Inflammation 6

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Inflammation 6

  1. 1. Inflammationand Repair - 6 Dr.CSBR.Prasad, M.D. v3-CSBRP-May-2012
  2. 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. 3. Out comes of Acute InflammationMay have one of three outcomes: 1. Complete resolutionRestoration of inflamed tissue to normalNo loss of cellsNo architectural lossSeen when:Inflammation is short livedThere is little tissue destructionThe tissue can regenerate – eg: liverIt involves:Removal of cellular debris and microbes by macrophages andResorption of edema fluid by lymphatics v3-CSBRP-May-2012
  4. 4. v3-CSBRP-May-2012
  5. 5. v3-CSBRP-May-2012Fulminant fatal acute viral hepatitis
  6. 6. v3-CSBRP-May-2012
  7. 7. Out comes of Acute InflammationMay have one of three outcomes:1. Complete resolution2. 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 clearedIn these conditions connective tissue grows into the area of destruction - ORGANIZATION v3-CSBRP-May-2012
  8. 8. Out comes of Acute InflammationMay have one of three outcomes:1. Complete resolution2. Healing by fibrosis3. Chronic inflammationThis occurs when:• There is persistence of injurious agent• There is interference with normal healing processEg: Peptic ulcer, Complicated pneumonia v3-CSBRP-May-2012
  9. 9. v3-CSBRP-May-2012
  10. 10. Morphologic Patterns of Acute InflammationThe 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. 11. Morphologic Patterns of Acute Inflammation  SEROUS INFLAMMATION  FIBRINOUS INFLAMMATION  SUPPURATIVE INFLAMMATION  ULCERATIVE INFLAMMATION v3-CSBRP-May-2012
  12. 12. Morphologic Patterns of Acute InflammationSEROUS 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. 13. SEROUS INFLAMMATION Catarrhv3-CSBRP-May-2012
  14. 14. v3-CSBRP-May-2012
  15. 15. Vesicular and Bullous Lesions of Poison Ivy v3-CSBRP-May-2012
  16. 16. v3-CSBRP-May-2012
  17. 17. v3-CSBRP-May-2012
  18. 18. Serous inflammationv3-CSBRP-May-2012
  19. 19. Morphologic Patterns of Acute Inflammation1. SEROUS INFLAMMATION2. 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. 20. The typical “bread and butter” appearance of fibrinous pericarditis. v3-CSBRP-May-2012
  21. 21. v3-CSBRP-May-2012
  22. 22. v3-CSBRP-May-2012
  23. 23. Fibrinous inflammationFIGURE 2-19 Fibrinous pericarditis. A, Deposits of fibrin on thepericardium. B, A pink meshwork of fibrin exudate (F) overlies thepericardial surface (P). v3-CSBRP-May-2012
  24. 24. v3-CSBRP-May-2012
  25. 25. Morphologic Patterns of Acute Inflammation1. SEROUS INFLAMMATION2. FIBRINOUS INFLAMMATION3. 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
  26. 26. v3-CSBRP-May-2012
  27. 27. v3-CSBRP-May-2012
  28. 28. v3-CSBRP-May-2012
  29. 29. Suppurative inflammationFIGURE 2-20 Purulent inflammation. A, Multiple bacterialabscesses in the lung, in a case of bronchopneumonia. B, Theabscess contains neutrophils and cellular debris, and is surroundedby congested blood vessels.v3-CSBRP-May-2012
  30. 30. v3-CSBRP-May-2012
  31. 31. v3-CSBRP-May-2012
  32. 32. Morphologic Patterns of Acute Inflammation1. SEROUS INFLAMMATION2. FIBRINOUS INFLAMMATION3. Suppurative inflammation: Abscess4. 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. 33. Ulcerative inflammationFIGURE 2-21 The morphology of an ulcer. A, A chronic duodenalulcer. B, Low-power cross-section of a duodenal ulcer crater with anacute inflammatory exudate in the base. v3-CSBRP-May-2012
  34. 34. v3-CSBRP-May-2012
  35. 35. Gastric ulcer v3-CSBRP-May-2012
  36. 36. Gastric ulcerv3-CSBRP-May-2012
  37. 37. v3-CSBRP-May-2012
  38. 38. v3-CSBRP-May-2012
  39. 39. v3-CSBRP-May-2012
  40. 40. ENDv3-CSBRP-May-2012
  41. 41. v3-CSBRP-May-2012

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