Cellular pathology
Introduction to pathology
What is pathology?
Pathology is the
scientific study of
diseases
The ultmate goal of pathology
Is the identification of cause of disease which
leads to the successful therapy and
prevention of disease
Cellular
responses to
injury
When cells have ability to adjust
acording to their environment
Stuctural and
functional changes
Acording to demand
and stress
Process is called
cellular adaptation
What is cellular
adaptation
Reversible changes in
number ,size ,function
or morphology of cells
in response to changes
in their environment
Normal
cell
Stress
/injury
adaptation
Normal
cell
Stress/injury
Cellular
injury
Example for adaptation
Eg:what happens when myocardium subjects
to increased load
Eg :in mitral valve stenosis
Mitral valve thickened and orifice
narrowed
Need additional effert to pump bld
Cells undergo hypertrophy(enlarge) and
maintain the pump
Example for cell injury
When coronary artery is occluded by
atheroma blood flaw to myocardium
reduces and muscle cells undergo injury
If mild occlusion: reversible injury
If complete occlution:irreversible injury
adaptation
Inability to adjust
Leads
surviv
al of
cell
Celllar injury
Leads cell death
Adaptation is divided as
1.Physiological adaptation-
responses of cells to normal
stimulations made by hormones
and chemical mediators in
special circumstances
Eg:enlargement of breast and
uterus during pregnancy
2.Pathological adaptation
It is a response to stress or increases load
Enables cells to escape the injury by
modulating their structure and function
There are 4 forms
4 responses to
adaptation
1.hypertrophy
2.hyperplasia
3.atrophy
4.metaplasia
hypertroph
y
hyperplasi
a
Cellular
adaptati
on
atrophy
metaplasia
hypertrophy
Definition
Is an increase in size of cells resulting
increase in the organ
Occurs mainly in permenent cells
Eg:heart,skeletal muscleCells
enlarge by increasing amount of organells
and structural proteins
2 types
1.physiological
Eg:hypertrophy of smooth muscle with weight
lifting
2.pathological
eg:myocardial hypertrophy with valve
stenosis
hyperplasia
Increase in number of cells as a response to
stress
Occurs when cells can replicate
Can occur with hypertrophy of the same
organ(hypertrophy and hyperplasia)
Physiological hyperplasia
1.hormonal hyperplasia
Proliferation of glandular epithelium of female
breast with pregnancy
2.compensatory hyperplasia
When part of a tissue is removed or diseased
Eg:liver partial resecction-can restore liver of
normal weight by mitotic proliferation
Pathological hyperplasia
By excessive hormonal or growth factor
stimulus
1.endometrial hyperplasia- due to
disturbances of balance bw estrogen and
progesterone
2.in wound healing- proliferation of
fibroblasts and blood vessels leads repair of
tissue
Atrophy
Is the process of shrinkage of size of cell by
loss of cell substances
Even entire tissue or organ can diminishes
Although atrophic cells are diminished
function they are not dead
Survival still possible
Causes of atrophy
1.decreased work load
eg:muscle atrophy in imobilized patients
due to fractures
2.loss of innervation
3.diminished blood supply
4.inadeuate nutrition
5.loss of endocrine stimulation
eg:menaupause-atrophy of uterus
6.aging(senile atrophy)
In atrophy
Cells still alive in a new equilibrium
established bw cell size and diminished blood
supply ,nutrition etc
In artophy reduced protein synthesis
increased protein degredation
In microscopic examination increased
autophagic vacuoles seen
Leading increased autophagy (self eating)
autophagy
Is the process in which starved cells eat its
own components as an attempt to find
nutrients and survive
Reduced brain substance, wide sulci,
narrow gyri
metaplasia
Is a reversible change in which adult cell type
is replaced by another adult cell type
Here cells are replaced by another cell type
which can easily withstand against stress
Formed by genetic programming of stem cells
Not by trans differentiation of already
differentiated cells
:in cigarette smokers: normal ciliated epithelium in
trachia and bronchi replaced by stratified squamous
epithelium
:in vit a defeciancy also squamous metaplasia of
respiratory epithelium
In chronic gasric reflux - stratified sq.epithelium in
lower oesophagous
Metaplatic transformation to gastric columnar
epithelium
What are the types of epithelium?
If influences that lead metaplasia are
prolonged
Can induce metaplastic transformation
If persistant leads malignant transformation
Cell injury
Normal cells are in a state of
homeostasis(equilibrium) with environment
Injury is a set of biochemical or morphologic
changes occur when this state of homeostasis
is disturbed by adverse influenses
Cell injury may be reversible or
irreversible
Causes of cell injury
1.Oxygen deprivation-hypoxia
ischemia-most common cause
inadequate oxygenation of
blood
eg;pneumonia
reduced oxygen carring
capasity of bld
eg;CO poisioning
2.chemical agents
glucose,salt,CO,pestisides,murcury
3.infectious agents
virus,bacteria,fungi,protozoa
4.immunological reactions
eg:autoimmune reactions
allergic reactions
5.genetic defects
accuilation of damaged DNA-trigger cell
death
6.nutritional imbalances
protein calorie insufficiency ,vit def
7.physiological agents trauma ,extreme
temp, electric shock, radiation
8.aging-reduced ability to respond injurious
agents
Reversible cell injury
In a state of reversible changes
2 morphological formes
1.cellular swelling
first menifestation of all forms of cell injury
plasma membrane alterations
blebbing
swelling of cell
swelling of mitochondria,ER
ORGAN looks pallor with increased turgor
and weight
2.Fatty change
Appearance of lipid vacuoles in cytoplasm
Sp.cells involving fat metabolism
eg;hepatocytes,myocytes
Cell death
With continuing damage the inury become
irreversible
Then cell cannot recover
2 forms of cell death
necrosis
appoptosis
Cell necrosis
When damage to membrane is severe enz
leak out of lysosomes
Enter cytoplasm
Digest the cell
NECROSIS
IN NECROSIS
INCREASED eosinophilia
Break down of plasma memb and orgenellar
memb
This is the major pathway of cell death in
many common injuries
Nessasarily pathologic
Apoptosis
Regulated suicidal program of cells when cell
is deprived of growth factor or if DNA or
PROTEINS are damaged
Cell it self get killed
appoptosis
Is an active enzymetic process
Energy dependent
Neucleo proteins are condenced and broken
down
Cell is fragmented by formation of apoptotic
bodies(fragments of nuclei and
cytoplasm)
Tightly regulated process
Not always pathological
No complete loss of membrane
Causes of appoptosis
Programmed cell destruction in
embryogenesis
Involution of hormone dependent tissue
regression of lactating breast after
weaning
Death of tissue after finishing the role
nutrophils after inflammatory response
lymphocytes after immune response
Viral infection
In DNA damage radiation, anticancer drugs
Thank you
