Upload
firat-guellue
View
2.481
Download
20
Tags:
Embed Size (px)
DESCRIPTION
Medical University Of Sofia Pathology Slides In English(Little bit bulgarian too:)
Citation preview
1
1
1-Necrosis renis /№ 34. Infarctus anaemicus renis/.
Anemic infarction of the kidney develops in blockage of some of the branches of renal areteriya - obiknovino of embolism, resulting in ischemia occurs with subsequent necrosis of the renal parenchyma in the relevant section. It is a coagulation necrosis, presented in a section of the body with preserved structure in which the visible shadows of glomeruli and tubules. In cells lacking nuclei tubes and homogenized cytoplasm, intense pink colored XE. Disappear cellular details can be seen only vaguely delineated cell borders. Morphological features of necrosis are different phases of nuclear fission: homogenization (compaction) of the nuclear chromatin - karyopycnosis, degradation of nuclei presented in the form of pellets - karyorrhexis and complete disappearance in necrotic cells - karyolysis. Affected cell and tissue structures are homogenized granular cytoplasm and stained more intensely than eozina. Around the area of necrosis is hiperemichnohemoragichnata area consisting of dilated blood vessels and bleeding. Near it there is segmented shaft of leukocytes, which may be missing in early stages. Adjacent renal tissue is found with a fully preserved structure.
2. Necrosis pulmonis /№ 58 Bronchopneumonia tbc caseosa./
Kazeozna necrosis of the lung is most commonly seen in kazeozna bronchopneumonia or in the center of granulomas formed in tuberculosis. It is represented by nonstructural, drebnozarnisti areas completely deleted sinkavorozov alveolar structure and color of stain H & E. Among the nonstructural fields can be monitored and blue colored remnants of nuclear
2
2
chromatin resulting from karyorrhexis. Around the necrotic zone are macrophages, monocytes that migrated from the blood flow in relation to the cellular response to chronic irritation. They are formed epiteloidni cells with oval nuclei and pale pink cytoplasm. With its form and arrangement they resemble epithelial cells, where labeled cells si.Sred epiteloidnite meet multicore type giant cells "Langhans" resulting from the merger of several epiteloidni cells. Their nuclei are located along the periphery of the cell in the form of a horseshoe with an opening to the central necrosis of the periphery of the granuloma are described T lymphocytes forming etc. lymphocyte shaft.
3. Necrosis lymphonodi. (=№58 Tuberculosis lymphonodi)
The process is represented by a centrally located area of necrosis in kazeozna lymph node - a large, structureless, rose-colored mass, which one can see the blue colored drebnozarnisti fragments of nuclear chromatin. About kazeoznata necrosis are characteristic features of spindle cell epiteloidni ordered palisades / boards as a fence /. Among them are found Multinucleated giant cell type "Langhans. Under the fibrous capsule of the lymph node on the periphery of the necrotic area is visible reserved lymph follicles.
Казеозна некроза
Giant type cells
„Langhans”
3
3
4. Necrosis myocardii /=№35 Infarctus anaemicus myocardii).
This study demonstrates the preparation ischemic / anemic / coagulation necrosis in the myocardium as a result of stopping the blood flow, due mostly to the blockage of coronary artery by a clot or prolonged vasoconstriction. In anemic / white / myocardial infarction was observed well homogenized limited area of cardiomyocytes, which have lost their transverse nabrazdenost and stained more intensely than eozina. Nuclei are not clearly visible. Among the necrotic cardiomyocytes reserved visible elements of the interstitial connective tissue and blood vessels from the shadows. After 6 to 8 hours of initial clinical manifestation of myocardial necrotic fields are separate from the surrounding tissue through etc. hyperemic-hemorrhagic area represented by dilated blood vessels and bleeding, and later by inflammatory leukocytes segmented shaft.
Казеозна некроза
Giant type cells
"Langhans"
4
4
5. Necrosis cerebri /=№ 36. Infarctus anaemicus cerebri –
encephalomalacia.
It is for anemic infarction due to obturation of the thrombus or thromboembolism artery in the brain. Necrosis is kolikvatsionen type, characteristic of cells and tissues poor in protein and rich in water and lipids. When hypoxia occurs the death of brain cells, which is manifested by "softening" of brain matter, etc. encephalomalacia. Microscopy in the area of necrosis is seen stretch of pale pink colored, homogeneous, structureless granular matter with a view or as a single thread veins. Gangliyni and glial cells, and nevrofibrili not observed. On the border with preserved tissue are very large cells with bright nuclei and sometimes piknotichni swollen, vacuolated cytoplasm, which detect lipids and brown pigment / hemosiderin. The same is formed by the disintegration of erythrocytes in the hearth of necrosis and their phagocytic glial cells. These cells are ingested and dissolved lipids of myelin sheath. They are marked as lipofagi (psevdoksantomni cells) and cells derived from mikrogliyata. When staining for lipids in Sudan III kriostatni cuts on their cytoplasm are stained yellow-orange. If fatalities occur after receiving the attack (stroke), the process of necrosis ends with the formation of glial scar formation or a pseudocyst. Years later when an autopsy can be found psevdokistata attesting spent cerebral infarction.
5
5
6. Emphysema pulmonis.
Pulmonary emphysema is a process of destruction and dilation of the airways distal to terminal bronchioles. In the most common form - panatsinaren histological picture of emphysema in the lung is represented by: - Advanced respiratory bronchioles, alveolar moves alveoli and pores of Cohn. - Destroyed mezhdualveolarni baffle. - Thin alveolar walls, poor in elastic fibers. - Reduced number and poor alveolar capillary wedge kravonapalneni. - In the alveoli and alveolar interstitial macrophages are loaded with pigment antrakotichen / koniofagi /.
pseudocyst
6
6
7. Atrophia fusca hepatis.
Brown atrophy of the liver is observed in the course of diseases associated with failure and inferiority of nutrition: idiopathic pyloric stenosis or gastric / doudenalna ulcer, cancer of the stomach and esophagus, cachexia, incl. and senile, diseases of the endocrine glands etc.. Macroscopically, the liver is reduced in size to brownish, thickened and sharp edge. Histological picture is represented by thin gredichki liver, mainly in centrilobular areas. Delchetata are reduced in size and portal spaces appear dilated. Hepatocytes around v. centralis are reduced in size (atrophic) in the cytoplasm, perinuklearno, there is accumulation of
7
7
yellow-brown pigment - lipofuscin.
8. Cell swelling / Dystrophia parenchymatosa renis /
Home of the cell damage due to most of the effects of hypoxia, toxic or infectious factors. It is for intracellular edema. The process is reversible upon removal of etiopatogenetichniya factor. With persistence, the impact goes into a severe severe cellular or tissue damage, incl. and necrosis. Most often this process occurs in the epithelial cells of proximal convoluted tubule of the kidney. The boundaries between cells are not well visible. Ducts are enlarged, and their lumens are irregular because they prominirane of swollen epithelial cells that stained intensely for XE are colored pink. In the process progresses in the cytoplasm may form vacuoles representing dilated cisterns of endoplazmatichniya reticulum. Hence the name or vakuolerna hidropichna dystrophy - a more advanced stage of intracellular edema.
8
8
9.Corpus albicans ovarii.
It is a physiological delay in involyuiralite yellow hyaline bodies in the fibrous stroma of the ovary. Because macroscopic deposition of hyaline in them they become white, and where bear its name. White bodies are final phase in the evolution of the Graafian follicle. Under the microscope appear as homogeneous pink-colored eozina of nonstructural forms. Their bodies are well-demarcated from the surrounding tissue folded in the form of swag border, tend to lobubirane.
№ 10. Fibrinoidna necrosis (bottom of a stomach ulcer). The product is an example of local deposition of fibrinoid necrosis in the mucous membranes in the case at the bottom of chronic stomach ulcer. The
Проксимални
тубули
гломерули
9
9
process is referred to as fibrinoidna necrosis and is a sign of exacerbation of the ulcer. Pathological findings is the result of changes in collagen fibers under the influence of end-of-vessels plazmenni protein albumin, globulin and fibrinogen. In this process, receive solid, insoluble compounds, stained pink from eozina who perished together with local cells form a layer fibrinoidnata necrosis. There remain four areas of the plague - surface, consisting of cellular detritus and inflammatory exudate of segmented leukocytes, fibrinoidna necrosis zone, represented by pink and blue uniform stripe layer of granulation tissue which is located in a mature fibrous tissue.
Fibrinoid
Necros(Fibrinoid)
10
10
11. Hyalinosis arteriolarum renis
The process is subendotelno hyaline deposition in the walls of arterioles as a result most of arterial hypertension. In preparation is presented in the deposition of hyaline walls of small arteries and arterioles of the kidneys. Vascular walls are unevenly thickened, homogeneously pink colored HE. Depending on the severity of their lumens process with varying degrees of narrowing. The worst injured were the walls of glomeruli privodyashtite vessels - arterioles in their vascular pole (vasa afferens), which can be seen in cross-section as pink rings.
