Pathology of Amyloidosis and Tissue Deposits

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Questions and Answers

What is amyloidosis?

The extracellular deposition of abnormal protein

Which of the following are types of amyloid material?

  • Amyloid light (AL) (correct)
  • Amyloid associated protein (AA) (correct)
  • Fibril protein (correct)
  • P component (correct)

What are the two main categories of amyloidosis?

  • Primary
  • Systemic (correct)
  • Localized (correct)
  • Tertiary
  • Secondary

What is a common cause of secondary amyloidosis?

<p>Chronic inflammation (A)</p> Signup and view all the answers

Amyloidosis is a common condition that affects most people.

<p>False (B)</p> Signup and view all the answers

What are the gross characteristics of an organ affected by amyloidosis?

<p>All of the above (D)</p> Signup and view all the answers

What are the two main types of microscopic stains used to identify amyloid deposits?

<p>Haematoxylin and eosin stain and Congo red stain</p> Signup and view all the answers

What is the primary complication of renal amyloidosis?

<p>Kidney failure (D)</p> Signup and view all the answers

Which of the following conditions can be caused by amyloidosis in the heart?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary diagnostic tool for amyloidosis?

<p>Biopsy</p> Signup and view all the answers

Which of the following is a common type of connective tissue hyalinosis?

<p>Arterial hyalinization (B)</p> Signup and view all the answers

What is the hallmark of cellular hyalinosis?

<p>The presence of Mallory bodies</p> Signup and view all the answers

Where are Russel bodies typically observed?

<p>Inflammation rich in plasma cells</p> Signup and view all the answers

What is the difference between mucoid and myxomatous change?

<p>Mucoid change occurs when mucin is deposited inside cells, while myxomatous change occurs when mucin is deposited outside cells.</p> Signup and view all the answers

Which of the following conditions is associated with melanin deficiency?

<p>All of the above (D)</p> Signup and view all the answers

What is the main pigment found in hemosiderosis?

<p>Hemosiderin (B)</p> Signup and view all the answers

What is the major difference between hemosiderosis and hemochromatosis?

<p>Hemosiderosis is localized, while hemochromatosis is generalized. (B)</p> Signup and view all the answers

Which of the following can cause anthracosis?

<p>All of the above (D)</p> Signup and view all the answers

What is the cause of gout?

<p>Disturbance in purine metabolism leading to the deposition of sodium urate crystals in tissues.</p> Signup and view all the answers

Where are urate crystals most commonly deposited in gout?

<p>The joints (C)</p> Signup and view all the answers

Which of the following conditions is often associated with secondary gout?

<p>Leukemia (B)</p> Signup and view all the answers

What is another name for metastatic calcification?

<p>Calcinosis</p> Signup and view all the answers

Calcification only occurs in dead tissue.

<p>False (B)</p> Signup and view all the answers

Flashcards

Amyloidosis

Extracellular deposition of abnormal protein.

Amyloid AL

Amyloid protein from abnormal immunoglobulin light chains.

Amyloid AA

Amyloid protein from inflammatory response.

Primary Amyloidosis

Amyloidosis with unknown cause, often associated with plasma cell disorders.

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Secondary Amyloidosis

Amyloidosis caused by chronic inflammatory or malignant conditions.

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Hyalinosis

Microscopically homogenous, structureless, pinkish tissue change.

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Connective Tissue Hyalinosis

Hyalinosis affecting connective tissues.

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Cellular Hyalinosis

Hyalinosis occurring within cells.

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Mallory Bodies

Hyaline inclusions seen in alcoholic liver disease.

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Russel Bodies

Hyaline inclusions in plasma cell-rich tissues.

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Mucoid Change

Mucin deposition within cells.

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Myxomatous Change

Mucin deposition outside cells.

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Congo Red Stain

Useful for detecting amyloid.

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Renal Amyloidosis

Amyloid deposition in the kidneys.

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Liver Amyloidosis

Amyloid deposition in the liver .

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Proteinuria

Protein in the urine.

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Diabetes Insipidus

Hormonal disorder affecting water balance.

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Arteriolosclerosis

Hardening of small arteries.

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Heart Failure

Inability of the heart to pump effectively.

