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CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VASCULAR INFLAMMATION. RESPIRATORY
SYSTEM. INFLAMMATION, TUMORS.
(Endocarditis, Cardiomyopathy, Aortal mukoid mediodystrophy, Nodose polyarteritis,
Lung emfysema, Bronchopneumonia, Lobar pneumoia, Small cell lung carcinoma.
Nasal polyp, Atherosclerosis.)
General Medicine
MUDr. Daniela Kobzová
MUDr.Michal Palkovič, PhD.
MUDr. Svetoslav Štvrtina, PhD.
MUDr. Pavol Janega, PhD.
Department of Pathology, Faculty of Medicine UK & FH
Branch : Staré mesto
Sasinkova 4, Bratislava
Endocarditis
1. Non-rheumatic endocardits
non-infectious
atypical verrucous (Libman-Sacks) – „collagen disorders“; SLE
non-bacterial thrombotic (marantic, cachectic)
infectious
infective bacterial (BE)
acute - ulcerous
subacute – polypous
Complications : cardiac – valve insufficiency, perforation / rupture of valve
leaflets, abscesses formation
systemic – hematogenous spreading of the infection , septic
embolisation, Lőhlein nephritis, toxemia
2. Rheumatic endocarditis (rheumatic fever)
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VESCULAR INFLAMATION.
Ulcerative endocarditis
Ulcerative endocarditis
Polypous endocarditis
Polypous endocarditis (gram)
Myocardial abscess
Myocardial abscess
Myocardial abscess (gram)
Cardiomyopathies
Classification:
Primary cardiomyopathy
idiopatic hypertrophic cardiomyopathy
idiopatic dilated cardiomyopathy
idiopatic restrictive cardiomyopathy
cardiac amyloidosis, endocardial fibroelastosis,
Secondary cardiomyopathy
toxic (toxic chemical, drugs, chronic alcoholism)
metabolic diseases
nutritional disorders
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VESCULAR INFLAMATION.
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy
Dilated cardiomyopathy (FH)
Medial dystrophy of aorta (227)
Pathogenesis : deposits of acid mucosubstancies in the vascular wall
focal separation of fibromuscular and elastic tissue of aortal media
cystic spaces in the media
elastic tissue fragmentation
fibrosis of the media
Complications : Erdheim idiopathic cystic medionecrosis and dissecting aneurysm
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VESCULAR INFLAMATION.
Aortic dissecting aneurysm
Normal aorta (staining for elastic fibers)
Medial dystrophy of aorta (HE)
Medial dystrophy of aorta (staining for elastic fibers)
Medial dystrophy of aorta (alcian blue pH 0.5)
Polyarteritis nodosa (90)
Necrotising vasculitis involving small and medium-sized muscular arteries
Pathogenesis : allergic reaction of immunocomplex type to various agents
Microscopic findings :
acute stage - fibrinoid necrosis of vascular wall with thrombosis, perivascular
inflammation
healing stage – fibroblastic proliferation, granulomas formation
healed stage – dense fibrosis
Complications : ischemic changes of affected tissues
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VESCULAR INFLAMATION.
Polyarteritis nodosa (fibrinoid necrosis of vascular wall, HE)
Polyarteritis nodosa (fibrinoid necrosis of vascular wall, HE)
Polyarteritis nodosa (fibrinoid necrosis of vascular wall, HE)
Polyarteritis nodosa (fibrinoid necrosis of vascular wall, FH)
Polyarteritis nodosa (granulomas, HE)
Polyarteritis nodosa (granulomas, FH)
Pulmonary emphysema (141)
Forms : centrilobular, panlobular, distal, irregular, mixed
Microscopic findings : destruction of alveolar septum
Complication : Cor pulmonale chronicum
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VESCULAR INFLAMATION.
Pulmonary emphysema
Bullous pulmonary emphysema
Rupture of emphysematous bulla
Pulmonary emphysema
Pulmonary emphysema
Pulmonary emphysema (Chronic bronchitis)
Pneumonias (86)
Forms : 1. Lobar pneumonia / 2. Bronchopneumonia (lobular) / 3. Interstitial pneumonia
A. Bacterial pneumonia / B. Primary atypical pneumonia (viral, chlamydias,
mycoplasmal pneumonia)
C. Special types (aspirative, hypostatic, ...)
Pathogenesis : inhalation pathway, aspirative, hematogenous dissemination,
Complication : pneumonia with abscess formation
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VESCULAR INFLAMATION.
