change )
normal mechanism
Fatty change is accumulation od triglyceride in the cytoplasm of parenchymal cells
Normal -> triglycerides metabolised in the liver
free fatty acids are carried in the blood to the liver where they convert in :
- triglycerids
- phospholipids
- cholesterol esters
these lipids then form complexes with proteins ( apoproteins - also synthetised in liver )
and secreted into plasma as ‘‘lipoproteins’’
when the triglycerides are metabolized normally ,
there is just a small amount of them in the liver cells
that cannot be seen
IN LIVER STEATOSIS:
Hepatic steatosis is excessive accumulation of triglycerides in parenchymal cells.
common in liver.
rare in kidney, myocardium
Fat intracellular accumulations
( disturbances in fat metabolism )
Steatosis ( fatty change )
definition
organs
IN LIVER STEATOSIS:
Hepatic steatosis is excessive accumulation of triglycerides in parenchymal cells.
common in liver.
rare in kidney, myocardium
Fat intracellular accumulations
( disturbances in fat metabolism )
Steatosis ( fatty change )
causes
- diabetes mellitus
- malnutrition
- toxic substances ( alcochol, CHCL3 )
- chronic hypoxia
- over-feeding
Fat intracellular accumulations
( disturbances in fat metabolism )
Steatosis ( fatty change )
pathology mild , chronic
Fatty liver is rare but serious condition
-
mild fatty liver
triglyceride accumulation as
small membrane-bound droplets
in cytoplasm
( microvacuolar fatty change ) -
chronic fatty liver
more common
fat droplets in the cytoplasm fuse to form progressively larger globules
( macrovacuolar fatty change )
Fat intracellular accumulations
( disturbances in fat metabolism )
Steatosis ( fatty change )
Mild fatty liver
triglyceride accumulation as
small membrane-bound droplets
in cytoplasm
( microvacuolar fatty change )
Fat intracellular accumulations
( disturbances in fat metabolism )
Steatosis ( fatty change )
Chronic fatty liver
more common
fat droplets in the cytoplasm fuse to form progressively larger globules
( macrovacuolar fatty change )
Fat intracellular accumulations
( disturbances in fat metabolism )
Steatosis ( fatty change )
appearance
Liver is :
- enlarged
- yellow
- greasy ( when cut )
- Mild steatosis : do not affect macroscopic
- in severe cases : liver can reach 3-6 kilos
Fat intracellular accumulations
( disturbances in fat metabolism )
Steatosis ( fatty change )
Microscopic
in ealry stages of fatty liver:
- pale , foamy cytoplasm
as fat accumulation increases:
- empty cytoplasm vacuoles appear
in the begging cytoplasm contains
small empty vacuoles with distinct limits
aroundthenucleus
( microvacuoles )
if process progresses :
the vacuoles fuse , resulting in large clear spaces
( macrovacuoles )
occupying the entire cell
Fat intracellular accumulations
( disturbances in fat metabolism )
Steatosis ( fatty change )
special stains
to determine the fat :
use frozen section made by fresh tissue
fat remains in the cytoplasm in frozen sections
can be demonstrated by fat stains :
- oil red
- sudan black B
resulting stained black lipids
intracellular accumulation of pigments
what are the pigments?
pigments are colored substances
- endogenous
- exogenous
intracellular accumulation of pigments
endogenous pigments
- hemosiderin
- billirubin
intracellular accumulation of pigments
endogenous pigments
Hemosiderin pigments accumulation
(hemosiderosis)
definition, whats hemosiderin?
Hemosiderosis is an excessive accumulation of hemosiderin in tissue and organs
hemosiderin is an endogenous pigment
containing iron
results from degradation of hemogobin ( Hb )
hemosiderin :
form of iron storage in tissue macrophages
intracellular accumulation of pigments
endogenous pigments
Hemosiderin pigments accumulation
(hemosiderosis)
microscopically
hemosiderin appears as a
yellow brown granular pigment
special stain :
Prussian blue - Perls reaction
intracellular accumulation of pigments
endogenous pigments
Hemosiderin pigments accumulation
(hemosiderosis)
Macroscopically
Organs accumulating hemosiderin have
brown tint
intracellular accumulation of pigments
endogenous pigments
Hemosiderin pigments accumulation
(hemosiderosis)
Forms
3 forms :
- Localized hemosiderosis
- Generalized hemosiderosis
- Hemocromatosis
intracellular accumulation of pigments
endogenous pigments
Hemosiderin pigments accumulation
(hemosiderosis)
LOCALIZED
location , causes
Common in any tissue that is a site of hemorrhage
hemoglobin is broken down and its iron is deposited locally in :
- macrophages
-
connective tissue
in the form of hemosiderin ( like a bruise )
Cause:
organs is conditions of chronic stasis
(lungs, liver)
or at periphery of bleeding
( ecchymosis )
intracellular accumulation of pigments
endogenous pigments
Hemosiderin pigments accumulation
(hemosiderosis)
LOCALIZED
appearance in lungs
in passive congestion of the lung :
brown granular material
in alveolar macrophages
intracellular accumulation of pigments
endogenous pigments
Hemosiderin pigments accumulation
(hemosiderosis)
LOCALIZED
appearance in liver
In passive congestion of the liver
hepatocytes contain
hemosiderin granules
coloured in blue
( because of Perls reaction staining )
intracellular accumulation of pigments
endogenous pigments
Bilirubin pigment accumulation
( jaundice, icterus )
What is it?
Jaundice ( increase in serum bilirubin ) represents the excessive accumulation of
bile pigment ( bilirubin )
in cells and tissues
clinicaly manifested by yellow color of
sclerae and skin
Bilirubin:
endogenous pigment without iron
result from degradation of hemoglobin ( Hb)
intracellular accumulation of pigments
endogenous pigments
Bilirubin pigment accumulation
( jaundice, icterus )
Macroscopically liver
the liver is
- pale
-
green-ish yellow
*
intracellular accumulation of pigments
endogenous pigments
Bilirubin pigment accumulation
( jaundice, icterus )
Microscopically liver
we have two forms of bilirubin accumulation
-
billiary cylinder
( small biliary channels are distended through greenish - yellow pigment )
( characteristic in cholestatic jaundice ) -
intrahepatocyte granular pigment
( hepatocyte cytoplasm contains billirubin
as small greenish-brown granules )
intracellular accumulation of pigments
endogenous pigments
Bilirubin pigment accumulation
( jaundice, icterus )
whats billiary cylinder?
In microscopic examination in icteric liver :
small biliary channels are distended through
greenish - yellow pigment
characteristic in cholestatic jaundice
Extracellular accumulations
Whats hyaline and how does it look like?
Hyaline is a descriptive term that refers to damaged
intracellular and extracellular protein
appearance :
- homogenous
- eosinophilic
