Necrosis (Basics).pptx

Superior University
Superior UniversityProfessor, Managing Director at Doctors Lab
Necrosis and Apoptosis: Dr Umar Hamid 1
NECROSIS
Dr. Umar Hamid
Lecturer, Program In charge (AHS) Ex-Consultant BSL-III Lab
Department of Allied Health Sciences District Headquarter Hospital
Superior University, Pakistan Sargodha
Necrosis
Cell Injury and Adaptation By: Dr Umar Hamid 2
“Irreversible death of cells or tissues within a living organism, typically as a result of injury, infection, or
inadequate blood supply”.
• It is a pathological process characterized by the breakdown of cellular components and the release of
cellular contents, which can lead to inflammation and further tissue damage.
• Type of cell death, that is associated with loss of membrane integrity and leakage of cellular contents
culminating in dissolution of cells, largely resulting from the degradative action of enzymes on
lethally injured cells.
• Leaked cellular contents often promote a local host reaction, called inflammation.
• Enzymes responsible for digestion of cell, may be derived from lysosomes of the dying cells
themselves and from lysosomes of leukocytes (that are recruited as a part of inflammatory reaction
to dead cells.
• Leakage of intracellular proteins through the damaged cell membrane and ultimately into the
circulation provides a means of detecting tissue-specific necrosis using blood or serum samples.
E.g.
- Cardiac muscle, contains a unique isoform of the enzyme creatine kinase and of the contractile
protein troponin.
Necrosis and Apoptosis: Dr Umar Hamid 3
- Hepatic bile duct epithelium contains the enzyme alkaline phosphatase.
- Hepatocytes contain transaminases.
Irreversible injury and cell death in these tissues elevate the serum levels of these proteins, which
makes them clinically useful markers of tissue damage.
Necrosis and Apoptosis: Dr Umar Hamid 4
Causes
Necrosis can occur due to various reasons, including:
• Ischemia: Insufficient blood supply to an area, leading to oxygen and nutrient deprivation.
• Trauma: Physical injury, such as severe impact or crushing, that disrupts the cells' integrity.
• Infection: Invasion of microorganisms, such as bacteria or viruses, that cause tissue damage and cell
death.
• Toxins: Exposure to harmful substances, like certain chemicals or drugs, that induce cellular damage
and necrotic changes.
• Immunological reactions: Inflammatory responses triggered by autoimmune conditions or
hypersensitivity reactions can lead to tissue necrosis.
Necrosis and Apoptosis: Dr Umar Hamid 5
Types
Different types of necrosis can be classified based on their characteristics and underlying causes. Some
common types include:
1. Coagulative necrosis:
• This type involves the preservation of tissue architecture with a firm texture.
• It occurs primarily in ischemic conditions, such as heart attacks or kidney infarctions.
2. Liquefactive necrosis:
• This form is characterized by the transformation of tissue into a liquid or pus-like consistency. It is
commonly seen in bacterial or fungal infections, particularly in the brain.
3. Caseous necrosis:
• This type is typically observed in tuberculosis infections and presents as a cheesy or granular tissue
appearance.
4. Fat necrosis:
• It occurs when adipose (fat) tissue undergoes necrosis, often due to trauma or inflammation.
Pancreatitis-related fat necrosis is a notable example.
Necrosis and Apoptosis: Dr Umar Hamid 6
5. Gangrenous necrosis:
• This type typically affects limbs and results from a combination of ischemia, bacterial infection, and
tissue death. It can be dry gangrene (coagulative necrosis) or wet gangrene (liquefactive necrosis).
6. Fibrinoid necrosis:
• It is associated with immune-mediated diseases, particularly involving blood vessel walls, such as in
vasculitis.
Necrosis and Apoptosis: Dr Umar Hamid 7
Examples
1. Myocardial infarction:
• A heart attack occurs when the blood flow to a section of the heart muscle is blocked, leading to
ischemic necrosis of the affected heart tissue.
2. Cerebral infarction:
• Stroke can result in necrotic brain tissue due to the interruption of blood supply to a particular brain
region.
3. Gangrenous appendicitis:
• An inflamed appendix can undergo necrosis, leading to gangrenous appendicitis, which often requires
surgical removal.
4. Pressure ulcers:
• Prolonged pressure on specific body areas, such as bedridden patients or wheelchair users, can cause
tissue necrosis, resulting in pressure ulcers or bedsores.
Necrosis and Apoptosis: Dr Umar Hamid 8
5. Frostbite:
• Exposure to extreme cold temperatures can lead to frostbite, which causes tissue damage and
necrosis due to freezing.
6. Severe burns:
• Extensive burns can cause necrosis of the affected skin and underlying tissues, requiring medical
intervention and skin grafting.
Necrosis and Apoptosis: Dr Umar Hamid 9
Morphology
1. Cytoplasmic changes:
• Cells show increased eosinophilia (i.e. pink staining from eosin dye).
• Cells may have a more glassy appearance, homogenous appearance, mostly b/c of loss of glycogen
particles.
• Myelin figures; more prominent.
• Mouth eaten appearance; when enzymes have digested cytoplasmic organelles, the cytoplasm
becomes vacuolated and appears “mouth-eaten”.
• Irreversible damage to mitochondria manifested by severe vacuolization.
• Extensive damage to plasma membrane.
• Massive calcium influx acting as poison for mitochondria.
• Loss of enzymes and proteins due to increased membrane permeability.
• Lysosomal swelling and leakage of enzymes.
Necrosis and Apoptosis: Dr Umar Hamid 10
• Electron microscopy shows:
- Discontinuities in plasma and organelle membrane.
- Marked dilation of mitochondria with the appearance of large amorphous densities.
- Intracytoplasmic myelin figures.
Necrosis and Apoptosis: Dr Umar Hamid 11
2. Nuclear changes: (all due to breakdown of DNA and chromatin)
• Pyknosis:
- Chromatin of dead cell clumps into coarse (rough) strands.
- Nucleus becomes shrunken, dense and deeply basophilic mass & increased basophilia.
- DNA condenses into a solid shrunken mass.
• Karyorrhexis:
- Pyknotic nucleus undergo fragmentation.
- In 1 to 2 days, nucleus in a dead cell may completely disappear.
- Electron microscopy shows nuclear dissolution.
• Karyolysis:
- Basophilia of chromatin may fade.
- Pyknotic nucleus may undergo lysis by enzyme DNAse.
Necrosis and Apoptosis: Dr Umar Hamid 12
3. Fate of necrotic cells:
• May persist for some time or
• May be digested by enzymes and disappear.
• May be replaced by myelin figures (which are either phagocytosed by other cells or further degraded
into fatty acids).
- These fatty acids bind calcium salts, which may result in the dead cells ultimately becoming calcified.
Necrosis and Apoptosis: Dr Umar Hamid 13
1 of 13

