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ATHEROSKLEROSIS

Morfologi
Fatty dots
lesi sub endotel 1 mm Lunak Kekuningan

Fatty streaks
elevasi 3 mm s/d 1,5 cm axis vessel

Histologi
foam cells SMCs few T-limfosit ekstraseluler lipid debris

Atheromatous plaque
fibrous cap bentuk ireguler putih keabuan Lokasi :
lower aorta abdominal a. coronary a. poplitea descending aorta thoracalis internal carotid arteri circle of Willis

Complicated plaque

Calcification Fissuring or ulceration Cholesterol emboli / thrombosis Hemorrhage Aneurysma aorta

Fatty streaks

Figure 11-6 Fatty streak-a collection of foam cells in the intima. A, Aorta with fatty streaks (arrows), associated largely with the ostia of branch vessels.

Figure 11-7 Schematic depiction of the major components of well-developed intimal atheromatous plaque overlying an intact media.
Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 20 June 2006 08:17 AM) 2005 Elsevier

Figure 11-9 Histologic features of atheromatous plaque in the coronary artery. A, Overall architecture demonstrating fibrous cap (F) and a central necrotic (largely lipid) core (C). The lumen (L) has been moderately narrowed. Note that a segment of the wall is plaque free (arrow). In this section, collagen has been stained blue (Masson's trichrome stain).

2005 Elsevier Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 20 June 2006 08:17 AM)

Figure 11-9 Histologic features of atheromatous plaque in the coronary artery. B, Higherpower photograph of a section of the plaque shown in A, stained for elastin (black), demonstrating that the internal and external elastic membranes are destroyed and the media of the artery is thinned under the most advanced plaque (arrow).

Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 20 June 2006 08:17 AM) 2005 Elsevier

Figure 11-9 Histologic features of atheromatous plaque in the coronary artery. C, Higher-magnification photomicrograph at the junction of the fibrous cap and core, showing scattered inflammatory cells, calcification (broad arrow), and neovascularization (small arrows).

Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 20 June 2006 08:17 AM) 2005 Elsevier

2. FIBROUS PLAQUE

2. FIBROUS PLAQUE

2. FIBROUS PLAQUE

2. FIBROUS PLAQUE & COMPLICATED LESIONS

Fibrosis kristal Kolester in

Bercak kuning melebar/ luas/membesar

3. COMPLICATED LESIONS

Fibrosis luas di intima Kalsifikasi pembuluh darah Bercak meluas menonjol ulkus

HEMANGIOMA
Neoplasma jinak pembuluh darah / limfe Histopatologi :
1. Hemangioma cavernosa 2. Hemangioma capillaris

Hemangioma cavernosa
Lokasi :
Kulit Mukosa visera :
Hati lien Pancreas cerebellum (von Hippel-Lindau) + lesi red-blue, spongious 2-3 cm

batas jelas tidak berkapsul

Hemangioma capillaris
Lokasi :
Kulit Subkutan mukosa mulut/bibir

Beberapa mm cm merah sampai biru Mudah berdarah Trauma ulserasi

Figure 11-30 Hemangiomas. A, Hemangioma of the tongue. B, Histology of juvenile capillary hemangioma. C, Histology of cavernous hemangioma. D, Pyogenic granuloma of the lip. (A and D, courtesy of John Sexton, M.D., Beth Israel Hospital, Boston; B, courtesy of Christopher D.M. Fletcher, M.D., Brigham and Women's Hospital, Boston; and C, courtesy of Thomas Rogers, M.D., University of Texas Southwestern Medical School, Dallas, TX.)
Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 20 June 2006 08:17 AM) 2005 Elsevier

Figure 11-30 Hemangiomas. B, Histology of juvenile capillary hemangioma. (courtesy of Christopher D.M. Fletcher, M.D., Brigham and Women's Hospital, Boston)

Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 20 June 2006 08:17 AM) 2005 Elsevier

Figure 11-30 Hemangiomas.C, Histology of cavernous hemangioma. C, courtesy of Thomas Rogers, M.D., University of Texas Southwestern Medical School, Dallas, TX.)

Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 20 June 2006 08:17 AM) 2005 Elsevier

MIOKARD INFARK
Ischemis Heart Disease Nekrosis iskemi akut miokard 2 macam :
transmural sub endokard

Transmural
> 2,5 cm seluruh lapisan miokard

Sub endokard
1/2 s/d 1/3 lapisan miokard

MORFOLOGI
Dimulai dari nekrosis koagulasi dan keradangan Diikuti pembentukan jaringan granulasi, resorbsi nekrosis miokardium Diakhiri dengan organisasi granulasi sampai fibrosis

0 2 jam 4 8 jam 18 24 jam 24 72 jam 10 hari Mgg 7 8

: : : : : :

perubahan macros (-) pucat pucat, kadang hiperemi hiperemi, perlunakan sangat kuning fibrosis

URUTAN PERISTIWA INFARK JANTUNG


WAKTU
15 DETIK 30 60 MENIT

MAKROSKOPIS
-

MIKROSKOPIS
OEDEMA

PERUBAHAN
EKG ELEKTRON MIKROSKOPE (+)

2 JAM

HIALINISASI SERABUT (EOSINOFLIK HOMOGEN) PENGELOMPOKAN SARCOPLASMA DEBLEMAU NEKROSIS

Ca ++ HILANG
Na+ ENZYM ASAM SITRAT CPK SERUM

3 JAM
4 JAM

REAKSI TTC (-)

URUTAN PERISTIWA INFARK JANTUNG


WAKTU
6 JAM
9 JAM 18 24 JAM 2 3 MINGGU 5 MINGGU

MAKROSKOPIS
PUCAT*
KUNING KENYAL KUNING KENYAL JARINGAN GRANULASI JARINGAN PARUT

MIKROSKOPIS
REAKSI LEUKOSIT
NEKROSIS MELUAS NEKROSIS LENGKAP JARINGAN GRANULASI JARINGAN PARUT

PERUBAHAN
CPK SERUM

ENZYM SERUM

2 BULAN

PUTIH KENYAL FIBROSIS

JARINGAN PARUT