病理学见习课课件：Inflammation+2.ppt

Acute and Chronic InflammationPart 2 * * Objectives Understand: basic pathologic changes of inflammationMorphologic pattern of inflammation—— Alterative (degeneration, necrosis)—— Exudative serous fibrinous suppurative (purulent) hemorrhagic—— Proliferative (parenchymal, mesenchymal cells)Recognize: various components in inflammatory exudate Slide 17: infective granuloma  (e.g. tubercular lymphadenitis)Slide 19: lobar pneumoniaSlide 22: foreign body granulomaSlide 25: pulmonary abscess Tubercular lymphadenitis Ideograph of typical tuberculous granuloma Slide 17 Tubercular lymphadenitis Multinuleated giant cell, Langhans’ cell (blue) Caseous necrosis (black) Slide 17 Slide 17 Epithelioid cells with eosinophilic cytoplasm and vague cell-cell conjunction Slide 17 The pink rod microbes, the causative agents engulfed in the giant cells, are Mycobacteria tuberculosis (Z-N stain) Lobar pneumonia Streptococcus pneumoniae Slide 19 Slide 19 Consolidation of a large portion of a lobe or of an entire lobe, the alveoli are filled with fibrinoid exudate Slide 19 The alveoli are filled with fibrinoid exudate, while the structure of alveolar septum still remains Slide 19 The alveoli are filled with fibrinoid exudate, some of which permeate through the alveolar pore (arrow) Slide 19 Recall that bacteria elicit a neutrophilic inflammatory response, you can see the alveolar spaces are full of PMNs Slide 19 PMNs can only live for 2 or 3 days, so macrophages have replaced the PMNs at late stage. The alveolar exudate has become fibrotic (organizing pneumonia) Slide 22 Foreign body granuloma