Practical Revision 1st Half

Cell Injury- Necrosis

 g y
Organ: Spleen
o
ol
Description:
h
PatCut surface of the

t of n e
spleen shows
i
en d i c
- Well circumscribed

rtm Me i t y
wedge shaped pale
s
epa o f e r
areas with; their base
v
D ty
u l ni
subcapsular and apex
U
Fa c ri a
pointing towards the

a n d hilum.
- The overlying
l ex capsule shows patches
A of fibrosis.
 g y
Organ: slice of brain
o
ol
Description:
h
PatThe brain shows

t of i n e
cystic areas
en d i c
surrounded and
rtm Me s i t y
traversed by glial

epa o f e r
tissue that give it
v
D ty
u l ni
honey comb
U
Fa c ri a
appearance .

a n d
l ex
A
 og y
Organ: Lymph nodes.
hol
Description:
Pat
- A group of lymph
t of i n e
nodes that are
en d i c
enlarged and matted
rtm Me s
together. i t y
epa o f v e r
- Cut surface: show
D ty
u l ni
numerous areas of
U
Fa c ri a
yellowish cheese like

a n d necrotic tissue.

l ex
A
Cell Injury- Gangrene
 o g y
h ol
Dry gangrene , hand P at
t o f i n e
e n d i c
I-6.1861
r t m M e s i t y
e p a
• Right hand is dried, shrunken, f
o v e r
D
black colour.
u l ty U ni
Fa c
• First three medial fingers are
ri a
d
lost.

a n
• Skin is wrinkled, mummified
x
and black.

A l e
• Line of demarcation.
• Line of separation.
 og y
hol
Line of separation
Pat
t ofi n e
n
Line of demarcation
e d i c
rtm Me s i t y
e p a , hand o f v e r
D ty ni
Dry gangrene

c u l U
a
FFront ndr i a
ex a
A l
By A. Prof. Dr Samar El Achy
 og y
hol
Line of separation
Pat
t of i n e
e n d i c
Line of demarcation

r tm Me s i t y
e p a o f v e r
DryDgangrene , hand
u l ty U ni
a c
FBack ndr i a
ex a
A l
By A. Prof. Dr Samar El Achy
 og y
hol
Pat
t of i n e
en d i c
Wet
rtm(Moist) e
gangrene
M s i t y
epa o f v e r
D ty
u l ni U
Fa c ri a
a n d
l ex
A
 o g y
h ol
Moist gangrene , foot P at
t of i n e
e n d i c
I-6.1862
r tm M e s i t y
e p a o f v e r
D black, mummified ty ni
• Swollen right foot, with
shrunken,
c u l U
F a
little toe (dry gangrene)
ri a
• The skin is dull, pale and
a n d
macerated.
l e x
A
 og y
hol
Pat
t i of
n e
Moist gangrene ,n
e d i c
r t
intestinem Me s i t y
e pa o f v e r
DIII-4.2186
ty u l ni U
Fa c
• Loop of small intestine
ri a
a n d
• A dark brown-black, lusterless
segment with no definite lines

l ex
of demarcation, or separation

A
• The serosa is dull, and opaque.
Cell Injury - Pigments
 Anthracosis in Lymph Node
og y
hol
Pat
t of i n e
en d i c
rtm Me s i t y
epa o f v e r
D ty
u l ni U
Fa c ri a
a n d
l ex
A
 og y
hol
Pat
t of i n e
en d i c
rtm Me s i t y
epa o f v e r
D ty
u l ni U
Fa c ri a
a n d
l ex
A
Immunology – Granuloma & T.B.
Non-Caseating granulomatous lymphadenitis
og y
hol
Pat
t i n of e
en d i c
rtm Me s i t y
epa o f v e r
D ty u l ni U
Fa c ri a
Lymph node showing

a n d
l ex
- Numerous varying sized and shaped tubercles of epitheliod macrophages (with abundant
eosinophilic poorly defined cytoplasm and vesicular nuclei) are seen with surrounding
lymphocytes
A
- Several multinucleated giant cells some with nuclei arranged in horse shoe pattern at
periphery (Langhan's giant cells) are seen.
- Others show irregularly scattered nuclei (foreign body type)
 Caseating granulomatous tuberculous
Lymphadenitis
og y
hol
Pat
t i n of e
en d i c
rtm Me s i t y
epa o f v e r
D ty u lni U
Fa c ri a
a n d
Lymph node showing:
l ex
-
- A
Extensive areas of caseous necrosis which is eosinophilic and granular.
At the periphery, several tubercles of epithelioid macrophages with abundant eosinophilic
cytoplasm and vesicular nuclei are seen rimmed by lymphocytes.
- Multinucleated giant cells of the Langhan’s and Foreign body types are detected.
 Caseating granulomatous tuberculous
Lymphadenitis

og y
Organ: Lymph nodes.
hol
Description:
Pat- A group of lymph
t i n of e
nodes that are
en d i c enlarged and matted
rtm Me s i t y together.
epa o f v e r - Cut surface: show
D ty u l ni U numerous areas of