Recommended

Causes of cell injury by
Causes of cell injuryCauses of cell injury
Causes of cell injuryAj Cocjin
62.3K views42 slides
Causesofcellinjury by
Causesofcellinjury Causesofcellinjury
Causesofcellinjury Sidal hospital
131 views42 slides
CELL INJURY,ADAPTATION AND DEATH-2.1.pptx by
CELL INJURY,ADAPTATION AND DEATH-2.1.pptxCELL INJURY,ADAPTATION AND DEATH-2.1.pptx
CELL INJURY,ADAPTATION AND DEATH-2.1.pptxPharmTecM
2 views82 slides
APOPTOSIS AND NECROSIS.pptx by
APOPTOSIS AND NECROSIS.pptxAPOPTOSIS AND NECROSIS.pptx
APOPTOSIS AND NECROSIS.pptxDRManasaMariyamJacks
127 views81 slides
Fate of dead cells by
Fate of dead cellsFate of dead cells
Fate of dead cellsMajd Emad
181 views85 slides
cell injury apotosis necrosis.pptx by
cell injury apotosis necrosis.pptxcell injury apotosis necrosis.pptx
cell injury apotosis necrosis.pptxDrmustafa Ali
19 views30 slides

More Related Content

Similar to Necrosis (Basics).pptx

Basic Pathology II.pptx by
Basic Pathology II.pptxBasic Pathology II.pptx
Basic Pathology II.pptxFrancisKazoba
5 views29 slides
lectureoncellinjury-170214073507.pptx by
lectureoncellinjury-170214073507.pptxlectureoncellinjury-170214073507.pptx
lectureoncellinjury-170214073507.pptxvandana thakur
2 views39 slides
Cell injury and Cell death.pptx by
Cell injury and Cell death.pptxCell injury and Cell death.pptx
Cell injury and Cell death.pptxAreesha Ahmad
35 views40 slides
Cell injury, apotosis and necrosis(1) by
Cell injury, apotosis and necrosis(1)Cell injury, apotosis and necrosis(1)
Cell injury, apotosis and necrosis(1)optometry student
5.4K views50 slides
Cell injury, apotosis and necrosis(1) by
Cell injury, apotosis and necrosis(1)Cell injury, apotosis and necrosis(1)
Cell injury, apotosis and necrosis(1)optometry student
4K views50 slides
Cell injury-necrosis by
Cell injury-necrosisCell injury-necrosis
Cell injury-necrosisArmin Eisazaei
3.6K views76 slides