11
11
12. Amyloidosis renis (HE).
Amyloid appears as a homogeneous, pink colored by eozina, structureless
substance in renal structures. Glomeruli are affected to varying degrees - from the
homogenization of individual capillaries in the early stage, to cover all the
glomeruli of the process. Damaged glomeruli are larger than normal as a result of
their accumulation of abnormal protein. Shows the preparation and accumulation
of pink colored protein in the walls of vessels of medium and small caliber and in
the basal membrane of the seminiferous that are thickened. The process leads to
fatty degeneration in epithelial cells them due to chronic hypoxia associated with
reduction in glomerular blood flow. Fatty degeneration of the epithelial cells of
proximal tubules is the cause of macroscopic findings "ren albus".
12
12
13. Amyloidosis renis (MV).
In preparation for staining with metilviolet property is used to amyloid
metahromatichno colors of some aniline dyes. The process is called
metahromaziya violet paint colors metilviolet amyloid selectively in red and other
tissues retain its main blue-violet color. Histologically all structures, with
enlarged size of the amyloid deposits are stained red. / Parts or whole glomeruli
glomeruli, vessel walls and basement membrane of ducts /.
13
13
14. Amyloidosis lienis (HE).
Deposition of amyloid in the spleen may be focal in the form of homogeneous pink-colored lymph follicles with eozin / t.n.sagova spleen / or as diffuse deposits in the walls of the sine wave and connective network of the red pulp / Ham-derson spleen /. The name derives from the spleen Sagova its macroscopic appearance - when she cut dotted with small whitish nodules, like grains of sago. In preparation demonstrate hearth deposition in follicles that are enlarged. Centrally located follicular arteries affected by the process are also homogenized, thickened with pink colored walls.
14
14
15. Amyloidosis lienis (MV).
Stained with metilviolet deposits in lymph follicles and their central arteries amyloid is red, and other tissues are blue-violet. This method is used for proof of amyloidosis in differential diagnosis with other processes.
15
15
16.Carcinoma gelatinosum (HE).
The presented case is a demonstration of glandular cancer /
adenocarcinoma / intracellular and extracellular sluzoobrazuvane. In the
malignant transformation of glandular cells due to impaired metabolism of
glikoproteidite they occur nekotroliruema production of mucus. In the early form
intracellular mucus vacuoles. Later they merged to form a mucus drop, forcing
the core to the periphery of the cell. It begins to look like a "ring with a stone."
Thoroughly congested with mucus cells die and form lakes of mucus, dyeing
basophilic - in sinkavovioletov color. Among them. visible single cell type "ring
with a stone."
16
16
17.Carcinoma gelatinosum (alcian blau ).
Glikoproteidite are complex organic compounds of proteins with polymerized hydrocarbons. Depending on their location, in violation of their metabolism accumulate neutral or acidic mucopolysaccharides. An example is again zhelatinozniyat, mucus producing adenocarcinoma. Preparation indicates the presence of acid mucopolysaccharides in tumor cells and lakes of mucus around them has been used to color blue altsianovo their demonstration. Histologically visible blue-green mucus sections and single cancer cells with blue stained mucus droplets.
17
17
18. Mucoviscidosis pancreatis.
Cystic Fibrosis / cystic fibrosis / a hereditary disorder of epithelial transport of chloride ions in mucus secretion in exocrine glands and the lining of the respiratory, gastrointestinal tract and pancreas In this case, the process affects pancreatic ductal cells from which the component produced exceptionally phlegm, blocked outgoing channels of the gland. They are expanding due to fluid retention with subsequent formation of retention cysts. The process is coupled with glandular atrophy and fibrosis around the canals. The preparation is described seeing changes - mostly dilated ducts filled with mucus retention periduktalnata fibrosis and cysts containing mucus pink homogeneous material.
18
18
19. Nаevus pigmentosus.
Pigment nevus is congenital or acquired benign neoplasm originating from dendritic melanocytes localized in the basal layer of epidermis. In this case it is seen as an example of impaired metabolism of aboriginal pigment melanin produced by dendritic melanocytes. Nevus can occur in various forms but the most common are: border, dermal, complex, spitz nevus, and nevus dizplastichen. In this case demonstrates dermal nevus. In melanocytes proliferate as it shaped nests in the epidermis. Usually they contain brown granules of melanin, the pigment but may not be evident. The nests are composed of uniform round or polygonal cells drained, with homogeneous or slightly granular cytoplasm and large round or oval nucleus. Nevus can give early malignant pigmented tumors - malignant melanoma.
20. Induratio fusca pulmonis (HE)
The process demonstrates the local deposition of haemosiderin in the lungs in chronic left heart failure (especially in congenital or acquired in later defects of the mitral valve). As a result of chronic venous stasis in the alveolar capillary wedge there is hypoxia, which leads to damage of endothelial cells and their permeability to increase. By diapedeza erythrocytes appear in the lumen of the alveoli, where phagocytosed by macrophages located there, in this case denoted as hemosiderofagi. In their hemoglobin is converted into ferritin, which aggregates in zlatistokafenikavite hemosiderin granules. Meanwhile, hypoxia leads to proliferation of fibroblasts to produce collagen and thickening of the
епидермис
19
19
alveolar walls. In the alveoli and the interstitial are many hemosiderofagi. Hemosiderofagite can be found in the sputum of patients as a diagnostic test and therefore are called cells of the heart defect (Hertzfehlercellen).
20
20
21.Induratio fusca pulmonis (Histochemical reaction to
demonstrate the Fe + + in the structure of hemosiderin).
To prove the nature of the postponed in brown induration of lung pigment / hemosiderin / used histohimichnata Max Perls reaction and with ferotsiankalii tsolna kitselina etc. Berlin blue. Hemosiderinat turns sinkavozeleno. Histologically observed glaucous granules in the cytoplasm of siderofagite located in the lumen of the alveoli.
21
21
22.Icterus renis. With increased level of bilirubin was observed in the deposition of the seminiferous epithelium, Henle's loop and more rarely in these legal and collecting tubules of the kidney. In the affected cells are found small greenish-brown grains. In the later stage these cells in the lumen of husked and ducts with bile acids and bile salts form cylinders. The epithelial cells of the proximal part of nephron develop dystrophic and necrotic changes, which represent the morphological equivalent etc. hepato-renal syndrome.
22
22
23.Anthracosis pulmonis The product is an example of exogenous pigment deposition in the lung - coal dust. Inhaled dust particles smaller than 5 microns mukotsiliarnata overcome the barrier of traheobronhialnoto tree and reach the alveoli where phagocytosed by alveolar macrophages. Phagocytosed dust particles, they are called macrophages koniofagi and the process is referred to as antrakoza. Histologically visible koniofagi whose cytoplasm contained black powder inclusions. After the death of koniofagite antrakotichniyat pigment is deposited in the interstitial connective tissue - in the walls of the alveoli, in the course of Sep subplevrano, peri-bronchially.
24. Steatosis hepatis = Dystrophia adiposa hepatis (HE).
Otlaganeto at lipidi under the format trigliceridi in černiâ CE
nablûdava when fraction uvreždaniâ toksični hipoksični s″stoâniâ, zaharen,
diabetes, zatl″stâvane, etc. and CE označava Kato steatoza. Kasai Xie nay-
frequently for natrupvaneto in hepatocitite under the format kapčici, koito when
ocvetâvane with hemalaun eozin se viždat Kato optically prazni vacuoles, t″j
Kato with his SA ekstrahirani parafinovata processing of alkohola. In zavisimost
from goleminata, Breu and razprostranenieto in hepatocitite černodrobnata
steatoza se podrazdelâ to ogniŝna and difuzna, drebnokapčesta and edrokapčesta.
Histologično strukturata to černiâ fraction (e) well. In the portalnite space
hepatocitite zonite about fatty vacuoles and s″d″ržat tezi at centralnite at delčetata
near centralnite CA Veni a comparatively s″hraneni. Zonalnoto otlagane to
mazninite dependence of proces″t, kojto go e predizvikal. When hipoksiâ
obiknoveno SA zasegnati centrolobularnite zone, toksični v″zdejstviâ, buying
uvreždaŝiât on the kr″vniâ current agent idva e steatozata periportalnite zone at
delčetata. Obilnoto natrupvane to dovede to trigliceridi can obrazuvaneto on Yes
23
23
fatty brushes and sm″rt at hepatocitite. Nekrozata predizvikva v″zpalitelna format
hroničen response under hepatit, kojto Mauger da premine in cirrhosis. Tak″v
process nablûdava with hroničen alkoholiz″m CE. Hepatociti steatoza s″s da CE
sreŝnat when you can virusen with hepatit and različni uvreždaniâ, toksični and
lekarstveno included obusloven hepatit.
25. Dystrophia adiposa hepatis (Sudan III ).
Demonstration of lipids in hepatocytes is implemented using kriostatni
cuts only on fresh or fixed in formalin material, but not on vlklyucheni
histologically in paraffin processed tissue fragments. Thus, the material does not
pass into alcoholic solutions, lipids do not dissolve and can be colored with
lipoboi. The most commonly used method is coloring Sudan III, where the lipids
are visualized as orange-drops in the cytoplasm of hepatocytes.
