NECROSIS


  Dr. R. Geetha M.D.
       Professor
Department of Pathology
         SMC
DEFINITION OF NECROSIS

Spectrum of morphologic changes
that follows cell death in living
tissues.
CAUSES OF NECROSIS

ISCHEMIA
PHYSICAL AGENTS
CHEMICAL AGENTS
IMMUNOLOGICAL INJURY
PATHOGENESIS OF NECROSIS

1.Denaturation of intracellular proteins.
2.Enzymatic digestion of the cell.
MORPHOLOGY
CYTOPLASMIC CHANGES

Increased eosinophilia of cytoplasm
Glassy homogeneous appearance
Cytoplasm is vacuolated,...
NUCLEAR CHANGES

1. KARYOLYSIS
   Fading of basophilia of chromatin
   Due to DNAase activity.
2. PYKNOSIS

Nuclear shrinkage and
increased basophilia
3.KARYORRHEXIS


Fragmentation of pyknotic nucleus
TYPES OF NECROSIS

Coagulative necrosis
Liquefactive necrosis
Caseous necrosis
Fat necrosis
Fibrinoid necrosis
COAGULATIVE NECROSIS
Preservation of general tissue
architecture-tombstone appearance
of the cells.
Affected tissue is fir...
NORMAL   COAGULATIVE
 HEART   NECROSIS
COAGULATIVE NECROSIS HEART
COAGULATIVE
NORMAL KIDNEY
                 NECROSIS
NORMAL SPLEEN   COAGULATION NECROSIS
LIQUIFACTIVE NECROSIS


The tissue becomes liquid viscous
mass
Material is creamy yellow in color
Seen in brain, abscess.
LIQUEFACTIVE NECROSIS BRAIN
LIQUEFACTIVE NECROSIS BRAIN
NORMAL BRAIN   LIQUEFACTIVE NECROSIS
LIQUEFACTIVE NECROSIS BRAIN
GANGRENOUS NECROSIS


Wet gangrene
Dry gangrene
Gas gangrene
WET GANGRENE
 Occurs in moist tissues like mouth, bowel,
lung, cervix
Diabetic foot
Bed sores
WET GANGRENE INTESTINE
WET GANGRENE
DRY GANGRENE

Toes and feet due to arteriosclerosis
Thromboangitis obliterans
Raynaud disease
Trauma
DRY GANGRENE
WET GANGRENE          DRY GANGRENE

 Bowel                Limb
 Venous obstruction   Arterial obstruction
 Moist,swollen,d...
GAS GANGRENE

 Wet gangrene caused by gram
positive anaerobic bacteria
 Seen in muscle and in colon
GAS GANGRENE
CASEOUS NECROSIS

Type of coagulative necrosis
Seen in tuberculous infections
Tissue is cheesy white in appearance
The tis...
CASEOUS NECROSIS LUNG
CASEOUS NECROSIS LUNG
CASEOUS NECROSIS LYMPHNODE
CASEOUS NECROSIS LYMPH NODE
CASEOUS NECROSIS
CASEATION NECROSIS LYMPH NODE
FAT NECROSIS
Seen in pancreas, breast
In acute pancreatitis ,activated
lipase causes fat necrosis.
Grossly visible chalky ...
FAT NECROSIS
FAT NECROSIS
FIBRINOID NECROSIS


Deposition of fibrin like material
 Seen in immunologic cell injury,
hypertension ,peptic ulcer.
FIBRINOID NECROSIS
Necrosis
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Necrosis

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Necrosis

  1. 1. NECROSIS Dr. R. Geetha M.D. Professor Department of Pathology SMC
  2. 2. DEFINITION OF NECROSIS Spectrum of morphologic changes that follows cell death in living tissues.
  3. 3. CAUSES OF NECROSIS ISCHEMIA PHYSICAL AGENTS CHEMICAL AGENTS IMMUNOLOGICAL INJURY
  4. 4. PATHOGENESIS OF NECROSIS 1.Denaturation of intracellular proteins. 2.Enzymatic digestion of the cell.
  5. 5. MORPHOLOGY CYTOPLASMIC CHANGES Increased eosinophilia of cytoplasm Glassy homogeneous appearance Cytoplasm is vacuolated,moth eaten Calcification of dead cells. Appearance of myelin figures Generation of calcium soaps
  6. 6. NUCLEAR CHANGES 1. KARYOLYSIS Fading of basophilia of chromatin Due to DNAase activity.
  7. 7. 2. PYKNOSIS Nuclear shrinkage and increased basophilia
  8. 8. 3.KARYORRHEXIS Fragmentation of pyknotic nucleus
  9. 9. TYPES OF NECROSIS Coagulative necrosis Liquefactive necrosis Caseous necrosis Fat necrosis Fibrinoid necrosis
  10. 10. COAGULATIVE NECROSIS Preservation of general tissue architecture-tombstone appearance of the cells. Affected tissue is firm Denaturation of structural proteins and enzymatic digestion of cells. Example – Heart, kidney,spleen.
  11. 11. NORMAL COAGULATIVE HEART NECROSIS
  12. 12. COAGULATIVE NECROSIS HEART
  13. 13. COAGULATIVE NORMAL KIDNEY NECROSIS
  14. 14. NORMAL SPLEEN COAGULATION NECROSIS
  15. 15. LIQUIFACTIVE NECROSIS The tissue becomes liquid viscous mass Material is creamy yellow in color Seen in brain, abscess.
  16. 16. LIQUEFACTIVE NECROSIS BRAIN
  17. 17. LIQUEFACTIVE NECROSIS BRAIN
  18. 18. NORMAL BRAIN LIQUEFACTIVE NECROSIS
  19. 19. LIQUEFACTIVE NECROSIS BRAIN
  20. 20. GANGRENOUS NECROSIS Wet gangrene Dry gangrene Gas gangrene
  21. 21. WET GANGRENE Occurs in moist tissues like mouth, bowel, lung, cervix Diabetic foot Bed sores
  22. 22. WET GANGRENE INTESTINE
  23. 23. WET GANGRENE
  24. 24. DRY GANGRENE Toes and feet due to arteriosclerosis Thromboangitis obliterans Raynaud disease Trauma
  25. 25. DRY GANGRENE
  26. 26. WET GANGRENE DRY GANGRENE Bowel Limb Venous obstruction Arterial obstruction Moist,swollen,dark Dry, shrunken, black No clear line of Presence of line of demarcation demarcation Bacteria present No bacteria Prognosis poor Prognosis better
  27. 27. GAS GANGRENE Wet gangrene caused by gram positive anaerobic bacteria Seen in muscle and in colon
  28. 28. GAS GANGRENE
  29. 29. CASEOUS NECROSIS Type of coagulative necrosis Seen in tuberculous infections Tissue is cheesy white in appearance The tissue architecture is preserved
  30. 30. CASEOUS NECROSIS LUNG
  31. 31. CASEOUS NECROSIS LUNG
  32. 32. CASEOUS NECROSIS LYMPHNODE
  33. 33. CASEOUS NECROSIS LYMPH NODE
  34. 34. CASEOUS NECROSIS
  35. 35. CASEATION NECROSIS LYMPH NODE
  36. 36. FAT NECROSIS Seen in pancreas, breast In acute pancreatitis ,activated lipase causes fat necrosis. Grossly visible chalky white areas. Presence of shadowy outlines of necrotic cells.
  37. 37. FAT NECROSIS
  38. 38. FAT NECROSIS
  39. 39. FIBRINOID NECROSIS Deposition of fibrin like material Seen in immunologic cell injury, hypertension ,peptic ulcer.
  40. 40. FIBRINOID NECROSIS
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