Similar to Necrosis (Basics).pptx(20)

lectureoncellinjury-170214073507.pptx by vandana thakur
lectureoncellinjury-170214073507.pptxlectureoncellinjury-170214073507.pptx
lectureoncellinjury-170214073507.pptx
vandana thakur2 views
Cell injury and Cell death.pptx by Areesha Ahmad
Cell injury and Cell death.pptxCell injury and Cell death.pptx
Cell injury and Cell death.pptx
Areesha Ahmad35 views
Cell injury, apotosis and necrosis(1) by optometry student
Cell injury, apotosis and necrosis(1)Cell injury, apotosis and necrosis(1)
Cell injury, apotosis and necrosis(1)
optometry student5.4K views
Cell death and necrosis by ekta dwivedi
Cell death and necrosisCell death and necrosis
Cell death and necrosis
ekta dwivedi95 views
Ischemia,necrosis,hypoxia by Muhammad Ammar
Ischemia,necrosis,hypoxiaIschemia,necrosis,hypoxia
Ischemia,necrosis,hypoxia
Muhammad Ammar9.3K views
CELL INJURY & CELLULAR ADAPTATIONS - Lecture 7 by Dr. Roopam Jain
CELL INJURY & CELLULAR ADAPTATIONS - Lecture 7CELL INJURY & CELLULAR ADAPTATIONS - Lecture 7
CELL INJURY & CELLULAR ADAPTATIONS - Lecture 7
Dr. Roopam Jain110 views
Introduction to pathology by Jomin George
Introduction to pathologyIntroduction to pathology
Introduction to pathology
Jomin George47.4K views
General pathology lecture 3 cell death or necrosis by viancksislove
General pathology lecture 3 cell death or necrosisGeneral pathology lecture 3 cell death or necrosis
General pathology lecture 3 cell death or necrosis
viancksislove2.3K views
General pathology lecture 3 cell death or necrosis by Za Flores
General pathology lecture 3 cell death or necrosisGeneral pathology lecture 3 cell death or necrosis
General pathology lecture 3 cell death or necrosis
Za Flores27K views
Trauma and cellular injury in pathophysiology by Muhammad Aurangzeb
Trauma and cellular injury in pathophysiologyTrauma and cellular injury in pathophysiology
Trauma and cellular injury in pathophysiology
Muhammad Aurangzeb3.9K views
Cell injury , cell death and adaptation mdc 2021 by aliya yasir
Cell injury , cell death and adaptation mdc 2021Cell injury , cell death and adaptation mdc 2021
Cell injury , cell death and adaptation mdc 2021
aliya yasir139 views

Recently uploaded

Pharma Franchise For Critical Care Medicine | Saphnix Lifesciences by
Pharma Franchise For Critical Care Medicine | Saphnix LifesciencesPharma Franchise For Critical Care Medicine | Saphnix Lifesciences
Pharma Franchise For Critical Care Medicine | Saphnix LifesciencesSaphnix Lifesciences
8 views8 slides
JANUARY 2013-Classical Prescribing.pdf by
JANUARY 2013-Classical Prescribing.pdfJANUARY 2013-Classical Prescribing.pdf
JANUARY 2013-Classical Prescribing.pdfAllen College of Homoeopathy USA
25 views12 slides
LMLR 2023 Back and Joint Pain at 50 by
LMLR 2023 Back and Joint Pain at 50LMLR 2023 Back and Joint Pain at 50
LMLR 2023 Back and Joint Pain at 50Allan Corpuz
324 views77 slides
Pregnancy tips.pptx by
Pregnancy tips.pptxPregnancy tips.pptx
Pregnancy tips.pptxreachout7
40 views10 slides
CAPSULE by
 CAPSULE CAPSULE
CAPSULEGanapathi Vankudoth
62 views24 slides

Recently uploaded(20)

