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CELL INJURY,
AND CELL DEATH
Irreversible injury
1. Necrosis
a. Coagulative necrosis
b. Liquefactive necrosis
c. Caseous necrosis
d. Enzymatic necrosis
2. Apoptosis
Hepatocyte cellular swelling
Enlarge of hepatocyte
Granular cytoplasm
Fatty change
Clear (lipid containing)
vacuoles in cytoplasm
Eccentric located nuclei
Coagulative necrosis
Tumor cells
Necrotic cells show
eosinophilic cells
Cell outline (+)
Coagulative necrosis
Hepar in septic shock
Paracentral necrosis
Necrotic cells show
eosinophilic cells
Cell outline (+)
Liquefactive necrosis
Acute appendicytis
Cell outline (-)
Replaced by inflammatory
cells and cell debris
Caseous Necrosis
Lung tuberculosis
Central necrosis
(eosinophilic amorphous
material), cell outline (-)
Surrounded by epitheloid
cells, lymphocyte, Langhans
giant cell
Tubercle (granuloma)
formation
Apoptosis
Cancer cells
Single cell
Small, dense nuclei
Intensely eosinophilic
cytoplasm
Intra & extra cellular accumulation
1. Lipids
a. Steatosis (Fatty change)
b. Cholesterol (Atherosclerosis)
2. Protein
a. Hyaline change
3. Pigment
a. Melanin
b. Carbon
c. Hemosiderin
Fatty change
Clear (lipid containing)
vacuoles in cytoplasm
Eccentric located nuclei
Atherosclerosis
Intimal thickening
(atheroma)
Subintimal cholesterol
deposition
Dystrophic calcification
Hyaline change
Hyaline (amorphous eosinophilic)
material in tubular lumina
Melanin pigment
Brown pigment
Hemosiderin pigment
Golden brown pigment in
alveolar macrophages
Pathologic calcification
1. Dystrophic calcification
2. Metastatic calcification
Dystrophic calcification
Fragmented basophilic
material