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Inflammation 6
- 1. Inflammation and Repair - 6 Dr.CSBR.Prasad, M.D. v3-CSBRP-May-2012
- 2. Out comes of Acute Inflammation May have one of three outcomes: 1. Complete resolution 2. Healing by fibrosis 3. Chronic inflammation v3-CSBRP-May-2012
- 3. 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
- 5. v3-CSBRP-May-2012 Fulminant fatal acute viral hepatitis
- 7. 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 v3-CSBRP-May-2012
- 8. 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 v3-CSBRP-May-2012
- 10. 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 v3-CSBRP-May-2012
- 11. Morphologic Patterns of Acute Inflammation SEROUS INFLAMMATION FIBRINOUS INFLAMMATION SUPPURATIVE INFLAMMATION ULCERATIVE INFLAMMATION v3-CSBRP-May-2012
- 12. 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 v3-CSBRP-May-2012
- 13. SEROUS INFLAMMATION Catarrh v3-CSBRP-May-2012
- 15. Vesicular and Bullous Lesions of Poison Ivy v3-CSBRP-May-2012
- 19. 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
- 20. The typical “bread and butter” appearance of fibrinous pericarditis. v3-CSBRP-May-2012
- 23. Fibrinous inflammation 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). v3-CSBRP-May-2012
- 25. 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 v3-CSBRP-May-2012
- 29. Suppurative inflammation 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.v3-CSBRP-May-2012
- 32. 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
- 33. Ulcerative inflammation 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. v3-CSBRP-May-2012
- 35. Gastric ulcer v3-CSBRP-May-2012
- 36. Gastric ulcer v3-CSBRP-May-2012