Pharma Franchise For Critical Care Medicine | Saphnix Lifesciences by Saphnix Lifesciences
Pharma Franchise For Critical Care Medicine | Saphnix LifesciencesPharma Franchise For Critical Care Medicine | Saphnix Lifesciences
Pharma Franchise For Critical Care Medicine | Saphnix Lifesciences
LMLR 2023 Back and Joint Pain at 50 by Allan Corpuz
LMLR 2023 Back and Joint Pain at 50LMLR 2023 Back and Joint Pain at 50
LMLR 2023 Back and Joint Pain at 50
Allan Corpuz324 views
Pregnancy tips.pptx by reachout7
Pregnancy tips.pptxPregnancy tips.pptx
Pregnancy tips.pptx
reachout740 views
Top PCD Pharma Franchise Companies in India | Saphnix Lifesciences by Saphnix Lifesciences
Top PCD Pharma Franchise Companies in India | Saphnix LifesciencesTop PCD Pharma Franchise Companies in India | Saphnix Lifesciences
Top PCD Pharma Franchise Companies in India | Saphnix Lifesciences
VarSeq 2.5.0: VSClinical AMP Workflow from the User Perspective by Golden Helix
VarSeq 2.5.0: VSClinical AMP Workflow from the User PerspectiveVarSeq 2.5.0: VSClinical AMP Workflow from the User Perspective
VarSeq 2.5.0: VSClinical AMP Workflow from the User Perspective
Golden Helix67 views
DEBATE IN CA BLADDER TMT VS CYSTECTOMY by Kanhu Charan
DEBATE IN CA BLADDER TMT VS CYSTECTOMYDEBATE IN CA BLADDER TMT VS CYSTECTOMY
DEBATE IN CA BLADDER TMT VS CYSTECTOMY
Kanhu Charan36 views
Blockchain based automatic diagnosis of the 12-lead ECG using a deep neural n... by RajaulKarim20
Blockchain based automatic diagnosis of the 12-lead ECG using a deep neural n...Blockchain based automatic diagnosis of the 12-lead ECG using a deep neural n...
Blockchain based automatic diagnosis of the 12-lead ECG using a deep neural n...
RajaulKarim2099 views
CMC(CHEMISTRY,MANUFACTURING AND CONTROL).pptx by JubinNath2
CMC(CHEMISTRY,MANUFACTURING AND CONTROL).pptxCMC(CHEMISTRY,MANUFACTURING AND CONTROL).pptx
CMC(CHEMISTRY,MANUFACTURING AND CONTROL).pptx
JubinNath27 views
STR-324.pdf by phbordeau
STR-324.pdfSTR-324.pdf
STR-324.pdf
phbordeau16 views

