INFLAMMATION
Assistant of professor
Nechiporenko G. V.
1
Inflammation- is a local vascularmesenchymal reaction to injury of living
tissue due to different agents.
 This reaction has protective-adaptive
character.
 It can kill agent caused injury and repair
injured tissue.
 Inflammation contains elements of
pathology and physiology.
 Heat (calor), redness (rubor), edema
(tumor), pain (dolor), and loss of function
(functio laesa).

2
Types of inflammation
Morphological types: alterative, exudative,
and proliferative (productive)
 Due to etiology: specific and non-specific
(banal)
 Due to duration: acute, subacute, and
chronic
 Due to type of tissue’s reaction:
normergic, hyperergic and hypoergic

3
4
Cells marginated along the dilated venule wall (arrow)
are squeezing through the basement membrane
(diapedesis) and spilling out into extravascular space.
5
6
Exudative inflammation
Catarrhal
 Serous
 Purulent (suppurative)
 Fibrinous
 Hemorrhagic
 Putrefactive
 Mixed

7
Serous inflammation
It is characterized by exudate contained
about 2% proteins, single neutrophilic
polymorphs and mesothelial cells. It
occurs in serosa, mucosa, meninges, skin
and internal organs.
 Outcome is usually favorable. In severe
cases it can be progressive into serouspurulent.

8
Serous inflammation
9
Suppurative inflammation
Phlegmon- diffuse unbounded purulent
inflammation. Types: soft and dense.
 Abscess- local purulent inflammation with
necrosis and formation of cavity.
 Empyema- appearance of pus in serosal
cavities or organs with cavity.
 Furuncle- purulent inflammation of hair
follicle.
 Carbuncle- formation of several closely
disposed furuncles with necrotic centre.

10
Hand, staphylococcal abscess
11
Pustule- purulent rash in epidermis.
Pimple.
 Panaritium- purulent inflammation of
ungula phalanx. Panaris, whitlow, felon.
 Paronychia- purulent inflammation of soft
periungual tissue.
 Pyemia- septic dissemination in blood.
 Fistula- pathologically formed canal from
organ to cavity, other organ or skin for pus
excretion.

12

Acute abscesses of
the lung in upper
lobe and lower
lobe.
13
Here is abscess in the lung. The
alveoli in that area are destroyed.
14

Chronic abscess in
the right middle
lobe of the lung.
15
Acute phlegmonous appendicitis
16
Acute phlegmonous-ulcerative
appendicitis
17
Acute Streptococcus meningitis.
A purulent exudate is seen in the meninges. The
exudate obscures the sulci.
18
Hand, healing by secondary intention
A whitish-greenish-yellow neutrophilic exudate represents
an inflammatory response to bacterial invasion of the
wound.
19
Streptococcal
purulent
inflammation
at lower leg.
20
Outcomes of purulent inflammation











Resolution,
scarring,
petrification,
organization,
incapsulation,
acute toxemia,
pyemia,
sepsis
keloid
chronic duration,
amyloidosis
21
Fibrinous inflammation
Exudate contains fibrin, neutrophils and
necrotic tissue elements.
 It occurs in mucosa, serosa, meninges,
and internal organs (lungs).


Croupous and dyphtheritic types of
fibrinous inflammation.
22
This yellow-green exudate on the surface of an inflamed,
hyperemic bowel mucosa consists of many neutrophils along with
fibrin and amorphous debris from dying cells.
23
Microscopically, exudate consists of inflammatory cells, necrotic
epithelium, and mucus in which the overgrowth of
microorganisms takes place. The underlying mucosa shows
congested vessels, but is still intact.
24
Croupous pneumonia
25

Here, the
pericardial cavity
has been opened
to reveal fibrinous
pericarditis with
strands of stringy
pale fibrin between
visceral and
parietal
pericardium.
26
The fibrinous exudate consists of pink strands of fibrin jutting
from the pericardial surface at the upper left. Below this, there
are a few scattered inflammatory cells.
27

It is fibrinous
pericarditis with
hemorrhage.
28
29
Outcomes of fibrinous inflammation
Resolution
 Organization
 Ulcers
 Scarring
 Obliteration of cavity
 Chronic duration

30
Anthrax
31
32
Miliary tuberculosis of the lung.
The granulomas 1-2 mm are scattered like millet
seeds.
33
Here are two pulmonary granulomas in tuberculosis. They
typically consist of epithelioid macrophages, giant cells,
lymphocytes, plasma cells, and fibroblasts.
34
These are epithelioid cells around the center of a
granuloma. They get their name from the fact that they
have lots of pink cytoplasm similar to squamous epithelial
cells. Their nuclei tend to be long and stringy.
35
leproma
36
Lepromatous leprosy.
Large collections of foamy macrophages
(Virchow cells) infiltrate the dermis.
37
Necrotizing granulomatous vasculitis (Wegener's
granulomatosis).
This is a renal biopsy with a focal lesion centered around a blood
vessel.
38
Sarcoidosis, granulomatous inflammation in Spleen
Granulomas are scattered diffusely throughout the splenic
parenchyma.
39
Sarcoidosis, Lymph node
The granulomas are closely packed, often merging, with scant
intervening lymphoid tissue. Scattered multinucleated giant cells
are apparent.
40
The granulomatous inflammation in Crohn's
disease is demonstrated with epithelioid cells,
giant cells, and many lymphocytes.
41

Disseminated
histoplasmosis in
liver.

Many fungal infections
can produce a
granulomatous pattern.
The immune response is
often poor, so
granulomas are poorly
formed. This portion of
liver demonstrates some
pinpoint yellow-tan
granulomas.
42
This is infection with Histoplasma capsulatum. Note how
each macrophage is filled with numerous small organisms.
The organisms have a clear zone around a central blue
nucleus which gives the cell membrane the appearance of a
capsule.
43
Hydatid disease of liver
44
Sometimes the inflammatory reaction is mainly one of
scarring, as seen here with a silicotic nodule of the lung. The
inhaled silica persists indefinitely and produces an
inflammatory reaction that is marked by prominent fibrosis.
Dense pink collagen is seen in the center of the nodule.
45
The interstitial lymphocytic infiltrates with little necrosis
are characteristic for a viral myocarditis (Coxsackie B). It
may be a cause for sudden death in young persons.
46
Chronic inflammation of the bronchi has led to dilation and
scarring with increased tan to white collagenous tissue.
47
The end result of inflammation can be scarring. Here, the
alveolar walls are thickened and filled with pink collagen.
48
Liver, chronic inflammation, cirrhosis
Secondary to a prior episode of severe hepatitis, fibrosis has
developed in this liver, altering its architecture.
49