pathology

1. DR.M.OSMAN KHAN
• SENIOR DEMONSTRATOR
• Deptt: of PATHOLOGY
• NISHTAR MEDICAL COLLEAGE
MULTAN

2. Cell Injury

3. GENETIC CAUSES
ACQUIRED CAUSES

4. Acquired causes
• Hypoxia and Ischemia
• Physical Agents
• Chemical Agents
• Microbial Agents
• Immunological Agents
• Nutritional
• Psychological

5. Pathogenesis of Cell Injury
Agent – Type, Duration
Severity
Target Cell – Type,
Adaptability

6. Types of Cell Injury

7. Reversible

8. Less ATP production
Reduced pH
Damage to Na pump and Plasma
membrane.

9. Irreversible

10. Persistence of Ischemia/Hypoxia
‘Point of No Return’

11. Mitochondrial Damage
Disturbed Cell membrane
Lysosomal Rupture

12. Free Radicals
Superoxide (O’2)
Hydrogen Peroxide (H2O2)
Hydroxyl Radical (OH’)

13. Hydroxil radical – Most reactive
Produces membrane damage by,
LIPID Peroxidation
PROTEIN Oxidation
DNA Damage
Cytoskeletal damage

14. Anti-Oxidants
Inactivates Free Radicals
Ex:
Vitamine: A, C, E
Cysteine, Glutathione
Ceruloplasmin & Transferrin
Enzymes: Superoxide dismutase, Catalase,
Glutathione peroxidase.

15. A C E

16. Morphology
of Cell Injury

17. Morphology of
Reversible cell Injury
“Degeneration”
“Retrogressive change”
“Reversible cell injury”

18. Cellular swelling
Hyaline change
Fatty change
Mucoid change

19. CELLULAR SWEELING
Commonest and Earliest form
of Cell injury
Cloudy change
Hydropic change
Vacuolar degenration

22. Causes of Cellular swelling –
Bacterial toxin,
Chemicals,
Poisons,
 Burns,
High fever
“Impaired regulation
of cellular volume”

23. Gross:
Kidney,
Liver, Heart,
Muscles enlarged
M/E:
Swollen cells Small clear vacuoles

24. Hyaline change
Hyaline – Glass like
Homogenous , pink material
Intracellular –
1. Droplets in PCT
2. Zenkers degeneration
3. Mallory’s hyaline – liver cells – alcohol
4. Russel bodies – Plasma cells

27. Extracellular Hyaline
1.Old scar
2.Arteriosclerosis
3.Leiomyomas of uterus

28. Mucoid change
Mucin , a glycoprotein
Normaly produced by mucous membrane
An Mucus glands
Epithelial mucin = PAS + ve
Connective tissue mucin = PAS – ve
With Alcian blue : both + ve

29. Epithelial mucin :
1. Catarrhal inlfammation of mucous membrane
2. Mucocele
3. Mucin secreting tumours of ovary, stomach
Connective tissue mucin
1. Myxoid degeneration of tumours
2. Dissecting aneurysm of aorta in marfans
3. Myxoid change in ganglion of wrist

30. Fatty change
Seen in
LIVER
Kidneys
Heart muscles

31. et

36. Fatty change – Steatosis
• LIVER’ most common site.
• Alcohol’ abuse is the most common
etiology of fatty change that results in
• Fatty liver

37. Causes of Fatty change
ALCOHOL
Malnutrition
Obesity
DM
Liver toxins – CCl4

38. THANKS