Inflammation 6

Designed for UG Pathology teaching.

1. Inflammation
and Repair - 6
Dr.CSBR.Prasad, M.D.
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2. Out comes of Acute Inflammation
May have one of three outcomes:

1.Complete resolution
2.Healing by fibrosis
3.Chronic inflammation
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3. Out comes of Acute Inflammation
May have one of three outcomes:
1.Complete resolution

Restoration of inflamed tissue to normal
No loss of cells
No architectural loss

Seen when:
Inflammation is short lived
There is little tissue destruction
The tissue can regenerate – eg: liver

It involves:
Removal of cellular debris and microbes by macrophages
and
Resorption of edema fluid by lymphatics
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5. Fulminant fatal acute viral hepatitis

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7. Out comes of Acute Inflammation
May have one of three outcomes:
1.Complete resolution
2.Healing by fibrosis:
It occurs:
–When there is substantial tissue loss
–When inflammation occurs in tissue incapable of
regeneration
–When there is excessive fibrin exudation which can
not be cleared

In these conditions connective tissue grows into
the area of destruction - ORGANIZATION
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8. Out comes of Acute Inflammation
May have one of three outcomes:
1.Complete resolution
2.Healing by fibrosis
3.Chronic inflammation
This occurs when:
•There is persistence of injurious agent
•There is interference with normal healing
process
Eg: Peptic ulcer, Complicated pneumonia
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10. Morphologic Patterns of Acute
Inflammation
The morphologic hallmarks of all acute inflammatory
reactions are:
•dilation of small blood vessels
•slowing of blood flow, and accumulation of leukocytes and
fluid in the extravascular tissue
•However, special morphologic patterns are often
superimposed on these general features, depending on the
severity of the reaction, its specific cause, and the particular
tissue and site involved
•The importance of recognizing the gross and microscopic
patterns is that they often provide valuable clues about the
underlying cause
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11. Morphologic Patterns of Acute
Inflammation
SEROUS INFLAMMATION
FIBRINOUS INFLAMMATION
SUPPURATIVE INFLAMMATION
ULCERATIVE INFLAMMATION
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12. Morphologic Patterns of Acute
Inflammation
SEROUS INFLAMMATION
•marked by the outpouring of a thin fluid
•The skin blister resulting from a burn or
viral infection represents a large
accumulation of serous fluid
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13. SEROUS INFLAMMATION
Catarrh
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15. Vesicular and Bullous Lesions of Poison Ivy
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18. Serous inflammation
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19. Morphologic Patterns of Acute Inflammation
1.SEROUS INFLAMMATION
2.FIBRINOUS INFLAMMATION

A fibrinous exudate develops when:

Vascular leaks are large or
Local procoagulant stimulus (e.g., cancer cells)

Fibrinogen will be converted to fibrin

Occurs in inflammations involving the body cavities

Histology of fibrin: Eosinophilic meshwork of threads
or amorphous coagulum

Presence of fibrin stimulate the fibroblasts and blood
vessels resulting in scarring

Scarring (organization) may result in functional
impairment eg: cardiac encasemnt v3-CSBRP-May-2012

20. The typical “bread and butter” appearance of fibrinous pericarditis.
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23. FIGURE 2-19 Fibrinous pericarditis. A, Deposits of fibrin on the
pericardium. B, A pink meshwork of fibrin exudate (F) overlies the
pericardial surface (P).
Fibrinous inflammation
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25. Morphologic Patterns of Acute Inflammation
1.SEROUS INFLAMMATION
2.FIBRINOUS INFLAMMATION
3.Suppurative inflammation: Abscess

Characterized by large amounts of PUS:

PMNs, Necrotic tissue
Edema fluid
Bacteria

Abscess: Localized collections of purulent
inflammatory tissue

Histologically:
Central core of necrotic tissue
Viable leucocytes at the periphery
Wall composed of granulation tissue

Walled off by fibrocollagenous tissue
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29. FIGURE 2-20 Purulent inflammation. A, Multiple bacterial
abscesses in the lung, in a case of bronchopneumonia. B, The
abscess contains neutrophils and cellular debris, and is surrounded
by congested blood vessels.
Suppurative inflammation
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32. Morphologic Patterns of Acute Inflammation
1.SEROUS INFLAMMATION
2.FIBRINOUS INFLAMMATION
3.Suppurative inflammation: Abscess
4.ULCERATIVE INFLAMMATION:

Def: An ulcer is a discontinuity in the surface epithelial
lining or tissue due to sloughing of necrotic cells

Commonly encountered in

Lining epithelia
Skin and subcutaneous tissue

Eg: Peptic ulcer, Ophthus ulcers

Histologically:
PMN infiltrates at the margins
Granulation tissue formation
Fibrosis with chronicity v3-CSBRP-May-2012

33. FIGURE 2-21 The morphology of an ulcer. A, A chronic duodenal
ulcer. B, Low-power cross-section of a duodenal ulcer crater with an
acute inflammatory exudate in the base.
Ulcerative inflammation
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35. Gastric ulcer
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36. Gastric
ulcer
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40. E N D
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