TERMS

Adaptation
• hypertrophy → increase in the size of cells
• hyperplasia → increase in the number of cells
• atrophy → decrease in the size of an organ
• aplasia → failure of cell production
• hypoplasia → decrease in the number of cells
• metaplasia → replacement of one cell type by another
• dysplasia → abnormal cell growth

CELL INJURY

Reversible Cell Injury Irreversible Cell Injury

• swelling of cell organelles and entire cell • dense bodies within mitochondria (flocculent
• dissociation of ribosomes from endoplasmic densities in heart)
reticulum • release of cellular enzymes (e.g., SGOT, LDH, and
• decreased energy production by mitochondria CPK after MI)
• increased glycolysis → decreased pH. → nuclear • nuclear degeneration (pyknosis, karyolysis,
chromatin clumping. karyorrhexis)
• cell death

CELL DEATH

Apoptosis Necrosis
• “programmed” cell death • cause → hypoxia or toxins (irreversible injury)
• single cells (not large groups of cells) • many cells or clusters of cells
• cells shrink → form apoptotic bodies • cells swell
• gene activation → forms endonucleases • inflammation present.
• peripheral condensation of chromatin with DNA
ladder Examples of necrosis:
• no inflammatory response.
• coagulative necrosis → ischemia (except the brain)
Examples of apoptosis: • liquefactive necrosis → bacterial infection (and
brain infarction)
1. Physiologic • fat necrosis → pancreatitis and trauma to the breast
• involution of thymus • caseous necrosis → tuberculosis
• cell death within germinal centers of lymph nodes • fibrinoid necrosis → autoimmune disease (type III
• fragmentation of endometrium during menses hypersensitivity reaction)
• lactating breast during weaning • gangrene → ischemia to extremities → dry (mainly
coagulative necrosis) or wet (mainly liquefactive
2. Pathologic necrosis due to bacterial infection)
• viral hepatitis
• cytotoxic T cell–mediated immune destruction (type
IV hypersensitivity)
GRANULOMATOUS INFLAMMATION

Caseating Granulomas Noncaseating Granulomas

• aggregates of activated macrophages (epithelioid • sarcoidosis
cells) • fungal infections
• tuberculosis • foreign-body reaction

EDEMA

Exudates Transudates
1. Composition 1. Composition
• increased protein • no increased protein
• increased cells • no increased cells
• specific gravity greater than 1.020 • specific gravity less than 1.012

2. Cause 2. Cause → abnormality of Starling forces

• inflammation
• increased blood vessel permeability a. increased hydrostatic (venous) pressure
• congestive heart failure
• portal hypertension.

b. decreased oncotic pressure → due to decreased

albumin
• liver disease
• renal disease (nephrotic syndrome)

c. lymphatic obstruction
• tumors or surgery
• filaria