24
24
26.Аtheromatosis aortae (HЕ)
It is for cholesterol deposition, holesterinovite esters and neutral fat in the
arteries of the intimate. Etc. are formed atherosclerotic plaques, which have three
main components:
A. cellular composition - mainly smooth muscle, macrophages and T -
lymphocytes
2. extracellular matrix including collagen, elastic fibers, proteoglycans and
3. intra-and extracellularly deposited lipids, cholesterol crystals
These components are found in different proportions and configurations for
different lesions. Most often the surface of plaques in the aorta ateromatoznite
visible fibrous layer ("top") composed of smooth muscle cells and relatively
dense collagen. Below it is the necrotic core of plaque, etc.. etc. athera,
containing lipids, cholesterol and cholesterol esters, detritus from dead cells and
foam cells. In the periphery of the lesion is an area of neovascularisation,
proliferation of small blood vessels. In advanced atherosclerotic plaques are
found in calcifications. On histological preparation of the aorta is seen splitting
cadovata wall between intimate and media blanks and optical processing of
soluble holesterinovite crystals and
25
25
lipids.
27. Atheromatosis aortae (Sudan III).
Suspended lipids in the aortic wall was demonstrated to freezing kriostatni cuts
on non-fixed formalin material. In the artery wall are displayed orange-drops and
crystals in place of suspended cholesterol and cholesterol esters.
Холестеролови
кристали
26
26
28. Thrombus mixtus .
Thrombosis is the process of prizhizneno clotting of blood formation in
the lumen of the vessels and cavities of the heart stoppers composed of elements
of blood.
On histological preparation is seen transversely cut vascular wall and
anchor the thrombus located in the lumen her very clear ivitsestiyat construction
of thrombi due to delay stratification of blood is so elementi.Vizhdat lines of
Zahn. Adjacent to the vessel wall are pale pink colored uniform tables
drebnozarnista structure containing razpadnati platelets. Between platelet layers
are deposited segmented leukocytes, whose nuclei are stained blue by hemalauna.
Erythrocytes are distributed unevenly in different parts of mixed thrombus and
stained by eozina in reddish color. In addition to blood cells in the mixed
thrombus contains fibrin and deposited in the form of fine threads between
cellular elements stained with hemalaun eozin they are clearly seen among
erythrocyte masa.Fibrinat can easily be proved if the product is colored by
Weigert, demonstrate is a sinkavovioletov color.
29. Thrombus organisatus canalisatus.
A favorable outcome of vascular thrombosis, organization and sanitation of
thrombotic mass. From the vascular wall starts sprouting of young mesenchymal
cells and newly formed capillaries with endothelial juicy. Along with the
organization in thrombus occurring processes of decay and destruction of its
components: the lysis of leucocyte nuclei, hemolysis of erythrocytes,
homogenization and dissolution of fibrin fibers. In thrombus forming slits in
which the periphery enter mesenchymal cells and capillaries. He became
Free Wall
27
27
multicellular, richly vascularised young granulation tissue which matures later,
with the growth of collagen fibers. Part of obliterating the capillaries, the other
extended. The functional load leads to thickening of capillary walls and
endoteliziranite slits, resulting in vascular walls are formed with smooth muscle
and elastic fibers, ie be designed structurally and functionally complete vessels
that restore blood flow interrupted.
28
28
31. Infarctus haemorrhagicus pulmonis.
Hemorrhagic infarction is necrosis, which develops in organs with
dual blood supply in terms of blood zastoy.Takav example is hemorrhagic
infarction of the lung.
It is an illustration of necrosis of the lung occurring as a result of
embolism of thrombi in the branches of the pulmonary artery, originating mostly
from the veins of the leg or pelvic venous plexuses.
Histologically visible necrotic cavity with walls filled with
erythrocytes, and kravonapalneni broken capillaries. Besides interstitial alveoli is
also covered by the hemorrhage. The center of the infarct structure of the alveoli
may completely disappear, to talk about what occurred difinitivno
nekroza.Otkrivat are blood vessels with thrombi in the lumen im.V border areas
of infarction and preserved lung tissue alveoli are filled with erythrocytes,
desquamation epithelial cells and siderofagi showing previous chronic venous,
stasis, and swollen technost.Ako heart attack at the periphery of the lung pleural
reaction occurs with deposition of inflammatory infiltrate rich in fibrin.Razviva
fireplace is fibrinous pleurisy.
тромб
29
29
32. Cyanosis hepatis.
Venous hyperaemia or cyanosis hepatis is a brief stagnation of blood in the
venous system of the liver.
Etiological factors involved in the development of congestive plethora may be
presented raznoobrazni.V case preparation for circulatory disturbances of cardiac
origin, which occurs due to stagnation of blood in the liver, initially in v.hepatica,
and later in still smaller branches, including in vv. centrales
The central veins are dilated in delchetata and kravonapalneni.Poradi expiry of
blood elements still making material for histological examination some central
veins remain completely free, but highlighted changes in form and goleminat of
lumens. Venous stasis leading to urinary erythrocytes and in adjacent capillary
wedge, pushing against the liver cells and cause moderate atrophic changes in
tyah.Drugi morphological changes in liver parenchyma are not, which means that
the process is stagnant at the beginning of its development and has a short duration
.
30
30
33. Hepar muschatum.
In progressive right heart weakness due to prolonged venous stasis in the central
veins of liver delcheta occurs centrilobular dystrophy and atrophy of hepatocytes.
These changes are due to developing hypoxia. Relatively preserved only
hepatocytes around portal prostranstva.Makroskopski picture resembles the cut
surface of moskatovo nutmeg, hence the name. Dark red congestive areas change
with areas of dystrophic yellow hepatocytes loaded with lipids. In continuation of
chronic venous stasis congestive centrilobular zones Dead zones merge with the
neighboring delcheta and form stagnant paths connecting the two adjacent central
veni.Poluchava be so Muscat liver, reverse type, where the center of zones of
preserved hepatocytes is portal space / not the central vein / surrounded by
dystrophic and atrophic hepatocytes with congestive landscaped walkways
between
them.
E.g: congestive paths
31
31
34. Oedema pulmonis.
Lung edema may be cardiogenic or not cardiogenic. Cardiogenic
occurs in acute left heart failure. not cardiogenic observed in shock, leading to
the development of respiratory distress sindrom.Firstly swelling occurs in the
alveolar walls, which expand, interstitial edema develops after excessive
accumulation of fluid in interstitial lung began filling the alveoli with fluid -
Picture intraalveolaren edema. Histologically shows homogeneous and pink
colored eozina of matter, filling alveoli, alveolar moves bronchi and bronchioles.
Between alveolar spacers appear thickened. In the accompanying prolonged
chronic venous stasis are thickened fibrosing alveolar walls, the presence of
siderofagi in them and in the alveoli, dilated capillaries and fully blood.
32
32
41. Haemorrhagiae punctatae cerebri.
Pinpoint hemorrhages in the brain occur with damage to small blood
vessels due to a number of infectious-toxic effects, trauma, tumors and
dr.Makroskopski they are represented by scattered dark red spotting polentsa in
white brain matter, which disappears when wipe im.Te result most of diapedezni
bleeding in increased permeability of vascular wall.
On histological preparations appear yellowish or tan circular or
elliptical groups of erythrocytes outside the vessels in the vicinity or in the form
of sleeves around them. Detected data is swelling around the cells and vessels and
nekrobiotichni dystrophic changes in the surrounding neurons and glial elements
..
33
33
42.Pneumonia lobиlaris.
It is for acute focal inflammation of the lung, engaging in varying
degrees delcheta individual or groups of delcheta due mostly to bacterial
infection.
On histological preparations appear larger or smaller groups of alveoli filled to
varying degrees with serous exudate mixed with neutrophil leukocytes,
macrophages, erythrocytes, alveolar epithelial desquamation and some fibrin.
Among the inflammatory foci are no alveoli or little quantity of exudate. From
the pathological process are affected bronchi and bronchioles located in
pneumonic outbreak. Their lumen is full of mucus material containing cell
desquamation and neutrophil
leukocytes.
43. Pneumonia crouposa. (Croupy - fibrinous, lobar pneumonia).
It is about an acute infectious disease with a picture of fibrinous
inflammation which occurs in four stages and covers fully one or more parts of
the lungs. Inflammatory process begins with the stage of active hyperemia
expansion and engorgement of the vessels in the interstitial and alveolar capillary
wedge and release scarce and interstitial fluid in the alveoli (first stage). In the
second stage becomes fibrinous exudates rich in red blood cells resulting in
macroscopic lung parenchyma is compacted, there is red and resembles liver.
This is the stage of red hepatizatsiya. Fibrin strands pass through the pores of
Cohn and histologically shows that all the respiratory bronchioles, alveoli and
alveolar moves are made from delicate fibrin network coloring in pale pink color.