Bronchopneumonia
Bronchopneumonia
Bronchopneumonia
Bronchopneumonia with abscess formation
Lobar pneumonia (83)
Stages : 1. Stage of congestion (inflammatory oedema)
2. Red hepatisation (early consolidation)
3. Grey hepatisation (late consolidation)
4. Resolution
Pathogenesis : inhalation pathway
Complications : organisation(repair) - lung carnification, empyema, abscess formation,
hematogenous dissemination of the infection
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VESCULAR INFLAMATION.
Lobar pneumonia
Lobar pneumonia (inflammatory oedema)
Lobar pneumonia (red hepatisation)
Lobar pneumonia (gray hepatisation)
Lobar pneumonia (resolution)
Tumors of lungs
Classification:
I. Epithelial tumors
Benign
Papilloma
Adenoma
Malignant
II. Soft tissue tumors (chondroma, myoepithelioma, ...)
III. Lymphohistiocytic tumors (lymphoma, ...)
IV. Tumors of ectopic origin (malignant melanoma, teratoma, ...)
V. Secondary tumors
KARDIOVASKULÁRNY SYSTÉM. CHOROBY PERIKARDU,
ENDOKARDU, MYOKARDU. ATEROSKLERÓZA,
DYSTROFIE A ZÁPALY CIEV. RESPIRAČNÝ SYSTÉM.
ZÁPALY. NÁDORY.
Malignant epithelial tumors
a) Adenocarcinoma (lepidic adenocarcinoma, ...)
b) Squamous cell carcinoma
c) Neuroendocrine tumors (small cell carcinoma, ...)
d) Large cell carcinoma
e) Adenosquamous carcinoma
f) Carcinosarcoma
g) ...
Localisation: central (often hilous), peripheral, „Pancoast tumor“ in apex of lungs
Etiology: smokers
Komplikácie : rapid lympho- and hematogenous dissemination
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VESCULAR INFLAMATION.
Periferal carcinoma of lungs
Central carcinoma of lungs
Small cell (oat-cell) carcinoma of lungs
Small cell (oat-cell) carcinoma of lungs
Small cell (oat-cell) carcinoma of lungs
Small cell (oat-cell) carcinoma of lungs
Small cell lung carcinoma overgrowth on epicardium and into myocard
Small cell lung carcinoma overgrowth on epicardium and into myocard
Metastasis of small cell lung carcinoma into the liver
Metastasis of small cell lung carcinoma into the liver
Squamous cell lung carcinoma with central necrosis
Squamous cell lung carcinoma
Squamous cell lung carcinoma with squamous „pearls“
Squamous cell lung carcinoma with squamous „pearls“
Squamous cell lung carcinoma with individual cell keratinisation
Squamous cell lung carcinoma (atypic mitosis)
Lepidic adenocarcinoma (bronchiolo – alveolar carcinoma) (279)
• cuboidal to tall columnar cells growing along the existing alveoli
• numerous papillary structures
KARDIOVASKULÁRNY SYSTÉM. CHOROBY PERIKARDU,
ENDOKARDU, MYOKARDU. ATEROSKLERÓZA,
DYSTROFIE A ZÁPALY CIEV. RESPIRAČNÝ SYSTÉM.
ZÁPALY. NÁDORY.
Lepidic adenocarcinoma (bronchiolo - alveolar lung carcinoma) (279)
Lepidic adenocarcinoma (bronchiolo - alveolar lung carcinoma) (279)
Lepidic adenocarcinoma (bronchiolo - alveolar lung carcinoma) (279)
Lepidic adenocarcinoma (bronchiolo - alveolar lung carcinoma) (279)
Nasal polyps (238)
• usually associated with chronic hypertrophic rhinosinusitis
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VESCULAR INFLAMATION.
Nasal polyp
Nasal polyp
Atherosclerosis (66)
• changes occurs on the intima of elastic and muscular arteries
Stages : 1. Fatty streaks and dots
2. gelationous lesions
3. atheromatous plaques (fibromuscular, fibrolipid, atheromas)
4. complicated plaques (calcification, ulcers, thromosis, bleeding in the plaque,
aneurysms formation)
Complications : ischemic changes of the affected tissues and organs
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VESCULAR INFLAMATION.
Atherosclerosis of abdominal aorta
Atherosclerosis of abdominal aorta (ulcers)
Atherosclerosis of coronary arteries
Diseminated myofibrosis of heart
Diseminated myofibrosis of heart
Atherosclerosis of the coronary arteries and myofibrosis of heart (FH)
Scar after an acute myocardial infarction
Scar after an acute myocardial infarction
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