17 Questions
Which process involves the rupture of fat cells leading to self-digestion?
Liquefactive necrosis
What is the fate of small areas affected by necrosis?
Removal by macrophages
Which process involves a distinctive morphologic pattern of cell death affecting individual cells or small groups of cells?
Apoptosis
What results from large areas affected by necrosis being surrounded by fibrous tissue?
Dystrophic calcification
Which type of necrosis is associated with the lack of inflammation in surrounding tissues?
Apoptosis
What is the characteristic feature of coagulative necrosis?
Firm and opaque white tissue
Which type of necrosis is commonly caused by a sudden cut-off in blood supply?
Coagulative necrosis
What is the main reason for liquefactive necrosis in the brain and spinal cord?
High lipid and fluid content of nervous tissue
Which type of necrosis results in the formation of blue-stained calcium deposits?
Fat necrosis
What happens to cells during apoptosis?
Cells dissolve and lose stainability
Which type of necrosis results in a homogeneous, structureless, pink-stained appearance?
Liquefactive necrosis
What is the central feature of a pyogenic abscess?
A liquefied necrotic core
What is the characteristic microscopic appearance of caseation necrosis?
Structureless, granular, and homogenous pink staining
Which type of necrosis is associated with acute hemorrhagic pancreatitis?
Enzymatic fat necrosis
What is the mechanism behind traumatic fat necrosis?
Trauma to adipose tissue
Which of the following is NOT a characteristic of caseation necrosis?
Involves liquefaction of the necrotic tissue
What is the fate of the fatty acids released during enzymatic fat necrosis?
They deposit with calcium as small white patches
Study Notes
Cell Death and Necrosis
- Fat cells rupture and undergo self-digestion, leading to fat necrosis
- Fate of necrosis:
- Small areas are removed by macrophages
- Large areas are surrounded by fibrous tissue and may undergo dystrophic calcification
Apoptosis
- Definition: Distinctive morphologic pattern of cell death affecting a cell or small group of cells
- Characteristics:
- Energy-dependent programmed cell death
- Morphological changes:
- Cell shrinkage
- Condensation and fragmentation of chromatin
- Rapid breakdown of the cell to form apoptotic bodies
- Apoptotic bodies have intense eosinophilic cytoplasm and dense chromatin fragments
- Phagocytosed by neighbouring cells or macrophages
- Lack of inflammation in surrounding tissues
Karyolysis
- Nucleus appears to dissolve and fails to take stain
Cytoplasmic Changes
- Cells appear swollen (cytomegaly)
- Cytoplasmic eosinophilia due to loss of RNA and increased binding of eosin to denatured cytoplasmic proteins
- Cells lose cell membrane and become indistinct from each other
- Blue-stained calcium deposits appear later on
Types of Necrosis
- Coagulative necrosis:
- Caused by sudden cut-off of blood supply (e.g., infarcts)
- Tissue becomes firm and opaque white
- Microscopically: Early stages show preserved tissue architecture, while later stages appear homogeneous and structureless
- Liquefactive necrosis:
- Seen in infarctions of the brain and spinal cord
- Necrotic tissue is rapidly liquefied due to high lipid and fluid content
- Also seen in pyogenic abscesses, where the central necrotic core is liquefied by proteolytic enzymes
- Caseation necrosis:
- Necrosis followed by slow partial liquefaction
- Grossly: Dry, pale yellow, and cheesy or casein-like appearance
- Microscopically: Loss of cellular details, structureless, granular or homogeneous, and pink-stained
- Caused by antigen-antibody reaction (allergic necrosis)
- Seen in tuberculous lesions
- Fat necrosis:
- Enzymatic fat necrosis:
- Occurs in acute hemorrhagic pancreatitis
- Lipase splits fat into glycerol and fatty acids
- Fatty acids deposit with calcium as small dull opaque white patches
- Traumatic fat necrosis:
- Occurs due to trauma to adipose tissue of the breast and subcutaneous fat
- Enzymatic fat necrosis:
Learn about the characteristics of pyogenic abscess, where the central necrotic core is liquefied by enzymes, and caseation necrosis, which results in slow partial liquefaction with caseating material resembling cheese. Understand the differences in gross and microscopic appearance of these two types of necrosis.
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