In reaction to Weigert it violetoovosinkav colors in color. In the third stage,
which was presented to the preparation, the number of leukocytes in the alveolar
exudate increases znachitelno.Osven among leukocytes and exudate are
macrophages. The color of the affected lobe becomes macroscopic off-white
34
34
(gray hepatizatsiya stage). Interstitial is extended to kravonapalneni vessels
infiltrated by neutrophil leukocytes. In Weigert stain shows how fibrin fibers pass
through the pores of Cohn from one socket to another, and cell nuclei dyed in
cherveno.Pri favorable outcome exudates completely absorbed, and this is the
fourth stage of the process if it becomes affected areas of the parenchyma
organize and fibrosing.
35
35
44. Pericarditis fibrinosa.
It is a fibrinous inflammation affecting mainly epicardium and
subepikardnata takan.Sreshta fat is common in end-stage chronic renal failure /
uremia / Trauma, inflammation in the myocardium and others.
On histological preparations shows that the epicardium is covered with
different thick layer of fibrin exudation, colored by eozina in pale pink. In the
deeper part of the layer and are neutrophil leukocytes in moderate amounts.
Underlying adipose tissue with dilated vessels and kravonapalneni, infiltration of
leukocytes and macrophages, mainly located perivazalno.
36
36
46. Pleuritis fibrinosa.
Fibrinous pleurisy is the most reactive - a place corresponding to a
subject a pathological process in the lung parenhim.Lokalizira is a visceral and
parietal pleura it affects only the surface layer of cells without passing border
membrane.
Histological deposition occurs mainly serofibrinozen exudate on
serosal moderate absolute neutrophil counts when it comes to inflammation in the
neighborhood. Fibrinous pleurisy can be sterile - with hemorrhagic infarction in
the lung, the relevant pleural cover accumulated fibrin. Under favorable
conditions exudates can be absorbed, but more often to organize and form
adhesions between the visceral and parietal
pleura.
37
37
47.Leptomeningitis purulenta.
In abscess meninges are infiltrated by diffuse large amount of
neutrophil leukocytes accumulated mainly around the dilated vessels and
kravonapalneni. Nuclei of leukocytes or hipersegmentirani or are at different
stages of dystrophic-necrotic changes. In the underlying gray matter vessels are
dilated and kravonapalneni with the presence of a significant amount of round
cells and leukocytes around single tyah.Nalitse is swelling around the cells and
vessels.
38
38
48. Nephritis purulenta (abscedens). Purulent inflammation of the kidneys may develop infection hematogenously
arrived by road or ascending urinary mehur.Hematogennite abscesses are
scattered evenly in kidney cortex and astsenedntnite may be single larger one of
the poles of the body into sections corresponding to the damaged cups of the
basin.Histologically in the renal parenchyma, mainly in the cortex are different
sizes outbreaks in which the bulk was destroyed and accumulated neutrophil
leukocytes, residues razpadnati cells and structureless necrotic material. Renal
structures in the periphery of the abscess are infiltrated by neutrophil leukocytes,
which fill many lumens and kanalcheta.Nalitse are dystrophic changes in cells of
proximal convoluted tubule, which are eosinophilic granular cytoplasm and the
boundaries between them are not well
visible.
39
39
49. Abscessus cerebri .
The most characteristic pathological changes in brain abscess are:
destruction of brain tissue and forming a cavity with purulent exudate
accumulation in it of segmented leukocytes. In the process of development in the
wall of the abscess formed three layers .. The inner layer, etc. "pyogenic
membrane" necrotic tissue is infiltrated with neutrophil leucocytes. Around it are
clustered macrophages, plasma cells, lymphocytes and young capillaries. Most
macrophages were foamy, cytoplasm mesh resulting from routine paraffin
processing of brain tissue, where they fagiranite lipids ekstrahirat.Yadrata they
are eccentric. These macrophages loaded with lipids by razpadnatoto brain
substance called lipofagi psevdoksantomni or cells that give macroscopic yellow
color of the second layer of wall abstsesa.Kogato to become chronic abscess is
encapsulated and is distinct from brain tissue with a wall of mature connective
tissue containing collagen fibroblesti, fibrocytes and blood vessels, representing a
third outer layer of abscess wall.
40
40
50. Granulatio.
By the term to mean granulatsio young granulation tissue that develops
in various processes in regenerators organizma.Formiraneto of granulation tissue
is an expression of chronic inflammation nespetsifichchno, as seen in wound
healing and in various toksoinfektsiozni effects .. This process is characterized
by:
1 / growth of young connective tissue rich in cells and
2 / neoplasms of capillary wedge.
Cellular elements in tissue novorazrastvalata differentiate well in large
increases in mikroskopa.Ot haraktertni them most are the young connective tissue
cells called fibroblasti.Tova are large cells with highly elongated spindle formats
bright oval or slightly drained yadra.Drugi cells found in tissue are neutrophil and
eosinophilic leukocytes with characteristic segmentation of nuclei, lymphocytes
almost naked hiperhromni nuclei or scant cytoplasm, plasma cells with eccentric
nuclei available in which the chromatin is arranged in the form of spokes of a
wheel epiteloidni cells - oval, slightly drained, bright blister nuclei poor in
chromatin and macrophages - large cells with abundant cytoplasm and oval or
kidney yadro.Mogat to meet and giant cells most often a "foreign body" with
many randomly located nuclei in the cytoplasm.
Ssred this cellular composition seen many young capillary wedge,
giving macroscopic granular appearance of newly formed tissue, and hence its
name - are upholstered granulatsio.Kapilarite juicy endothelial whose nuclei are
marked indentation whose penetration in education im.This construction is
inherent in newly formed blood vessels young characterizing granulation tissue ..
41
41
51.Granuloma typus corporis alieni.
With the entry of foreign objects into the body or outside in the
formation of unusual for normal body bodies in his / due to a variety of
inflammatory / tissue immediately surrounding the foreign body granulation
tissue develops, which means the name granuloma type "foreign body"
The process is a productive inflammation in the body seeks to limit and
defuse it become trapped foreign bodies. Most often these are sutures, paraffin,
silicone, gauze, cellulose materials, oil solutions, bone sekvestri, parasites, and
other metal particles. Around them proliferate young granulation tissue
containing capillaries, fibroblasts fibrocytes, lymphocytes, plasma cells,
lymphocytes and segmented most characteristic for this tissue type giant cells
"foreign body". They are multi-core, their cores are almost identical and are
located in the cell pole opposite the foreign body. The cells congregate around the
foreign body, surrounding it, and sometimes when it is small enough it
"swallow." In cases where foreign bodies can be removed through absorption,
then located around granulation tissue gradually matures and becomes a mature
fibrous takan.Po thus foreign body remains difinitivno included encapsulated in
tsikatrisialna formed tissue.
Giant Multinucleated
cells a "foreign
body"
42
42
52.Cicatrices myocardii / постинфарктен цикатрикс /
Scarring in the myocardium are areas of mature connective tissue,
which develops due to hypoxia or myocardial infarction. This tissue is rich in cell
elementi.Sastoi mainly of fibrocytes, fibroblasts and a small number of blood
vessels, surrounded by collagen fibers. When staining hemalaun eozin scar turns
pale pink. Peripheral myofibres atrophic or hypertrophied.
43
43
53. Cicatrices myocardii (V.G.)
With Van Gieson staining scar tissue turns rozovocherveno because it
is rich in collagen and muscle tissue environment - in yellow
44
44
54. Cirrhosis hepatis (HE).
Liver cirrhosis is the end stage of many pathological processes in the liver.
Characteristics: 1.razrastvane of scar tissue at the site of the destroyed hepatocytes,
which also distorts the structure and circulation in the body. Histologically observed
fibrotic septa connecting two adjacent portal areas, two neighboring central veins or
portal areas with neighboring central vein surrounding so different sized islands of
relatively preserved hepatocytes. This leads to
2.Razrushavane normal architectonics of the liver and formation etc.
psevdodelcheta
3.Kraglokletachna infiltration of lymphocytes and plasma cells in portal areas and
fibrous septa.
4.Proliferatsiya of bile ducts in fibrous septa.
5.Distrofichni changes in hepatocytes in the form of vakuolerna or fatty
degeneration and necrosis of the same.
6.Regeneratorni processes in hepatocytes, which are larger, lighter cytoplasm,
larger and darker colored form yadra.Te regenerators nodes are visible
macroscopically on the surface of Liver drob.Imat different sizes depending type of
cirrhosis-mikronodularna nodes with a diameter of 3 mm. and makronodularna -
significantly larger / more than 3 mm. /
псевдоделчета
45
45
55.Cirrhоsis hepatis (V.G.)
In this preparation is used histochemical staining Van Gieson, which
proves the presence of collagen in connective tissue grew surrounding the newly
formed psevdodelcheta.Toy colors are red and the remaining liver tissue - the
yellowish color.
46
46
56. Tuberculosis miliaris pulmonis.
Miliary is a chronic granulomatous tubelkuloza, specific inflammation.