Necrosis (Basics).pptx

  • 1. Necrosis and Apoptosis: Dr Umar Hamid 1 NECROSIS Dr. Umar Hamid Lecturer, Program In charge (AHS) Ex-Consultant BSL-III Lab Department of Allied Health Sciences District Headquarter Hospital Superior University, Pakistan Sargodha
  • 2. Necrosis Cell Injury and Adaptation By: Dr Umar Hamid 2
  • 3. “Irreversible death of cells or tissues within a living organism, typically as a result of injury, infection, or inadequate blood supply”. • It is a pathological process characterized by the breakdown of cellular components and the release of cellular contents, which can lead to inflammation and further tissue damage. • Type of cell death, that is associated with loss of membrane integrity and leakage of cellular contents culminating in dissolution of cells, largely resulting from the degradative action of enzymes on lethally injured cells. • Leaked cellular contents often promote a local host reaction, called inflammation. • Enzymes responsible for digestion of cell, may be derived from lysosomes of the dying cells themselves and from lysosomes of leukocytes (that are recruited as a part of inflammatory reaction to dead cells. • Leakage of intracellular proteins through the damaged cell membrane and ultimately into the circulation provides a means of detecting tissue-specific necrosis using blood or serum samples. E.g. - Cardiac muscle, contains a unique isoform of the enzyme creatine kinase and of the contractile protein troponin. Necrosis and Apoptosis: Dr Umar Hamid 3
  • 4. - Hepatic bile duct epithelium contains the enzyme alkaline phosphatase. - Hepatocytes contain transaminases. Irreversible injury and cell death in these tissues elevate the serum levels of these proteins, which makes them clinically useful markers of tissue damage. Necrosis and Apoptosis: Dr Umar Hamid 4
  • 5. Causes Necrosis can occur due to various reasons, including: • Ischemia: Insufficient blood supply to an area, leading to oxygen and nutrient deprivation. • Trauma: Physical injury, such as severe impact or crushing, that disrupts the cells' integrity. • Infection: Invasion of microorganisms, such as bacteria or viruses, that cause tissue damage and cell death. • Toxins: Exposure to harmful substances, like certain chemicals or drugs, that induce cellular damage and necrotic changes. • Immunological reactions: Inflammatory responses triggered by autoimmune conditions or hypersensitivity reactions can lead to tissue necrosis. Necrosis and Apoptosis: Dr Umar Hamid 5
  • 6. Types Different types of necrosis can be classified based on their characteristics and underlying causes. Some common types include: 1. Coagulative necrosis: • This type involves the preservation of tissue architecture with a firm texture. • It occurs primarily in ischemic conditions, such as heart attacks or kidney infarctions. 2. Liquefactive necrosis: • This form is characterized by the transformation of tissue into a liquid or pus-like consistency. It is commonly seen in bacterial or fungal infections, particularly in the brain. 3. Caseous necrosis: • This type is typically observed in tuberculosis infections and presents as a cheesy or granular tissue appearance. 4. Fat necrosis: • It occurs when adipose (fat) tissue undergoes necrosis, often due to trauma or inflammation. Pancreatitis-related fat necrosis is a notable example. Necrosis and Apoptosis: Dr Umar Hamid 6
  • 7. 5. Gangrenous necrosis: • This type typically affects limbs and results from a combination of ischemia, bacterial infection, and tissue death. It can be dry gangrene (coagulative necrosis) or wet gangrene (liquefactive necrosis). 6. Fibrinoid necrosis: • It is associated with immune-mediated diseases, particularly involving blood vessel walls, such as in vasculitis. Necrosis and Apoptosis: Dr Umar Hamid 7
  • 8. Examples 1. Myocardial infarction: • A heart attack occurs when the blood flow to a section of the heart muscle is blocked, leading to ischemic necrosis of the affected heart tissue. 2. Cerebral infarction: • Stroke can result in necrotic brain tissue due to the interruption of blood supply to a particular brain region. 3. Gangrenous appendicitis: • An inflamed appendix can undergo necrosis, leading to gangrenous appendicitis, which often requires surgical removal. 4. Pressure ulcers: • Prolonged pressure on specific body areas, such as bedridden patients or wheelchair users, can cause tissue necrosis, resulting in pressure ulcers or bedsores. Necrosis and Apoptosis: Dr Umar Hamid 8
  • 9. 5. Frostbite: • Exposure to extreme cold temperatures can lead to frostbite, which causes tissue damage and necrosis due to freezing. 6. Severe burns: • Extensive burns can cause necrosis of the affected skin and underlying tissues, requiring medical intervention and skin grafting. Necrosis and Apoptosis: Dr Umar Hamid 9
  • 10. Morphology 1. Cytoplasmic changes: • Cells show increased eosinophilia (i.e. pink staining from eosin dye). • Cells may have a more glassy appearance, homogenous appearance, mostly b/c of loss of glycogen particles. • Myelin figures; more prominent. • Mouth eaten appearance; when enzymes have digested cytoplasmic organelles, the cytoplasm becomes vacuolated and appears “mouth-eaten”. • Irreversible damage to mitochondria manifested by severe vacuolization. • Extensive damage to plasma membrane. • Massive calcium influx acting as poison for mitochondria. • Loss of enzymes and proteins due to increased membrane permeability. • Lysosomal swelling and leakage of enzymes. Necrosis and Apoptosis: Dr Umar Hamid 10
  • 11. • Electron microscopy shows: - Discontinuities in plasma and organelle membrane. - Marked dilation of mitochondria with the appearance of large amorphous densities. - Intracytoplasmic myelin figures. Necrosis and Apoptosis: Dr Umar Hamid 11
  • 12. 2. Nuclear changes: (all due to breakdown of DNA and chromatin) • Pyknosis: - Chromatin of dead cell clumps into coarse (rough) strands. - Nucleus becomes shrunken, dense and deeply basophilic mass & increased basophilia. - DNA condenses into a solid shrunken mass. • Karyorrhexis: - Pyknotic nucleus undergo fragmentation. - In 1 to 2 days, nucleus in a dead cell may completely disappear. - Electron microscopy shows nuclear dissolution. • Karyolysis: - Basophilia of chromatin may fade. - Pyknotic nucleus may undergo lysis by enzyme DNAse. Necrosis and Apoptosis: Dr Umar Hamid 12
  • 13. 3. Fate of necrotic cells: • May persist for some time or • May be digested by enzymes and disappear. • May be replaced by myelin figures (which are either phagocytosed by other cells or further degraded into fatty acids). - These fatty acids bind calcium salts, which may result in the dead cells ultimately becoming calcified. Necrosis and Apoptosis: Dr Umar Hamid 13