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Morfológia Poškodenia Buniek

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Morfológia Poškodenia Buniek Morphology INTITUTE OF PATHOLOGICAL of cell ANATOMY damage FM CU OVERVIEW Reversible cell damage 1. disorders of protein metabolism 2. disorders of fat metabolism 3. disorders of glucose metabolism 4. disorders of water and mineral metabolism Adaptation 1. hyperplasia 2. hypertrophy 3. atrophy 4. metaplasia Histological slides - hydropic dystrophy of the kidney, amyloidosis, liver steatosis, pancreatic lipomatosis, myocardial hypertrophy, muscle atrophy, prostate hyperplasia, lung metaplasia case studies ⮚Disorder of fat metabolism steatosis lipidosis Regressive ⮚Disorder of glocose metabolism changes glykogenosis diabetes mellitus • Reversible cell damage • It is most often a ⮚Disorder of protein metabolism disorder of cellular metabolism amyloidosis hyaline, mucus, albumin .... • Accumulation of metabolites in the cell ⮚Disorder of mineral and pigment metabolism • Accumulation of calcifications pigments (endogenous, exogenous), minerals Hydropic change of kidney Disorder of mineral metabolism • disorder of oxidative phosphorylation in the cell • hypoxia, toxic damage, cytokines Pathogenesis intracellular accumulation Na → water entry into the cell → swelling mitochondria and endoplasmic reticulum and cell swelling The kidneys are enlarged, the cortex is dilated, and arches slightly above the plane of the incision. The epithelial cells of the renal canals are enlarged, they fill almost the entire lumen, the boundaries are indistinct in places, the nuclei are preserved, the cytoplasm contains granular eosinophilic material, when the grains represent hydropically swollen mitochondria (detection by electron microscope) Amyloidosis Disorder of protein metabolism • pathological deposition of abnormal extracellular protein in various tissues • Clinical classification - focal (Alzheimer's disease, tongue) systemic (involvement of several organs simultaneously) • Historical classification – primary amyloidosis (product of pathological plasma cells) secondary amyloidosis (consequence of chronic decay processes) Diagnostics - Congo red staining, electron microscopy, polarized light Amyloidosis of heart-the heart has a waxy, pale appearance, the tissue is firm Amyloid appears as an extracellular amorphous, hyaline, pale, eosinophilic material in interstitium of the tissue Amyloidosis of the tongue - hematoxylin and eosin (HE) Amyloidosis of the tongue – congo red stain Tongue amyloidosis - Congo red, polarized light Amyloidosis of the lymphatic node Amyloidosis of the kidney Steatosis Disorder of the fat metabolism Intracellular accumulation of fatty substances Etiology • conditions with excessive fat intake (hyperlipidemia) • damage to liver metabolism (alcohol, starvation, chronic diseases, hypoxia, toxins, drugs) makro Liver steatosis Liver steatosis - fat vacuoles in hepatocytes Small droplet steatosis Large droplet steatosis Liver steatosis - Oil red Adaptations • Reversible and functional response to changes in the body • Compensatory mechanisms for various stimuli • Physiological compensation of changing demands on metabolism and functional load on the organism • Increased demands on adaptation (stress) • Adaptive change according to cell type Hypertrophy • increase in cell volume • adaptation of the cells to an increased load by proliferation of intracellular organelles • pseudohypertrophy - compensatory increase in adipose tissue in the organ o physiological (functional) hypertrophy o pathological hypertrophy Left ventricular muscle hypertrophy (normal thickness <15 mm) Hypertrophic myocardium with thickened muscle fibers, with enlarged nuclei, on the pole of the nuclei with the yellow pigment – lipofuscin - consequence of wear. Lipomatosis • is not a "true" regressive change • accumulation of fat cells in the parenchyma as a result of diminished volume of the original tissue • compensatory hyperplasia of fat tissue Kidney lipomatosis with increased pelvic adipose tissue Lipomatosis of the pancreas Adipose tissue between preserved deposits of pancreatic tissue Lipomatosis of the pancreas Atrophy • reversible change • numerical atrophy - reduction in the number of cells (bone marrow) • simple atrophy - reduction in tissue cell volume, organs with a stable cell population o Physiological atrophy - the process of aging o Pathological atrophy Striated skeletal muscle, left partially preserved muscle fibers, right atrophic muscle fibers Hyperplasia • proliferation of tissue and organ cells • hyperplasia together with hypertrophy and hyperregeneration may be among the atypically occurring progressive tissue changes • nodular hyperplasia of the adrenal cortex, hyperplasia of the islets of Langerhans, hyperplasia of the gastric mucosa physiologic prostate hyperplasia of the prostate physiologic endometrium hyperplasia of endometrium Metaplasia • conversion of one differentiated tissue to another tissue type • epithelial metaplasia - squamous, glandular • mesenchymal metaplasia – bone • smoking, gastro-oesophageal reflux, HPV infection of the cervical epithelium, chronic gastritis Respiratory tract - transformation of cylindrical epithelium into squamous Glandular metaplasia in Barrett's esophagus Physiologic gastric mucosa Intestinal metaplasia of the gastric mucosa Combined PAS and AM staining (alcian blue) depicting mucus vesicles in intestinal- type epithelial cells. Squamous metaplasia of the endocervix Bone metaplasia of collagen fibers Apocrine metaplasia in the breast • disorders of cell metabolism are manifested by intracellular accumulations • regressive changes are the most common reversible changes in cellular metabolism Summary • adaptation mechanisms are reversible changes • stable cells adapt to hypertrophy • we distinguish a disorder of the metabolism of proteins, fats, sugars, minerals and pigments Case reports • A 69-year-old obese man with a history of type 2 diabetes mellitus and hypertension • Admitted to hospital for gradually worsening exertional dyspnea - has trouble getting to 1. floor 1. case • he is often tired, tolerates physical exertion poorly • recently, he wakes up a few hours after falling asleep and has to sit down • A 72-year-old patient has a problem with urination. He complains that he cannot empty his bladder "completely", has to urinate 2. case frequently, in small amounts, especially at night. Hyperplasia of the prostate • A 51-year-old perimenopausal patient 3. case started bleeding irregularly • without pre-disease .
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