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CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,

ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,

DYSTROPHIES AND VASCULAR INFLAMMATION. RESPIRATORY

SYSTEM. INFLAMMATION, TUMORS.

(Endocarditis, Cardiomyopathy, Aortal mukoid mediodystrophy, Nodose polyarteritis,

Lung emfysema, Bronchopneumonia, Lobar pneumoia, Small cell lung carcinoma.

Nasal polyp, Atherosclerosis.)

General Medicine

MUDr. Daniela Kobzová

MUDr.Michal Palkovič, PhD.

MUDr. Svetoslav Štvrtina, PhD.

MUDr. Pavol Janega, PhD.

Department of Pathology, Faculty of Medicine UK & FH

Branch : Staré mesto

Sasinkova 4, Bratislava

Endocarditis

1. Non-rheumatic endocardits

non-infectious

atypical verrucous (Libman-Sacks) – „collagen disorders“; SLE

non-bacterial thrombotic (marantic, cachectic)

infectious

infective bacterial (BE)

acute - ulcerous

subacute – polypous

Complications : cardiac – valve insufficiency, perforation / rupture of valve

leaflets, abscesses formation

systemic – hematogenous spreading of the infection , septic

embolisation, Lőhlein nephritis, toxemia

2. Rheumatic endocarditis (rheumatic fever)



DYSTROPHIES AND VESCULAR INFLAMATION.

Ulcerative endocarditis

Polypous endocarditis

Polypous endocarditis (gram)

Myocardial abscess

Myocardial abscess (gram)

Cardiomyopathies

Classification:

Primary cardiomyopathy

idiopatic hypertrophic cardiomyopathy

idiopatic dilated cardiomyopathy

idiopatic restrictive cardiomyopathy

cardiac amyloidosis, endocardial fibroelastosis,

Secondary cardiomyopathy

toxic (toxic chemical, drugs, chronic alcoholism)

metabolic diseases

nutritional disorders




Hypertrophic cardiomyopathy

Dilated cardiomyopathy (FH)

Medial dystrophy of aorta (227)

Pathogenesis : deposits of acid mucosubstancies in the vascular wall

focal separation of fibromuscular and elastic tissue of aortal media

cystic spaces in the media

elastic tissue fragmentation

fibrosis of the media

Complications : Erdheim idiopathic cystic medionecrosis and dissecting aneurysm




Aortic dissecting aneurysm

Normal aorta (staining for elastic fibers)

Medial dystrophy of aorta (HE)

Medial dystrophy of aorta (staining for elastic fibers)

Medial dystrophy of aorta (alcian blue pH 0.5)

Polyarteritis nodosa (90)

Necrotising vasculitis involving small and medium-sized muscular arteries

Pathogenesis : allergic reaction of immunocomplex type to various agents

Microscopic findings :

acute stage - fibrinoid necrosis of vascular wall with thrombosis, perivascular

inflammation

healing stage – fibroblastic proliferation, granulomas formation

healed stage – dense fibrosis

Complications : ischemic changes of affected tissues




Polyarteritis nodosa (fibrinoid necrosis of vascular wall, HE)

Polyarteritis nodosa (fibrinoid necrosis of vascular wall, FH)

Polyarteritis nodosa (granulomas, HE)

Polyarteritis nodosa (granulomas, FH)

Pulmonary emphysema (141)

Forms : centrilobular, panlobular, distal, irregular, mixed

Microscopic findings : destruction of alveolar septum

Complication : Cor pulmonale chronicum




Pulmonary emphysema

Bullous pulmonary emphysema

Rupture of emphysematous bulla

Pulmonary emphysema

Pulmonary emphysema (Chronic bronchitis)

Pneumonias (86)

Forms : 1. Lobar pneumonia / 2. Bronchopneumonia (lobular) / 3. Interstitial pneumonia

A. Bacterial pneumonia / B. Primary atypical pneumonia (viral, chlamydias,

mycoplasmal pneumonia)

