inflammation 6
DESCRIPTION
Designed for UG Pathology teaching.TRANSCRIPT
Inflammation
and Repair - 6
Dr.CSBR.Prasad, M.D.
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Out comes of Acute Inflammation
May have one of three outcomes:
1. Complete resolution
2. Healing by fibrosis
3. Chronic inflammation
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Out comes of Acute Inflammation May have one of three outcomes:
1. Complete resolution
Restoration of inflamed tissue to normal
No loss of cells
No architectural loss
Seen when:
Inflammation is short lived
There is little tissue destruction
The tissue can regenerate – eg: liver
It involves:
Removal of cellular debris and microbes by macrophages and
Resorption of edema fluid by lymphatics v3-CSBRP-May-2012
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Fulminant fatal acute viral hepatitis
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Out comes of Acute Inflammation
May have one of three outcomes:
1. Complete resolution
2. Healing by fibrosis:
It occurs: – When there is substantial tissue loss
– When inflammation occurs in tissue incapable of regeneration
– When there is excessive fibrin exudation which can not be cleared
In these conditions connective tissue grows into the area of destruction - ORGANIZATION
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Out comes of Acute Inflammation
May have one of three outcomes:
1. Complete resolution
2. Healing by fibrosis
3. Chronic inflammation
This occurs when:
• There is persistence of injurious agent
• There is interference with normal healing
process
Eg: Peptic ulcer, Complicated pneumonia
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Morphologic Patterns of Acute
Inflammation
The morphologic hallmarks of all acute inflammatory reactions are:
• dilation of small blood vessels
• slowing of blood flow, and accumulation of leukocytes and fluid in the extravascular tissue
• However, special morphologic patterns are often superimposed on these general features, depending on the severity of the reaction, its specific cause, and the particular tissue and site involved
• The importance of recognizing the gross and microscopic patterns is that they often provide valuable clues about the underlying cause
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Morphologic Patterns of Acute
Inflammation
SEROUS INFLAMMATION
FIBRINOUS INFLAMMATION
SUPPURATIVE INFLAMMATION
ULCERATIVE INFLAMMATION
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Morphologic Patterns of Acute
Inflammation
SEROUS INFLAMMATION
• marked by the outpouring of a thin fluid
• The skin blister resulting from a burn or
viral infection represents a large
accumulation of serous fluid
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SEROUS INFLAMMATION
Catarrh
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Vesicular and Bullous Lesions of Poison Ivy v3-CSBRP-May-2012
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Serous inflammation
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Morphologic Patterns of Acute Inflammation 1. SEROUS INFLAMMATION
2. FIBRINOUS INFLAMMATION
A fibrinous exudate develops when:
Vascular leaks are large or Local procoagulant stimulus (e.g., cancer cells)
Fibrinogen will be converted to fibrin
Occurs in inflammations involving the body cavities
Histology of fibrin: Eosinophilic meshwork of threads
or amorphous coagulum
Presence of fibrin stimulate the fibroblasts and blood vessels resulting in scarring
Scarring (organization) may result in functional impairment eg: cardiac encasemnt v3-CSBRP-May-2012
The typical “bread and butter” appearance of fibrinous pericarditis. v3-CSBRP-May-2012
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FIGURE 2-19 Fibrinous pericarditis. A, Deposits of fibrin on the
pericardium. B, A pink meshwork of fibrin exudate (F) overlies the
pericardial surface (P).
Fibrinous inflammation
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Morphologic Patterns of Acute Inflammation 1. SEROUS INFLAMMATION
2. FIBRINOUS INFLAMMATION 3. Suppurative inflammation: Abscess
Characterized by large amounts of PUS:
PMNs, Necrotic tissue Edema fluid Bacteria
Abscess: Localized collections of purulent
inflammatory tissue
Histologically: Central core of necrotic tissue Viable leucocytes at the periphery Wall composed of granulation tissue
Walled off by fibrocollagenous tissue
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FIGURE 2-20 Purulent inflammation. A, Multiple bacterial
abscesses in the lung, in a case of bronchopneumonia. B, The
abscess contains neutrophils and cellular debris, and is surrounded
by congested blood vessels.
Suppurative inflammation
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Morphologic Patterns of Acute Inflammation 1. SEROUS INFLAMMATION
2. FIBRINOUS INFLAMMATION 3. Suppurative inflammation: Abscess
4. ULCERATIVE INFLAMMATION:
Def: An ulcer is a discontinuity in the surface epithelial lining or tissue due to sloughing of necrotic cells
Commonly encountered in
Lining epithelia Skin and subcutaneous tissue
Eg: Peptic ulcer, Ophthus ulcers Histologically:
PMN infiltrates at the margins Granulation tissue formation Fibrosis with chronicity v3-CSBRP-May-2012
FIGURE 2-21 The morphology of an ulcer. A, A chronic duodenal
ulcer. B, Low-power cross-section of a duodenal ulcer crater with an
acute inflammatory exudate in the base.
Ulcerative inflammation
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Gastric ulcer v3-CSBRP-May-2012
Gastric
ulcer
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E N D
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