Fa c ri a yellowish cheese like

a n d necrotic tissue.

l ex
A
 Primary Pulmonary tuberculosis

og y
Organ: lung
hol
Description:
Pat
The hilar lymph nodes

t ofi n e
are markedly enlarged,
en d i c
e y
matted together full of

rtm M
necrotic caseous cheesy-
a rs i t
ep o f
like friable material.
v e
D ty
The Ghon’s focus is small

u l ni U
c
and subpleural

Fa ri a
a n d
l ex
A
Tabes Mesenterica (primary intestinal
tuberculosis) yo g
h o l
Pat Organ: Small intestine

t of i n e lymph
Description:

en d i c
The mesenteric

e y
nodes are enlarged,
m togethertfull
art f M matted
rs i of

ep o necrotic
v e caseous cheesy-

D ty
u l niGhon’s focus is small
like friable
U
material.

c
The

Fa ri a and in the intestinal

a n d parenchyma

l ex
A
Fibrocaseous secondary
tuberculosis
og y
hol
Organ: Lung
Description:
Pat
The apex of the lung shows a
t iof
n e
en d
large cavity surrounded by
i c
rtm e
fibrous tissue and full of
M s i t y
epa o f
necrotic caseous cheesy-like

v e r
ty ni
friable material.
D l
a
mildly enlarged. u
The hilar lymph nodes are
c i a U
F n dr
ex a
A l
Miliary tuberculosis

og y
hol
Organ: lung
Pat
Description:

t of
i n e
The lung is studded by
en d i c
e y
small tubercles formed of

rtm M
granuloma with cheesy-like
a rs i t
ep o f
friable caseous necrosis
v e
D ty u l ni U
Fa c ri a
a n d
l ex
A
Amyloidosis
 Amyloidosis, Liver.

og y
Organ: liver
hol
Description:
Pat
The liver is enlarged, firm
t of
i n e
and waxy.
en d i c
rtm
-The amyloid material
Me s i t y
epa o
appears brown due to f v e r
D
iodine stain ty u l ni U
Fa c ri a
a n d
l ex
A
 Amyloidosis of the
og y
spleen
hol
Pat
t i n of e
c
Organ: Spleen
Description:
en
ed i y
m t
The spleen is enlarged, firm and waxy.

art M s i
-The amyloid material appears brown due

f r
p o e
to iodine stain

De ty l ni v
a c u i a U
F n dr
ex a
A l
Liver amyloidosis og y
hol
Pat
t of i n e
en d i c
rtm Me s i t y
epa o f v e r
D ty
u l ni U
Fa c ri a
a n d
l ex
A
Hemodynamics
Congestion & Infarction
Hemorrhagic infarction on top of
chronic venous congestion of lung
Chronic Venous Congestion Lung
Chronic venous congestion Liver
Chronic Venous Congestion Spleen
Hemodynamics-thrombosis &
embolism
Arterial thrombosis
• Organ: part of the Aorta

• The intima of the Aorta looks variegated and shows

interconnected geographic-like appearance, composed
of:

1) numerous atheromatous plaques which are;

• slightly elevated above the surface.

• large size
• different in shapes.
• whitish-yellow in colour.
• some are ulcerated .

2) Complicated by deposition of red brown and granular

mural thrombi
Atherosclerosis, aneurysm and thrombosis of the abdominal
aorta

• Organ: part of the Aorta

• The intima of the Aorta looks variegated and shows interconnected

geographic-like appearance, composed of:

1) numerous atheromatous plaques which are;

• slightly elevated above the surface.

• large size
• different in shapes.
• whitish-yellow in colour.

• some are ulcerated .

2) Complicated by deposition of red brown and granular mural thrombi

 Acute rheumatic valvulitis, mitral valve

Rheumatic vegetations

Mitral valve: swollen

oedematous but not
fibrotic or deformed.

Vegetations: small,
pinpoint, at the line
of closure of the
valve, firmly
adherent.
 Infective endocarditis, mitral valve

Mitral valve: swollen

oedematous but not
fibrotic or deformed.

Vegetations: large,
friable, covering the
whole surface of the
valve.
 Ball valve thrombus in left atrium

• Organ : heart
• Description: A large ball
like thrombus occupying
the left atrial lumen in
severe mitral stenosis,
 Pulmonary artery embolism

Organ:heart
The heart is normal in size
The pulmonary artery is opened with a large
impacted embolus
 Pulmonary embolism of the lung

Organ: lung
The lung is normal
The hilum is filled with multiple impacted
emboli