Cellular pathology
Cell injury & Cellular Adaptive Changes
a) Physical agents
• Trauma, Burn, pressure, irradiation
b) Chemical agents; Poisons and drugs
c) Micro organisms- Bacteria, Virus, Fungus and
Parasites
d) Genetic defects; Can affect cellular metabolism
through inborn errors of metabolism or gross
malformation
e) Hypoxia
• Is the most common stimuli (cause)
• Is because of inadequate oxygen in the blood
or decreased tissue Perfusion.
f) Nutritional imbalances ; Under nutrition or
over nutrition causes cellular injury or
changes.
g) Immunologic reaction; E.g. Hypersensitivity
reaction.
Types of cellular Adaptive-changes
I. Increased concentrations of normal cellular
constituents.
ii. Accumulate abnormal substances
iii. Change the cellular size or number
iv. Undergo a lethal change.
Changes to cellular size or numbers
• I) Atrophy (decrease in cell size).
• Causes: - Decreased work load (Disuse atrophy)
• Loss of nerve supply
• Decreased blood supply
• Inadequate nutrition
• Loss of hormonal stimulation; Eg. - Uterine
atrophy after menopause.
• Physiologic Atrophy; Eg. - Loss of muscle bulk
with ageing
Dysplasia:-
• the appearance of cells that have undergone
some atypical changes in response to chronic
irritation.
• It is controlled reproduction of cells, but
closely related to malignancy in that it may
transform into uncontrolled, rapid
reproduction.
III) Hyperplasia:-
• increase of tissue mass due to an increase in
the number of cells.
IV) Hypertrophy
• increase in the size of individual cells, resulting in
increased tissue mass with out an increase in the
number of cells.
• It is usually response of a specific organ to an
increased demand for work; Enlargement of
muscles in Athletes
V) Metaplasia
• Metaplasia is a reversible change in which one type
of adult cell is replaced by another type.
• It is an adaptive substitution of one cell type more
suitable to the hostile environment for another
• Eg. - Replacement of the normal columnar, ciliated
goblet cells of the bronchial mucosa by Stratified
squamous epithelial cells in chronic smokers
CELLULAR INJURY AND LETHAL CHANGES
• (Cell Death)
• Cell injury can be sub lethal or lethal. Sub lethal
injury alters functions with out causing cell death.
• The changes caused by this type of injury are
potentially reversible if the injuring stimuli are
removed.
• Causes of cell injury:-
Classification of cell injury:-
• Cellular injury can be reversible or it may
progress to irreversible change (Lethal
change).
1. Reversible cell injury:-
• Is cell injury which can be reversed when the
stimulus or the cause of injury is removed.
• Example-Ischemia:
• Ischemia refers to a critical lack of blood supply to
a localized area.
• It is reversible in that tissues are restored to
normal function when oxygen is again supplied to
them
2. Irreversible Cell injury
• It is cellular injury that can not be corrected (reversed) after
the stimulus or cause has been removed.
• Example:-a. Infarction:-
• Is localized area of tissue death due to lack of blood supply.
• It is also called Ischemic Necrosis.
• It is due to occlusion of blood vessels by thrombus or
embolus.
• Septic Infarction is added when there is evidence of
infection in the area.
b. Necrosis:-
• The term necrosis refers to cell or tissue death
characterized by structural evidence of this death.
• T h e s t r u c t u r a l c h a n g e s a r e mitochondrial
swelling, rupture of cell membrane, shrinking of
nucleus or fragmenting, and release of lysozomal
enzymes
Neoplasm
• Definition of terms:-
• Neoplasm: - New abnormal growth because of
abnormal cellular- reproduction.
• It is synonymously used with tumor.
• Tumor: - A growth of Neoplastic cells clustered
together to form a mass.
• It can be benign or malignant.
• Benign tumor: - Is characterized by abnormal cell
division but no metastasis or invasion of the
surrounding tissues.
• Malignant tumor: - Abnormal cell division
characterized by ability to invade locally,
metastasize and reoccur. It is cancer cells.
• Carcinogenesis: - production or origination of
cancer cells.
• Sarcoma: - Malignant growth from mesodermal
tissues I.e. connective tissues, blood-vessels, organs,
• Metastasis: - Ability to establish secondary tumor
growth at a new location away from the primary
tumor.
• Carcinoma: - Malignant growth originating in
epithelial tissues
Mechanisms of carcinogenesis
a. Genetic Instability:-
• The theory of somatic cell mutation supports
the concept that mutational carcinogenic
agents and heredity susceptibility can induce
genetic abnormalities.
b. Carcinogens
• Carcinogens are those substances that are
capable of inducing neoplastic growth.
• They are also called oncogenes.
• Some substances induce neoplastic growth at
higher doses and exposure rates while others can
be carcinogenic at lower doses and exposure rate.
4. Other Factors in carcinogenesis
• Epidemiologic studies have revealed other factors
in the occurrence of neoplasms besides chemical,
physical and viral-carcinogens.
• Some of these factors are dietary habits, sexuality,
and other personal habits like smoking, alcohol
consumption
