Cellular Responses
Path
is
Lots O’
Fun
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• A 60-year-old man died
secondary to a fungal
infection of the brain. An
autopsy revealed the gross
findings in the photograph.
Necrosis of the brain is
classified as
LIQUIFACTIVE NECROSIS
• A 30-year-old woman who had leukemia
was treated with bone marrow
transplantation. She developed a skin rash
that was interpreted as a sign of a graftversus- host reaction. In the epidermis,
there were scattered dead epidermal cells
that had rounded contours and pyknotic
nuclei. This form of cell death is caused by
activation of caspases through
receptor transmitted signals
on the cell surface
• Uptake of bacteria into the
cytoplasm of neutrophilic
leukocytes is called
PHAGOCYTOSIS
• A 28-year-old man was found to have
cirrhosis of the liver and pulmonary
emphysema. The liver cells contained
globular inclusions in their cytoplasm,
which by electron microscopy are shown to
be located inside the
Dilated cisterns of the
rough endoplasmic
reticulum
A 60-year-old obese man was admitted
to the hospital for treatment of
alcoholism. He has diabetes mellitus.
A liver biopsy was performed, and the
specimen showed that the liver cells
contain increased amounts of
TRIGLYCERIDES
Metastatic calcification
A 48-year-old woman has a malignant
lymphoma. She is treated with a
chemotherapeutic agent which results
in the loss of individual neoplastic cells
through fragmentation of cell nuclei
and cytoplasm. The lymphoma
decreases in size. The mechanism by
which her neoplasm primarily
responded was
Apoptosis
A 53-year-old man has experienced
severe chest pain for the past 6
hours. A coronary angiogram is
performed and reveals >90%
occlusion of the left anterior
descending artery. What cellular
change seen in irreversible injury
will have occurred?
Nuclei undergo
karyorrhexis
A 30-year-old man is struck on the leg by a
falling path book, which strikes him on
his left leg in the region of his thigh. The
skin is not broken. Within 2 days there is
a 3 x 4 cm purple color at the site of
injury. This substance most likely
accumulated at the site of injury and
produced a yellow-brown color 16 days
later
Hemosiderin
A 54-year-old man with a chronic cough
has a squamous cell carcinoma
diagnosed in his right lung. During
surgery, the hilar lymph nodes are jet
black in color. This pigment is the
most likely cause for this appearance
to the hilar nodes
Anthracotic pigment
A 50-year-old woman with a history of
unstable angina suffers an acute heart
attack. Therapy to restore coronary blood
flow is given. In spite of this therapy, the
degree of myocardial fiber injury may
increase because of this cellular
abnormality
Increased free radicals
A 29-year-old man visited the sandy luxurious
beaches on Presque Isle State Park. The next
day he has a darker complexion. His skin
does not show warmth, redness, or
tenderness. His skin tone fades to its original
appearance within a month. This substance
contributes the most to the biochemical
process leading to these skin changes
Tyrosine
A 55-year-old man has a 30-year history
of poorly controlled diabetes mellitus.
He has had extensive black
discoloration of skin and soft tissue of
his right foot, with areas of yellowish
soft tissue, for the past 2 months. A
below-the-knee amputation is
performed. This type of necrosis is
called
Gangrenous necrosis
A 45-year-old man has a traumatic injury
to his forearm and incurs extensive
blood loss. On physical examination in
the emergency department his blood
pressure is 70/30 mm Hg. This cellular
change is most likely to represent
irreversible cellular injury
Nuclear pyknosis
• A 90-year-old woman dies from
pneumonia complicating Parkinson
disease. At autopsy her heart is normal
in size. On microscopic examination,
there is increased lipochrome
(lipofuscin) seen adjacent to the nuclei
within the myocardial fibers. The cellular
mechanism responsible for these
findings is
Autophagocytosis
This is the first manifestation of
almost all forms of injury to cells
Cellular swelling
Necrosis and Apoptosis
This is the result of denaturation of
intracellular proteins and enzymatic
digestion of the lethally injured cell
Necrosis
Fibrinoid Necrosis
A 38-year-old man has a health screening
examination. He has a routine chest xray that shows a 2 cm nodule in the
right lower lobe. The nodule shows
caseous necrosis and calcification. The
following process explains the
appearance of the calcium deposition
Dystrophic calcification