C. Special types (aspirative, hypostatic, ...)

Pathogenesis : inhalation pathway, aspirative, hematogenous dissemination,

Complication : pneumonia with abscess formation




Bronchopneumonia

Bronchopneumonia with abscess formation

Lobar pneumonia (83)

Stages : 1. Stage of congestion (inflammatory oedema)

2. Red hepatisation (early consolidation)

3. Grey hepatisation (late consolidation)

4. Resolution

Pathogenesis : inhalation pathway

Complications : organisation(repair) - lung carnification, empyema, abscess formation,

hematogenous dissemination of the infection




Lobar pneumonia

Lobar pneumonia (inflammatory oedema)

Lobar pneumonia (red hepatisation)

Lobar pneumonia (gray hepatisation)

Lobar pneumonia (resolution)

Tumors of lungs

Classification:

I. Epithelial tumors

Benign

Papilloma

Adenoma

Malignant

II. Soft tissue tumors (chondroma, myoepithelioma, ...)

III. Lymphohistiocytic tumors (lymphoma, ...)

IV. Tumors of ectopic origin (malignant melanoma, teratoma, ...)

V. Secondary tumors

KARDIOVASKULÁRNY SYSTÉM. CHOROBY PERIKARDU,

ENDOKARDU, MYOKARDU. ATEROSKLERÓZA,

DYSTROFIE A ZÁPALY CIEV. RESPIRAČNÝ SYSTÉM.

ZÁPALY. NÁDORY.

Malignant epithelial tumors

a) Adenocarcinoma (lepidic adenocarcinoma, ...)

b) Squamous cell carcinoma

c) Neuroendocrine tumors (small cell carcinoma, ...)

d) Large cell carcinoma

e) Adenosquamous carcinoma

f) Carcinosarcoma

g) ...

Localisation: central (often hilous), peripheral, „Pancoast tumor“ in apex of lungs

Etiology: smokers

Komplikácie : rapid lympho- and hematogenous dissemination




Periferal carcinoma of lungs

Central carcinoma of lungs

Small cell (oat-cell) carcinoma of lungs

Small cell lung carcinoma overgrowth on epicardium and into myocard

Metastasis of small cell lung carcinoma into the liver

Squamous cell lung carcinoma with central necrosis

Squamous cell lung carcinoma

Squamous cell lung carcinoma with squamous „pearls“

Squamous cell lung carcinoma with individual cell keratinisation

Squamous cell lung carcinoma (atypic mitosis)

Lepidic adenocarcinoma (bronchiolo – alveolar carcinoma) (279)

• cuboidal to tall columnar cells growing along the existing alveoli

• numerous papillary structures

KARDIOVASKULÁRNY SYSTÉM. CHOROBY PERIKARDU,

ENDOKARDU, MYOKARDU. ATEROSKLERÓZA,

DYSTROFIE A ZÁPALY CIEV. RESPIRAČNÝ SYSTÉM.

ZÁPALY. NÁDORY.

Lepidic adenocarcinoma (bronchiolo - alveolar lung carcinoma) (279)

Nasal polyps (238)

• usually associated with chronic hypertrophic rhinosinusitis




Nasal polyp

Atherosclerosis (66)

• changes occurs on the intima of elastic and muscular arteries

Stages : 1. Fatty streaks and dots

2. gelationous lesions

3. atheromatous plaques (fibromuscular, fibrolipid, atheromas)

4. complicated plaques (calcification, ulcers, thromosis, bleeding in the plaque,

aneurysms formation)

Complications : ischemic changes of the affected tissues and organs




Atherosclerosis of abdominal aorta

Atherosclerosis of abdominal aorta (ulcers)

Atherosclerosis of coronary arteries

Diseminated myofibrosis of heart

Atherosclerosis of the coronary arteries and myofibrosis of heart (FH)

Scar after an acute myocardial infarction

cardiovascular system. diseases of the … · cardiovascular system. diseases of the pericardium,...

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