Histologically among lung parenchyma seen many tubercles with typical
construction. In the center of the granuloma is homogeneous, structureless, pink-
colored zone of eozina kazeozna necrosis around it are arranged next to one
another palisading (such as boards of a fence), drained epiteloidni cells, which
include light cytoplasm and round, low-chromatin core . Among them are giant
multi-type cells "Langhans", which together with epiteloidnite cells specific for
tuberculous granuloma. Their cytoplasm is abundant, but their cores are round or
oval, situated on the periphery of the cell in the form of a horseshoe with the
opening to the central necrosis. Most peripherally around epiteloidnite cells
located shaft T-lymphocytes. Another specific characteristic of tubers is the lack
of blood vessels and plasma cells in it, unlike syphilis
granuloma.
Tuberculo
47
47
57. Leptomeningitis tuberculosa.
Mycobacterium tuberculosis most often causes chronic meningitis or
meningoencephalitis. Inflammation of the meninges are usually localized at the
base of the brain on hiazmata, bridge pins and Silvievite cerebral sulci. The most
significant finding is the presence of foci of necrosis kazeozna in which the
structure of the meninges is completely removed and is surrounded by epiteloidni
cells, giant cell type "Langhans" and lymphocytes. Formed typical tuberkuli.V
underlying gray matter to rub swelling, bleeding and scant lymphocytic
infiltration around blood vessels.
Tuberculosa
48
48
58.Mesoaortitis luetica.
Is one of the serious complications of syphilis in its third stage. It is a
chronic inflammatory process involving primarily the media of the aorta, which
expressed no specific character. Histologically characterized by:
1. / Vascularity of mediyata.Normalno expressed in the media of the
aorta vessels do.
2. / Perivascular infiltrates in the media kraglokletachni and
adventitsiyata of lymphocytes and plasma cells
3. / Proliferation of vessels in intimate adventitsiyata to complete
occlusion of their lumen (endarteriitis obliterans), which alone has a specific
character. The development of pathological changes in the media accompanied
by destruction of elastic fibers and increase of fibrous tissue that forms small
fields of vascular fibrosis stena.Mozhe to form and aneurysm, most often in the
ascending aorta.
49
49
59. Morbus Hodgkin
Hodgkin's disease has four forms: nodular sclerosis, mixed tselularitet,
lymphocyte predominance and lymphocyte depletion. Typical cells are
pathognomonic for the diagnosis of cells Reed-Sternberg. They are large cells
with multi-core diameter 15-45 micrometers in prominirashti nucleons and
abundant lightly eosinophilic cytoplasm. Especially characteristic are the dual
cells with mirror images of nuclei containing acidophilic nucleons surrounded by
clear zone. In nodular sclerosis razraztvaneto of connective tissue gives nodular
type tumor takan.Pri it most often found, etc. lakunarni cells, which are
considered a special variant of the cells in Reed - Sternberg. They are large single
lobulirani nuclei and abundant pale cytoplasm. The combined tselularitet which is
the most common form of the disease is heterogeneous infiltrate of lymphocytes,
plasma cells and eosinophils are found histiotsiti.Trudno cells of classic Reed
Sternberg. They are so lymphocytic variant - with a gentle lobulirani nuclei,
resembling popcorn / popcorn cells .The diagnosis of Hodgkin's disease is based
on the finding of Reed Sternberg cells or their variants among heterogeneous
cellular composition of inflammatory lymphocytes, plasma cells, eosinophils and
histiocytes epiteloidni.
50
50
60. Myoсarditis rheumatica.
It is a chronic inflammation specifically, in developing cyclic
interstitial infarction near blood vessels and subendotelno. In the early phase was
observed histologically mucoid edema and swelling of the interstitial tissue in the
myocardium and its impregnation with acidic mucopolysaccharides. They are
basophilic in staining hemalaun eozin and give metahromaziya tuloidinovo with
blue. Later came fibrinoidno swelling of collagen fibers and the main substance
formed zone fibrinoidna necrosis. In it Van Gieson stain ceases to be positive for
kolagen.Okolo necrotic foci are found predominantly neutrophil leukocytes,
scattered lymphocytes, plasma cells and histiocytes.
In the second phase of the process demonstrated on histological
preparation, the specific form of rheumatism granuloma of Aschoff-Talalaev. It is
presented with central necrosis located around it and ordered Anichkov cells
having abundant slightly basophilic cytoplasm. . Their nuclei are large, in
longitudinal section shows the central location of their chromatin (bar wavy
appendages, like a caterpillar) and in cross-section similar to the "eye of the owl."
The second type of cells are specific granuloma of giant cells Ashoff, which have
abundant cytoplasm and centrally located 1 to 4 cores. Around them are
lymphocytes, plasma cells and rare neutrophil leukocytes.
In the third phase cells gradually disappear and be replaced by
granulomas mature connective scar takan.Obrazuva is a fusiform shape.
51
51
61. Hyperplasia mucosae uteri glandularis cystica It is a hormonally driven process to an imbalance between estrogen and progesterone
- continuous prevalence of estrogen in relative or absolute reduction
прогестерона.Предразполагащи factors are menopause, prolonged administration of
estrogenic drugs, estrogen - producing tumors and polycystic ovarian syndrome, the
same. These conditions can lead to endometrial hyperplasia zhlezi.Te grow in
proliferative phase are different in size, some are cystic dilated .. upholstered them
cylindrical epithelial cells with nuclei hiperhromni located close to each other.
Hyperplasia of the glands is accompanied by hyperplasia and endometrial stromal
cells, which are also compressed. Among Hyperplastic structures can sometimes be
seen swollen pink colored liquid or kravoizlivi.Hiperplaziyata may be atypical or
complex, where the glands are closely back to back and they are epithelial multilayer
with signs of atipizam.Bazalnite membranes of the glands are preserved, unlike
glandular endometrial cancer, in which they razrushavat.Tova condition is
precancerous and may lead to the development of endometrial cancer, usually
occurring in older age.
52
52
62.Hypertrophia glandulae prostatae.
Prostatic hypertrophy is the result of a hormonal deficiency - loss of
gonadal function in mazhete.Protsesat develops gradually over years after the age
of 50 and 70 year olds were observed in 90% of mazhete.Kasae to diffuse
enlargement zhlezata.Histologichno characterized by hyperplasia of the glandular
and stromal structures. The process is represented by the proliferation of glands
located close to each other, but with preserved basal membrani.Zhlezite are
larger, upholstered with two rows of cells - the same basal cylindrical and cubic -
mioepitelni cells that showed no signs of atypia. Some of the glands were dilated
with cystic vatrezhlezna proliferation of tubular epithelial cells, having basal
located yadra.Hipertrofiyata may be glandular proliferation only in glandular
structures and adenomiomatozna when expanding and smooth muscle fibers of
stromal gland.
53
53
63.Struma colloides.
It is about increasing the size of the thyroid gland, resulting in
expansion and enlargement of the follicles with abundant colloid accumulation in
them. When colloidal accumulate in large quantities, it depresses follicular
epithelial cells of cubic and they become flat. Process is referred as histological
accommodation. / adaptation to changed conditions / Histologically observed
sizes of follicles, sometimes forming large cysts from the merger of several
follicles, filled with pink eozina of homogeneous koloid.V depending on the size
of folikulitei goitre is referred to as micro or makrofolikularna .
54
54
64. Fibroma cutis.
Benign tumor of mature connective tissue composed of fibroblasts,
fibrocytes and collagen fibers, consist mostly subcutaneous. Histologically
characterized by the appearance of spindle cells and collagen bundles of fibers
crossing each other in different directions. In longitudinally cut bundles of nuclei
of the cells are elongated with sharp edges in the cross - they are round. Between
the cells are deposited collagen fibers which are stained a pale eozin with cellular
components of the tumor. When the tumor is dominated by collagen fiber texture
is denser and is called a hard fibroma (fibroma durum), where the predominant
cellular component is soft and is called soft fibroma (fibroma molle). If it shows
scant stroma, carrying blood vessels and merging in separate sections of the
tumor parenchyma.
55
55
68 Lipoma Wen is a benign tumor of mature adipose tissue and is the most
common tumor of soft tissue in vazrastni.Histologichno is well encapsulated,
contains delcheta surrounded by soft connective tissue network, which carries
blood vessels and form a stromal tumor. Bulk of the tumor consists of lipotsiti -
large cells containing in their cytoplasm different in size fat droplets which after
routine paraffin processing appear optically empty. As a result of accumulation of
fatty droplets lipotsitite nuclei are pushed to the periphery of the cells.
56
56
69 Leiomyoma (HE).
Benign tumor of smooth muscle., Which can develop anywhere there
is smooth muscle, but is - in honor of her matkata.V it is often multiple and the
diagnosis was uterus myomatosus. Bulk of the tumor consists of bundles of
different thickness smooth muscle cells, which are intertwined in different
directions. Cytoplasm of muscle cells are stained more intensely red than eozina
compared with cells of the connective tissue that forms the capsule and stromal
tumor. Because vortical arrangement of smooth muscle bundles, cell nuclei in
histological preparations were cut in different planes, so we have a round, oval or
rod shape with cut corners, unlike fusiform nuclei of the
fibrocytes.