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Intestinal Obstruction

Blockage of the intestines.

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Study Notes

Tissue Accumulations and Deposits

  • Types of tissue accumulations and deposits include: amyloidosis, hyalinization, mucoid and myxomatous changes, deposited pigments, gout, and pathological calcification.

  • Amyloidosis is the extracellular deposition of abnormal proteins.

Nature of Amyloid Material

  • Amyloid material is composed of fibril protein.
  • The fibril protein has amyloid light chain (AL) and amyloid-associated protein (AA) components.

Types of Amyloidosis

  • Amyloidosis can be localized or systemic.
  • Localized amyloidosis is associated with conditions like haemodialysis and hereditary transthyretin neuropathy.
  • Systemic amyloidosis can be primary or secondary.
    • Primary amyloidosis is linked to amyloid light (AL)
    • Secondary amyloidosis is associated with amyloid-associated protein (AA)

Pathogenesis of Systemic Amyloidosis

  • Primary amyloidosis is related to multiple myeloma (malignant tumor of plasma cells).
  • Secondary amyloidosis arises from chronic inflammation or malignant conditions.

Secondary Amyloidosis

  • Conditions linked to secondary amyloidosis include:
    • Rheumatoid arthritis
    • Chronic suppurative conditions (empyema, lung abscess, bronchiectasis)
    • Infective granulomas (tuberculosis)
    • Malignant tumors (Hodgkin lymphoma, gastric carcinoma, renal cell carcinoma)

Amyloid Stains

  • Gross staining involves Lugol's iodine stain and iodine and sulphuric acid stains.
  • Microscopic staining includes hematoxylin and eosin stain, Congo red stain, and metachromatic stain.

Gross Affection of any Organ

  • Grossly affected organs exhibit enlargement, firmness, and a rubbery texture.

Liver Amyloidosis

  • Liver amyloidosis displays specific microscopic features.

Renal Amyloidosis

  • Renal amyloidosis can lead to significant complications like proteinuria, diabetes insipidus, and reduced kidney function due to arteriolosclerosis, and ischemia.

Diagnosis of Amyloidosis

  • Biopsy is crucial for diagnosing amyloidosis.
  • Potential complications of amyloidosis include renal failure, heart failure, intestinal obstruction, and Addison's disease.

Hyalinosis

  • Hyalinosis refers to a microscopic change in tissues.
  • It involves a homogenous, structureless appearance and pinkish coloration.
  • Hyalinosis can manifest in connective tissues.

Cellular Hyalinosis

  • Cellular hyalinosis is another form of hyalinization.
  • Mallory body formation in alcoholic cirrhosis is a prominent example of cellular hyalinosis.

Mucoid Change

  • Mucoid change occurs when mucin is deposited inside cells. this commonly found in inflammatory conditions like catarrhal inflammation.

Myxomatous Change

  • Myxomatous change involves deposition of mucin outside the cells.
  • Leiomyoma and umbilical cords are typical locations where myxomatous changes arise.

Pigments

  • Pigments can be endogenous or exogenous.
  • Melanin deficiency leads to conditions like albinism and leucoderma.
  • Exogenous pigmentation includes anthracosis, lead exposure, parasitic pigmentation, or tattooing.
  • Endogenous pigments include melanin, lipofuscin, hemoglobin-derived pigments (haemosiderin, hemosiderosis, and hematin), iron pigment.

Exogenous Pigmentation

  • Routes of exogenous pigmentation include inhalation (anthracosis), inoculation (tattoing), and ingestion (lead).

Gout

  • Gout results from a purine metabolism disturbance, leading to sodium urate crystal deposits.
  • This can manifest in joints and cause inflammation.
  • Gout has primary (hereditary) and secondary (leukemia-related) causes.

Pathological Calcification

  • Pathological calcification involves calcium salt deposits in tissues other than bone and teeth.
  • A type of pathological calcification, dystrophic calcification, occurs.

Metastatic Calcification

  • Metastatic calcification involves calcium deposits in tissues due to elevated calcium levels from increased absorption or mobilization.
  • Causes include hypervitaminosis D, hyperparathyroidism, and metastatic bone lesions.

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