Granulation tissue.and calcification.31 07-2013

28-05-2014 1

PATHOLOGY PRACTICAL

28-05-2014 2

HISTOPATHOLOGY SLIDES

28-05-2014 3

1.GRANULATION TISSUE.

2.MONCKEBERGS MEDIAL CALCIFICATION.

28-05-2014 4

28-05-2014 5

• GRANULATION TISSUE

–Glistening red, moist connective tissue that contains newly formed capillaries, proliferating fibroblasts and residual inflammatory cells.

28-05-2014 7

• Healing of skin ulcers.

• Pressure ulcer of the skin, commonly found in diabetic patients.

• Skin ulcer with a large gap between the edges of the lesion;

• Thin layer of epidermal re-epithelialization and extensive granulation tissue formation in the dermis

• Continuing re-epithelialization of the epidermis and wound contraction.

28-05-2014 8

28-05-2014 9

28-05-2014 10

• Granulation tissue showing numerous blood vessels, edema, and a loose ECM containing occasional inflammatory cells.

• Collagen is stained blue by the trichrome stain; minimal mature collagen can be seen at this point.

• Trichrome stain of mature scar, showing dense collagen, with only scattered vascular channels.

28-05-2014 11

28-05-2014 12

28-05-2014 13

28-05-2014 14

• At the time of surgery sectioning through the tissue produces tissue damage and interstitial haemorrhage.

• Subsequently, there is repair of the damaged tissue and organisation of the interstitial haemorrhage by granulation tissue.

• Ultimately, the granulation tissue will disappear and be replaced by mature fibrous tissue

28-05-2014 15

• Healing of a fracture is a continuous process but can be divided easily into three stages.

• The first stage is the development of a haematoma at the fracture site and organisation of this haematoma to form granulation tissue known as procallus.

• In the second stage (fibro cartilaginous callus) cells from the displaced periosteal and the endosteum overlying the bone fragments proliferate to form cartilage, fibrous tissue, and woven bone.

• In the third stage the fibro cartilaginous callus is steadily replaced by woven bone to form bony provisional callus.

• In time this bony callus is remodelled along the lines of weight bearing to complete the fracture repair.

28-05-2014 16

MONCKEBERGS MEDIAL CALCIFICATION

Pathological calcification :

Deposition of calcium salts in tissues other than osteoid or enamel.

Dystrophic calcification

Metastatic calcification

28-05-2014 17

• In 1903, Johann Georg Mönckeberg described medial calcification in arteries in predominately older individuals.

• Calcification in the media of peripheral arteries is defined as Monckeberg’s medial sclerosis and can be seen in diabetic and elderly individuals.

28-05-2014 18

Typical hematoxylin-eosin appearance of peripheral artery with so-called Mönckeberg medial sclerosis.

• In addition to the obvious medial calcification, there is calcification of the internal elastic lamina.

• Deeply basophilic, irregular and granular clumps.

• von Kossa stain of 2 less severe cases showing focal calcification of the internal elastic lamina (arrows) in addition to medial calcification that also involves the internal elastic lamina.

28-05-2014 19

28-05-2014 20

28-05-2014 21

28-05-2014 22