57
57
70 Leiomyoma (V.G.)
When staining hemalaun-eozin, muscle cells and the stromal collagen
fibers are stained a pale pink. Histological finding in fibroid and Leiomyoma is
relatively uniform and sometimes difficult to differentiate between both tumors.
To differentiate between fibroid Leiomyoma of using histochemical staining Van
Gieson, in which collagen is colored in red and muscle cells - in
yellow.
58
58
71 Chondroma.
Hondromat a benign tumor of hyaline hrushtyal.Kogato develops in the
bone canal enhondroma, if the surface - is referred to as ekhondroma Outside
tumor was covered with perichondrium, from which connective tissue strands
start separating tumor delcheta and shaping tumor stroma. Bulk of the tumor
consists of various size cartilage cells (chondrocytes), which are scattered in
groups included 2-3 cells per capsule, located unevenly colored matrix.
59
59
72 Hаemangioma cavernosum hepatis.
Hemangiomas are common benign tumors characterized by the growth
of normal and abnormal vessels filled with blood. Most common are cavernous
and capillary wedge hemangiom.Kavernozniyat haemangioma, which was
presented to the preparation, an interconnected voids surrounded by thin bands of
connective tissue, upholstered in endothelial cells. Cavities are among the liver
tissue in the form of poorly demarcated from the liver parenchyma cavernous
bodies, filled with krav.Can be seen intravascular thrombosis and calcification.
60
60
73 . Fbrosarcoma. Fibrosarcomas a malignant tumor, composed of fibroblasti.Sreshta is in
adults in the deep tissues of the hip, knee and
ретроперитонеума.Характеризира with hipertselularitet - tightly packed,
spindle cells with polymorphism, which are arranged like a fish bone is
heringa.Chesto found atypical mitozi.Tumorat a positive expression of vimentin.
Stromal is underdeveloped and is represented mainly by collagen fibers.
Metastasize through blood.
61
61
74 .Leiomyosarcoma.
Leiomyosarcoma is a malignant tumor of smooth muscle tissue, representing
10% -20% of soft tissue tumors sarkomi.Povecheto of this type originate from the
uterine muscle or the gastrointestinal tract .. may be encountered in women with
localization in the deep soft tissues of the extremities and retroperitoneum .
Histologically its cells are characterized by marked cellular atypia and form tufts,
intertwined in different directions. Stromal relatively less represented by mature
fibrous tissue. Tumor parenchyma is stained yellow by the method of Van
Gieson, and in stromal rozovocherven tsvyat.Osven obiknoveniyag
vretenovidnokletachen leyomoosarkomat type can be epiteloiden and
pleomorphic tip.Pri last polymorphism is also characteristic of high mitotic
activity.
62
62
75. Sarcoma osteogenes.
Osteogenic sarcoma is the most common primary malignant tumor of
bone. It occurs in all age groups, but 75% of cases are in young people under 20
godini.Razviva in long bones and affects men more often. The bulk are usually
composed of large polygonal, sometimes oval or spindly cells with pronounced
atypia, giant cells and numerous atypical mitozi.Produktsiyata of mineralized or
non-mineralized bone / osteoid / form of primitive bone gredichki is the hallmark
of tumora.Dopalnitelna finding in osteosarcoma can be vascular proliferation, the
presence of cartilage matrix and fields of fibrous connective tissue. According to
the prevalence of some of these elements are defined and some types of
гигантоклетъчен.Имунохистохомичното and staining with antibody against
vimentin gives chervenokafenikava reaction in the cytoplasm of tumor expression
of vimentin kletki.Pozitivnata is characteristic of many types of sarcomas..
76. Fibroadenoma glandulae .мammae.
osteoid
63
63
Fibroadenoma is the most common benign tumor of gardata.Schita that its
development is related to increased activity of estrogen. Usually occurs in young
zheni.Toy well encapsulated with a diameter of 1 to 10 cm
Bulk of it consists of two tissue components:
1.adenomatozna component representing tumor growth of canals and
2. scar - fibrous tissue derived from the gland. When scar tissue grows around
the canals, it is a fibroadenoma perikanalikularen. If the connective component enters
and pushes almost complete obliteration glandular ducts talk about intrakanalikularna
form. Stromal oskadno.V case presents two types of fibrous tissue, one element of the
parenchyma of the tumor is located immediately around glandular structures, - a poor
collagen and colors sinkavorozovo while stromal tumor is a mature connective tissue,
rich collagen and intense red color of eozina.Taka shows that the tumor parenchyma
contained in their epithelial and mesenchymal / fibrotic /Component.
77. Cystadenoma papilliferum ovarii.
64
64
Serous tumors are the most common ovarian neoplasms constitute 20%
to 60% of all ovarian tumors .. Sixty percent of them are benign, 15% have low
malignant potential - with borderline malignancy and 25% are malignant.
Benign serous tumors may be endophytic and tsistadenomi ekzofitni /
surface papillomas / or dvete.Serozniyat tsistadenom is composed of cysts
containing serous fluid light, upholstered with a single layer of cylindrical
epithelium, partly with cilia, partially secreted. Without signs of atypia .
epithelium resembles that of the fallopian tube, proliferate into the lumen of the
cyst and formed papillary strukturi.V papillae can be seen concentric laminar
cells containing calcium - etc psamomni cells, which help to differentiate
between tumor of neoplasms of different origin in this oblast.Kogato the cover is
a multilayer epithelium with signs of atypia without invasion of epithelial cells in
stromal tumor is referred to as serous tumor of borderline malignancy / low
malignant potential /. . In serous carcinoma mnogorednostta atipizmat and are
even more pronounced and there is a massive invasion of the tumor stromal cells,
and the surface of the ovary.
cystic cavity
Pappilary Structures
65
65
78. Adenoma рleomorphe glаndulae parotis (т.н. tumor “mixtus”
gl. parotis).
Eighty percent of neoplasms of the salivary glands are the parotid
gland, 70 /% - 80% of them are honor-dobrokachestveni.Nay pleomorphic
adenoma, indicated that because of his heterogennost.Izgraden is of two types of
cells - epithelial ducts of the glands and mioepitelni.Te form channels, glandular
epithelial structures and drags .. Parenchymal cells are cylindrical or cubic in
shape, surrounded by different sized areas of mucoid substance whose quantity in
some areas is quite large and the epithelial cells appear as islands among them.
The type of the parent compound is different: basophilic mucus, type of cartilage
is rarely a case of bone tissue. This diverse type of tumor is given ground in the
past to be called mixed tumor.Dnes believe that the compound is a product of
epithelial cells. "
66
66
79..Papilloma vesicae urinariae.
Papilloma of the bladder is a benign tumor originating in the urothelium, occurs
rarely and has dimensions of 0.2 - 1.0 cm. It is built with a tender of papillae
fibrovaskularna stroma, Branching Tree. Histologically there are papillary
structures are covered in multi prehodnokletachen epithelium without signs of
atypia, with very little stroma, sometimes stromal blood vessels lie almost
kletki.Za among parenchymal contrast papilloma prehodnokletachniyat bladder
cancer is characterized by a coarse papillary structures, more mnogorednost
epithelium with marked cellular atypia and invasion of tumor cells into the
subepithelial fibrous tissue and muscle tissue in the wall of mehura.Otkasnati
papillae in these tumors can be detected in urine of patients with concomitant
hematuria and are important for setting the
diagnosis.
67
67
80.Carcinoma planocellulare Squamous cell carcinoma is a malignant tumor originating in a multilayered
squamous epithelium. Can be found everywhere in the body where there is such
epithelium - oral cavity, esophagus, cervix, vagina and dr.i is particularly
frequent in armor developed on the basis of metaplasia of filamentous cylindrical
multilayered epithelium in flat, mainly in smokers. Histologically composed of
nests of a multilayered squamous epithelium with typical construction, are
located outside the cylindrical cells with dark nuclei, characteristic of the basal
layer, followed inside the other cell layers (Spinoza, granulosa and light). Spinoza
often dominated by layer, so the tumor mean as spinotselularen. All layers are
marked cellular and nuclear atypia, especially spinozniyat.V center of nests,
depending on the degree of differentiation in more mature tumors detected output
horn / horn beads etc /. Stromal is represented by broad strands of connective
tissue, among which the stroma reaction - infiltration by lymphocytes, plasma
cells and lymphocytes
„cancer pearls”
tumor
clusters
68
68
81. Carcinoma basocellulare.
Basal cell carcinoma is the most common cancer in choveka.Sreshta is on skin
areas exposed to sunshine and slightly pigmented individi.Toy grows slowly in
the form of plaque, which razyazvyava and forms etc. ulcus rodens.Ryadko
metastasize .. It originates from the basal layer of the multilayered squamous
epithelium, mainly the face and exposed areas, and entering into the
subcutaneous tissue. Bulk of it consists of clusters of cells similar to the basal
layer of the epidermis - with scant cytoplasm and elongated, hiperhromni nuclei.
