2. It arises in the following setting
1-Progression of acute inflammation
2-Persistant infection e.g. in TB,
syphilis
3-prolong exposure to potentially
toxic material
4-Autoimmune disease
3. The inhaled silica produces an inflammatory reaction that is marked by
prominent fibrosis. Dense pink collagen is seen in the center
4. Characterized by
1-Infiltration with mononuclear inflammatory cells
2-Tissue destruction induce by inflammatory cells
3- Repair (angiogenesis & fibrosis)
6. Chronic inflammatory cells
1-Macrophage
It is monocyte in the extravascular
tissue, it become larger & has
phagocytic ability
7. Macrophage activated by
1- Bacterial endotoxin
2-Mediators produce during acute
inflammation
3-cytokines secreted by sensitized T
lymphocyte
4-Extracellular proteins
e.g. fibronectin
8. Activated macrophage has
1- larger size
2- more lysosomal enzyme
3- more active metabolism
4-Greater ability to kill ingested
organisms
11. Chronic inflammatory cells
2- Lymphocytes
# 2 types B &T both migrate into
inflammatory site via adhesion molecules
& chemokines.
##T Lymphocytes can be activated by
IL-1 & TNF secreted from activated
macrophage
12.
13. Chronic inflammatory cells
3-Plasma cell
Activated B-lymphocyte which
produce antibodies against:
1-antigens in the inflammatory site.
2- altered tissue components.
14. Eosinophils
characteristically found in inflammatory
sites cause by parasitic infections.
or as part of immune reactions mediated
by IgE, (allergies).
15. Mast cells
They are widely distributed in
connective tissues throughout the
body, and they can participate in
both acute & chronic inflammatory
responses.
16. Granulomatous Inflammation
A pattern of chronic
inflammation
characterized by
aggregation of
activated macrophage
which have enlarged,
squamous cell-like
appearance
(epithelioid).
17. Epithelioid cells around the center of a granuloma. they have lots of pink
cytoplasm similar to squamous epithelial cells. Their nuclei tend to be long
18. Morphology of granuloma
In the usual H and E preparations, epithelioid cells in
granulomas have pink, granular cytoplasm with
indistinct cell boundaries.
The aggregates of epithelioid macrophages are
surrounded by a collar of lymphocytes. Older
granulomas may have a rim of fibroblasts and
connective tissue.
Frequently, there is multinucleated giant cells .
19. Granulomatous Inflammation seen in
1-Bacterial infection e.g. TB,
Leprosy ,Syphilis
2-Parasitic infection e.g.
Schistosomiasis
3-Fungal infection e.g. Histoplasma
4-Foreign body e.g. suture material
5- Inorganic metals e.g. Silicosis
6- Unknown e.g. Sarcoidosis
20. Systemic effects of inflammation
acute-phase reaction.
consists of several clinical and
pathologic changes
21. 1-Fever
Bacterial products, such as lipopolysaccharide
(LPS; called exogenous pyrogens), stimulate
leukocytes to release cytokines such as IL-1 and
TNF (called endogenous pyrogens)
Both act to increase the levels of cyclooxygenases
Which convert Archedonic Acids into
prostaglandins.
In the hypothalamus the PGs, especially PGE2,
stimulate the production of neurotransmitters,
which function to reset the temperature set point
at a higher level
22.
23. 2-Elevated plasma levels of acute-
phase proteins
plasma proteins, mostly synthesized in the liver.
concentrations may increase several 100-fold as
part of the response to inflammatory stimuli.
C-reactive protein (CRP), fibrinogen, and serum
amyloid A (SAA) protein.
Synthesis of these molecules by hepatocytes is
up-regulated by cytokines, especially IL-6.
Many acute-phase proteins, such as C-RP bind to
microbial cell walls, and they may act as opsonins
thus promoting the elimination of the microbes.
