Cellular Injury II

Types of cellular injury

• Chronic reversible lesions
- Intracellular lipid acumulation
 Mi : Hepatic steatosis (fatty change)
- Intracellular accumulation of pigments
 Mi : Jaundice
• Extracellular lesions
 Mi: Hyalinosis of arterioles in kidneys
 Mi: Amiloidosis (Congo Red)
 Steatosis
• Steatosis=Accumulation
of triglycerides in cells
that normally contain
such a metabolit but in a
masked form
• MI-identification
– HE
– Sudan Black
 Hepatic Steatosis
Cross section through liver –HE
•Cytoplasm of hepatocytes contains:
–Small vacuoles with clear
borders around the nucleus
–By fusion of such vacuoles
result clear spaces in the
cytoplasm which can occupy all
the cell (the hepatocyte seem to
be like an adipocyte
–The rupture of adjacent cellular
membranes and the
coalescence of the fat vacuoles
produces fat cysts
Jaundice
• Jaundice = excesive accumulation
of bilirubin in cells and tissues
• Bilirubin = an endogenous
pigment that is a product of heme
degradation
• HE - granular greenish-brown
HE
pigment
• Differential diagnosis with
hemosiderin = endogenous
pigment that contain Fe and
results from the degradation of
heme
– HE- brown-yellow granular
pigment
– Identification - Perls
• hemosiderin appears as a
blue pigment

Hemosiderina-R. Perls
 Icteric liver
2 microscopic aspects

Cross section through liver, HE

– intrahepatocyte
granular pigment –
citoplasma of
hepatocytes contain
bilirubin as small
green – brown
granules
– biliary plugs– the
small bile canaliculi
are dilated and
contain a condensed
mass of bile which is
green-brown; this
appearance is specific
to cholestatic
conditions
 Hyalinosis
• Hyalinosis = intracellular and extracellular
acumulation of hyalin
• Hyalin = is a substance with eosinophilic,
homogeneous appearance that can be intracellular or
extracellular
• Example: hyalinosis of afferent glomerular arteriole –
it appears as a consequence of systemic hypertension
 Hyalinosis of
afferent glomerular
arteriole
• Afferent arteriole – the wall
is thickened, homogeneous,
eosinophilic with narrowing
of the lumen
• Hyalinisation or total
sclerosis of glomeruli
• Tubular atrophy and
interstitial fibrosis leading
to fibrous scars
• The tubules of unaffected
nephrons are dilated and
contain hyaline plugs
 Amyloidosis
• Amyloidosis = extracelular accumulation of
amyloid
• Amyloid = it is a fibrilar proteinaceous
material with chemically diverse structure with
a characteristic cross-β-pleated conformation
• Chemical structure
 95 % fibril proteins
 5% P component
 Amyloid -
ultrastructural

• Physic
structure – linear
nonbranching
aggregated
fibrils arranged
in sheets (like a
network)
 Renal Amyloidosis
• Cross section through liver, HE
• Amyloid deposits
 Basement membrane of the glomerular capillaries
and the mesangial matrix
 Basement membrane of tubules
 The arterioles are also affected
Amiloidoza renală

• The stain for amyloid identification:

Congo Red
 The amyloid is staining in
red-brick
 The deposits show
yellow-green birefringence
when are examined by
polarizing microscope