Of dystrophic changes in tumor cells sometimes acquire psevdozhlezist strands
form. The tumor may be multifocal growth - the type of surface or grows in
depth, forming a knot structures among the connective tissue or mucinous
matriks.V connective tissue stroma appears stroma reaction by lymphocytes and
plasma cells.
69
69
82.Adenocarcinoma ventriculi.
Midst of malignant tumors of the stomach adenocarcinoma is the most common
and most - important / 90-95% / .. It originates from the gland epithelium of
gastric mucosa and classified according to the depth of invasion, macroscopic
type and histological podtip.Tumorat two histological forms - intestinal variant,
which is typical gastric adenocarcinoma, composed of atypical glands located
next to each other with broken basement membrane, forming strands and gland
resembling Bowel cancer The second is the diffuse type in which tumor cells
infiltrating the mucosa and deeper layers of the wall stomach. Cells resemble
stone ring with the inside wall of the ring and contain sluz.Poslednata is dakazva
with PAS reaction and staining with altsianovo blue according to the nature of
mukopolizapharidite located in sluzta.Tazi form called linitis plastica and is
characterized by diffuse thickening of the without the formation of gastric tumor
in its
lumen.
70
70
83.Adenocarcinoma uteri.
The most common form of endometrial cancer is endometroidniyat type of
adenocarcinoma, one of the most commonly occurring malignant tumors in the female
reproductive sistema.Sreshta are mostly between the ages of 55 and 65
godini.Razvitieto it is associated with increased estrogen stimulation and is often
based on atypical endometrial hiperplaziya.Tumorat may be infiltrative or
predominantly ekzofiten rastezh.Toy infiltrates myometrium and gives metastases in
lymph regionarnite vazli.Histologichno is represented by glandular structures lying
back to back, forming epithelial strands with damaged basal membrane between them
with cells arranged in multiple rows with marked atypia.
. In some glands and papillary growths observed in the lumen of the glands
im.Atipizmat is expressed in varying degrees, depending on the degree of
differentiation of the tumor, it can be: high, moderate or low differentiated.
71
71
84.Adenocarcinima gelatinosum(HE)
View slide № 17, where the described the same tumor.
85. Invasive ductal breast cancer with dezmoplastichna stromal
reaction (skirozen cancer etc.).
It is a carcinoma with abundant stroma, predominantly from the parenchyma. The
bulk is presented as individually arranged or small groups of cells, solid nests,
tubular structures and others.
Хиалинизирана
съединителна
тъкан
tumor
nests
72
72
86. Medullary breast cancer - carcinoma with scant stroma. The structure of this cancer is completely opposite to the structure of skirozniya
cancer. Medullary carcinoma with abundant parenchyma, composed of cells with
basophilic cytoplasm and vesicular nuclei with oval or polygonal shape. Tumor
parenchyma is nest building, sometimes the cells are arranged in strands (syncytial
growth). Is extremely scarce stromal vessels and it can not supply the necessary
nutrients to all cells, resulting in often visible necrosis and hemorrhage.
Tumor outbreaks of
syncytial type
73
73
89. Glioblastoma multiforme
Glial brain tumors are subdivided into astrocytomas, ependymoma and
oligodendrotgliomi. Astrocytoma subtypes are different, but most common are
fibrilerniyat / 80% / pilotsitniyat tip.Spored and degree of differentiation
fibrilerniyat astrocytoma is divided into astrocytoma, anaplastic astrocytoma and
glioblastoma multiforme.
Glioblastoma multiforme is the lowest diferentsiran.Toy spongioblastite comes
from representing the earliest phase of the glia. Histologically there are cells with a
strong cellular and nuclear atypia. Are characteristic giant cells with single nuclei and
ugly large number atypical mitoses in tumor .. there are many blood vessels with
endothelial cells and areas of hemorrhage and necrosis. There are areas with
palisading arrangement of tumor cells ..
74
74
90.Astrocytoma.
The tumor is derived from mature astrocytes. Histologically composed
of large cells with pale cytoplasm, with fewer fibrils in protoplazmatichniya type
astrocytes or more gliofibrili - in fibrous astrocytoma .. The cells resemble one
another and have a little nuclear polymorphism. Growths of cells in the form of
delicate fibrils show a positive immunohistochemical reaction for glial acidic
protein fibrileren / GFAP /. Fibrils form a fine network around the blood vessels.
Rarely seen dystrophic-necrotic changes in tumor tissue and eventually forming
cysts.
75
75
91. Neurinoma (schvanoma).
Nevrinomat is a benign tumor that develops from Schwann sheaths nervite.Toy is
common in the cranial cavity and comes from the eighth craniocerebral nerve.
Histologically consists of elongated cells arranged in strands, intertwined in
various posoki.Razlichavat are two subtypes of the tumor - Antoni A type that
meet the so-called Lewy Verokay in which cells with elongated cytoplasmic their
spines are arranged in bundles around area in which only appendages without
nuclei. Rodlike nuclei of the cells are arranged parallel to each other, like soldiers
on parade, forming a blue colored hemalaun eozin bands around the area free of
nuclei. In Antoni type B cells lacking a Verokay, the cells are arranged in loose,
show miksoidni changes and can form a positive mikrokisti.Tumorat
immunohistochemical reaction for S - 100 protein. Stromal often contain dilated
blood vessels. Has been shown between nevrinoma cells can form collagen
fibers
76
76
92.Meningioma.
Tumors of the meninges / meningioma / are benign neoplasms and occur in adults
they come from meningotelnite arahnoideyata cells and are usually secured to
durata.Podrazdelyat on the following / in the presence of PAS positive droplets in
cells / s mikrokistichen. presented syncytial tumor type and is composed of oval
and spindle cells. which are arranged concentrically as bulbs, separated by
connective tissue stroma. Sometimes in these cell layers occurs hialinizatsiya or
deposition of calcium and form etc. psamomni teltsa.Kogato dominated
psamomnite tumor cells is defined as psamomatozen option.
Psamomni cells
77
77
93.Melanoma malignum.
Malignant melanoma is a pigmented malignant tumor that timely
diagnosis can be treated with wide surgical incisions. The main histological types
of malignant melanoma are superficial spreading melanoma, melanoma lumpy,
akralno lentigiozen melanoma and lentigo maligna melanoma.Tumorat contains
two types of parenchymal cells: 1) cells with extremely epitelopodobni
polymorphism arranged in clusters like cancer and 2) spindle cells forming
fascicles, with some diffuse structure similar to sarkoma.Kletkite usually have
large nuclei with irregular contour and contained chromatin at the nuclear
periphery membrana.Harakterni eosinophilic their nucleons are described as
"cherry red". tumor may have horizontal or vertical growth, which determines its
shape. melanin content also shows great diversity, it may be lacking in so-called
achromatic melanoma.
The depth of vertical growth determines the biological behavior of
melanoma.Spored classification of Clark - when the tumor is confined to the
epidermis is level I, leaching into the surface of the papillary layer II level of the
entry of tumor cells in the superficial vascular plexus III is - it level with invasion
into the reticular layer of dermis - IV level. V-th level is when the tumor has
entered into the subcutaneous tissue. Forecast and the possibility of metastatic
tumor is determined by the depth of invasion in millimeters for vertical growth of
the tumor from the granular layer of the epidermis proper. /
/
78
78
94. Choriocarcinoma / chorionepithelioма /
Horiokartsinomat highly aggressive malignant tumor growing from the
trophoblastic elements platsentata.Makroskopski is represented by multiple
hemorrhagic masses filling the uterine kuhina.Kletachnite components include
horiokartsinoma sintsitiotrofoblasti, tsitotrofoblasti and intermediate /
intermediate / trophoblastic клетки.Синнцитиотрофобластите Multinucleated
cells are finally differentiated and show no mitotic aktivnost.Te are
pathognomonic for tumora.Tsitoplazmata their thick and stained intensely
eosinophilic bazofilno.Chesto to contain many vacuoles of advanced tanks
endoplazmatichniya reticulum. Tsitotrofoblastnite cells are small to moderate
sized single-cells with scant pale to bright granular
цитоплазма.Интермедиерните trophoblastic cells have characteristics of both.
They are large, polygonal with one or more nuclei and abundant cytoplasm that is
dense eosinophilic, without vacuoles. The chorionic villi are not a component of
horiokartsinoma, except in rare cases where it comes from a normally developing
placenta.
79
79
95. Carcinoma Renis ( hypernephroma).
Renal cell carcinoma originates from the seminiferous epithelium and
is localized mainly in korata.Toy represents 80% to 85% of all primary malignant
tumors of the kidney and 2% to 3% of all malignant neoplasms in adults. It
occurs most frequently in the sixth - seventh decade and is twice as frequent in
mazhete.Svetlokletachniyat carcinoma is the most common type and is 70% to
80% of all kidney cancers. The bulk is made up of cells with pale granular
cytoplasm rich in glycogen and lipids, which give a yellowish color macroscopic
tumor there, because his likeness with adrenal gland and its previous name
hypernephroma. Nuclei of light cells are small, round and hiperhromni, mostly
located in the center of kletkite.Granuliranite cells resemble the seminiferous
epithelium have small round nuclei and granular cytoplasm pink. The tumor has
nest building, there are also atsinarni structures surrounded by thin bands of
connective tissue and thin-walled blood vessels, which are due to hemorrhage and
necrotic areas.
80
80
96.Seminoma testis.
Seminoma represents 50% of all testicular tumors and
germinativnokletachni occurs in men 40 years vazrast.Makroskopski
zhaltenikavorozova lobulirana tumor mass with necrosis and hemorrhage. It is a
malignant tumor growing from the seminiferous epithelium. Histologically seen
large cells with pale eosinophilic cytoplasm and centrally located round nucleus
with one or two нуклеоли.Съединителнотъканната stroma is represented by
bands sprouting in the tumor parenchyma and dividing irregular strands and nests
.. A characteristic feature of seminoma is the presence of lymphoid infiltrates in
stromal that can form lymph follicles and germinativnokletachni tsentrove.Mozhe
occur granulomatous reaction epiteloidni cells and giant cells type "Langhans."
Most seminoma contain glycogen in parenchymal cells and give your PAS
positive reaction.
81
81
97.Carcinoma hepatocellulare.
Hepatocellular cancer predsavlyava 5.4% of all malignant tumors in
humans as the frequency varies in different parts of sveta.Razvitieto is related
largely to infection by hepatitis B and hepatitis C viruses. Macroscopically, the
tumor has three forms: can be a single node , multifocal or diffuse growing. In
well differentiated forms its cells reproduce and form a liver gredichki
zhlezistopodobni strukturi.Te are large, polygonal with acidophilic cytoplasm and
large hiperhromni yadra.V them can be found zhaltozelenikav bile pigment. In
low differentiated cancer cells are large, multi ..
Stromal tumor is scarce and is represented only by sinusoidal vessels.
Histology of hepatocellular carcinoma is quite diverse and, depending on cell
arrangement the following types:
- Trabecular where atypical hepatocytes are arranged as trabeculae and
gredichki with different orientations.
- Atsinozen (psevdoglandularen) with formation of kanalikuli
zhlezistopodobni or structures whose lumen can sometimes be found bile.
- Clear-option when tumor cells are rich in glycogen and lipids.
82
82
98. Myelosis hepatis.
Preparation demonstrated extramedullary hematopoiesis in the liver in
chronic mielolevkoza. Histologically sinusoidal in highly advanced izpulneni
with myeloid cell line, which are at different stages of maturity (blasts). The
accumulation of immature white blood cells is most pronounced in sinusoidal
central parts of delchetata. In severe exacerbation of leukemia (blast crisis)
proliferation of immature elements are observed in portal spaces.
83
83
99.Lymphadenosis hepatis.
Preparation illustrates the morphological substrate of chronic hepatic
limfolevkoza drob.Patologichniyat process develops in portal spaces and consists
primarily perivazalna proliferation of lymphocytes and fewer lymphoblasts.
Lymphocyte proliferation is lumpy in nature and locates perivazalno. During
prolonged treatment of patients with cytostatics may occur growths of connective
tissue collagen and development of cirrhosis.
84
84
100. “Mastopathia chronica fibrosa cystica”.
Fibrokistichnata breast disease is hormonally driven process resulting in
hiperestrogenemiya. Violation occurs in the ratio between connective and
epithelial components of breast cancer. The process refers to mamarnata
dysplasia. It consists in marked expansion of periduktalnata perilobularnata and
connective tissue that is coupled with hyperplasia of ductal and lobular
epithelium and formation of single or multiple cysts. Lining the cysts is
upholstered single-breasted or double-breasted cube, often epithelial cells have
acidophilic cytoplasm, similar to the epithelium of sweat glands - case for
hidroadenoidna / apocrine / epithelial metaplasia. There are sections
vatrekistichni papillary growths of epithelial / ductal papilomatoza /. The contents
of the cysts is a homogeneous pink-colored fabric with eozina. Sometimes, there
is atypical lobular hyperplasia, which resembles the cytological carcinoma in situ,
but the cells do not fill more than 50% in atsinite lobula.Tazi hyperplasia is a risk
of developing in situ or invasive carcinoma. Another element of fibrokistichnata
disease can be sclerotic adenoza.Tya is characterized by proliferation of roofing
and mioepitelni epithelial cells in small ducts located back to back with
significant stromal fibrosis, which forces them. Overgrowth of scar tissue
pressing on atsinite lumens and channels and they look as solid strands of cells.
Differential diagnosis of invasive carcinoma is difficult. Immunohistochemical
demonstration of intact smooth muscle cells mioepitelni actone in favor of the
diagnosis sclerosing adenosis.
101. Actinomycosis.
Actinomycosis is a chronic purulent inflammation caused by fungi -
aktinomitseti.Glavniyat cause of human actinomycosis eu is Actinomyces Israeli.
Actinomycosis has four forms according to its localization tservikofatsialna,
thoracic, abdominal and tazova.Histologichno it is characterized by the formation of
abscesses which appear aktinomitsetni Druze surrounded by a large number of
segmented leukocytes and macrophages loaded with lipids of phagocytosed dead cell
is elementi.Harakterno finding of granules with a diameter of 1 micrometer in
exudate, and aggregates of filaments of the fungus with a diameter of 30 to 3000
micrometers in diametar.Aktinomitsetnite Druze give a positive PAS-
Fibrose
Adenose
85
85
reaction.
102.Adenoma villosum recti.
Adenomas of the colon are three basic forms, tubular, and vilozen
tubulovilozen.Te occur most often in rektosgmoidnata oblast.Vilozniyat adenoma
may reach larger sizes. - Up to 10 cm in diametar.Toy looks like a cauliflower
growths with one to three centimeters above ligavitsata.Papilarnite structures are
often covered by single-breasted or multilayer cylindrical epithelium with mild to
moderate and severe dysplasia. In 40% of the lesions can be found invasive
carcinoma.
actinomycosis druse
86
86
103. Carcinoma papillare gl. тhyreoideae
Thyroid cancer has four main histological types: papillary
carcinoma / 75% -85% of cases / follicular carcinoma / 10% to 20% /, medullary
carcinoma / 5% / and anaplastic carcinoma / less than 5%. . papillary cancer may be
solitary or multifocal type. Macroscopically can be encapsulated or have invasive
growth to surrounding tissues. Histological type is characteristic of the nuclei of cells
constituting the tumor. Their chromatin is finely dispersed and they look optically
transparent "ground glass" papillary structures are present, although some tumors are
largely composed of follicles. These follicular variants biologically related as
papillary tumors if they have previously described nuclei in vid.V papillary structures
can be seen concentric laminar calcified structures, denoted as psamomni cells..
104./Hronichen lymphocytic Hashimoto's thyroiditis
Hashimoto's Hashimoto e autoimmune disease characterized by progressive
reduction of epithelial cells tireoideyata which gradually replaced by mononuclear
cell infiltration and fibroza.Toy is the most common cause of hypothyroidism in parts
of the world where there is no shortage of yod.Makroskopski gland is diffusely and
symmetrically enlarged with sivkavorozova surface at srez.Histologichno picture is
represented by abundant mononuclear inflammatory infiltration of small lymphocytes,
plasma cells and lymphoid germinal formed tsenvtrove folikuli.Tireoidnite lymph
follicles are atrophic and are often seen covered in cells with abundant eosinophilic
granular cytoplasm, denoted as oksifilni cells or Hurthle. ultrastructure of these cells
are rich in mitochondria. Less gland is reduced in size, compact and fibrosing /
87
87
atrophic variant of Hashimoto
/
Лимфен
фоликул
88
88
105 .Metastases carcinomatosae lymphonodi.
Malignant tumors of epithelial origin metastasize initially lymph channels in the
lymph regionernite vazli.Metastatichniyat process begins first in the peripheral
sinuses of the node that is gradually filled with tumor kletki.Po later formed last
pockets are separated from each other lymphoid cells. aggression leads to tumor
filling the entire lymph node with tumor nests by the cancer, with germination in
the capsule of the node and even perinodalnata tissue.
89
89
107. Liposarcoma.
Liposarcoma is a malignant tumor originating from adipose takan.Toy is one of
the most common sarcomas in adults in the fourth - fifth decade, rarely occurring
in detsa.Obiknoveno develops in deep soft tissues of the extremities and abdomen
/ retroperitoneal /. Histologically there are following types of tumor: well-
differentiated, miksoiden, kraglokletachen pleomorfen.Tumorat and usually
consists of lipotsiti lipoblasti and which mesh with cytoplasm and centrally
located place yadro.Na of fat extracted in the cytoplasm are vacuoles. Grease
prove to freezing kriostatni cut stained with Sudan III and dyed in oranzhevozhalt
tsvyat.Tumornite cells are expressed in varying degrees
polimorfizam.Posledniyat becomes particularly demonstrative in pleomorphic
type tumora.Stromata usually scarce - fibrous strands of blood vessels but it can
be quite pronounced and the case is described as fibrosing liposarcoma