Adaptation

types of adaptation

1- atrophy
2- hypertrophy
3- hyperplasia
4- metaplasia

-
 " ""
"
* " •

.? y
Lisbon soft testicular atrophy
↳• firm
↳• hard →•eg , malignancies microscopic

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•
•
gross 1 decrease in the size of semi nephrons tubules .

cell
population
.

germ
.

size
2- decrease
in
1- decrease
in
trauma sertoli cells
-

infection
inflammation firm consistency 3- More prominent
.

thickness and stained pink

+
2-
membrane
•

basement
4- increase
www.g.gy.nnwn.my
,, , . .
-
radiation g. n.gg.
ischemia

h÷ni
-

if acute → testicular
infarction

eoommpptiieoattiionnss.ge .

infertility

On the left is a normal testis. On

the right is a testis that has
 40-I.tw

*,

Sertoli cell _-*

This is the microscopic appearance of normal testis. The seminiferous

tubules have numerous germ cells. Sertoli cells are inconspicuous.
Small dark oblong spermatozoa are seen in the center of the tubules
 ¥02.5
leydig

✓
are
cells
normal

decrease "
"^£°"
"

{
¥
.

Ñ*Ñ
of
9- mostly are

thick elongated sertoli

basement cells

membrane

→
congested
vessels
blood

Atrophic testis is demonstrated here. Note the marked loss of germ cells with
remaining tall pink Sertoli cells, peritubular fibrosis, and interstitial fibrosis
 BPH
Benign prostatic hyperplasia
"
✗

gross
normal noduteeleel
enlarged gland (160-10091) 20g
is
=☒

TÉ•*
.
,
% -

in proliferation
of stromal and
=
/ in number of cells
soft to firm consistency
.

cell
epithelial
. -

pale gray
yellow pink
.

or
-

soft ooze fluid

epi
.

• → -
may

firm → stroma

• complications ,

- urine retention microscopic

infections buds
papillary
"

nephropathy
modularity
yellowish cuboidal flat
-

•• or
gray or "

( inner columnar , outer

2 layer epi
.

fluid membrane
inked basement
oozing
-

carcinoma plasia
basement intact basement
ruptured membrane
membrane

of epi cells
layer of
1 epi . cell 2 layer .

columnar inner columnar and outer

only inner

cuboidal or flat

This prostate is enlarged due to prostatic hyperplasia,

which appears nodular
4011

÷
!
µoÑ→
stroma
muscular
fibro

The normal histologic appearance of prostate

glands and surrounding fibromuscular stroma is
shown here at high magnification
4/1
64

i.
Apiary
nodules
of
projections p number
optically → cells

\
dilated

.im?jl gD.&.pbsjHkib- 1t
Microscopically, benign prostatic hyperplasia can involve both
glands and stroma, though the former is usually more prominent.
Here, a large hyperplastic nodule of glands is seen(low power)
10X crossly →
sectioned
papillary
projection

At higher magnification, the enlarged prostate has

glandular hyperplasia. The glands are well-differentiated
and still have some intervening stroma .
 -
hypothalamus
Thyroid hyperplasia

€
1-
HH •
Microscopical
pituitary gland in number
Thyroid follicles
increase

# crowded
-

T
columnar
elongated
,

follicular
,
-
cell are
or

intothelumurthyro.cl
gland
the colloid
papillae
with
result in the formation of

pate scalloping
.

is
Is ,T4 -

of stroma increased vascularity

proliferation
,
,

infiltration
-

disease
lymphocytes
autoimmune
ggrrcawveess , an

which , ther are antibodies act

disease in

as TSH , causing
continual stimulation

thyroid gland
of

clinical features → Isaiah

receptors
.

TSH on

commonly young female

gross
-

of
91 and nervousness ←
symmetrical enlargement
-

increased apatite weight loss

-

+
smooth and soft in consistency -

tachycardia palpitation
increased
-

worm or not due to ,

- -

vascularity
→ symmetrical -

sweating
* graves -
tremors
multi nodulargoiter -
* asymmetrical
 cuboidal
cells

µ. c cells or

paratollicular
IF cells

Normal thyroid seen microscopically consists of follicles lined by a an

epithelium and filled with colloid. The follicles vary somewhat in size. The
.interstitium, which may contain "C" cells, is not prominent
 BYnumber of cell
•
was

papillary projection scalloping

be
↳ crowding + •

• cuboidal _p columnar
white vesicles due to rapid uptake
0¥ Ts ,T4
• colloid , pink → pale increase
in number
•

but decrease in
size of colloids

"

ME

answer autoimmune •
papillary
to the lumen → hyperplasia
carcinoma
? -• disease not to the lumen *

ympnoogtos
-

point papillary
→
black "
②
cells

A diffusely enlarged thyroid gland associated with hyperthyroidism

is known as Grave's disease. At low power here, note the
prominent infoldings of the hyperplastic epithelium
 scalloping

1.

-8
congested
capillary

At high power, the tall columnar thyroid epithelium

with Grave's disease lines the hyperplastic infoldings
into the colloid. Note the clear vacuoles in the colloid
next to the epithelium ,this is called scalloping
The endometrial cavity is opened to reveal
.lush fronds of hyperplastic endometrium
Benign simple cystic endometrial
hyperplasia
Dilated glands/multi layers
This is endometrial cystic hyperplasia in which the amount of
endometrium is abnormally increased and not cycling as it should
 simple
columnar"
cells in
the
Metaplasia gross
goblet barrett esophagus µedmÑ_
PM
's

gland
=
,

squamous
strmaf.it#iniudepi

Barrett's esophagus" in which there is gastric-type

mucosa above the gastroesophageal junction male
midde aged
heartburn ,
chest pain ,
Lab. Two
cell injury
 gross ,

1- increase
size and weight
color
2- pale

§
$ "^^* " macroscopic •

-
↳

Cloudy swelling of kidney

 microscopic

tubular cells
-

enlarged
colon cytoplasm
-

pale
- no central lumen

-
vacillated cytoplasm

gross
increase in the size and
color
weight and turgor , pale

Cloudy swelling of kidney

water inside the cells
 the cells
fat inside gross
of liver
- enlargement
in consistency , soft
•
greasy
• yellowish colour

Microscopic
-
enlarged cell size

-
nuclei pushed to the periphery
are

-
vacates cytoplasm ¥4 :
in

then fuse together and

may rupture to form cyst a

vacates-B

.fatty change. of the liver in which deranged lipoprotein

transport from injury (most often alcoholism) leads to
accumulation of lipid in the cytoplasm of hepatocytes.
 of irreversible cell injury :•
changes
cytoplasmic changes ,

1.
deep pink colour

giassy hemogenous appearance

Lab. Three
.

2 .

nuclear charges ,

1. shrinkage and deep blue .

pyknosis

2. fragmentation karyorrhexis
, .

irrevesible
3. complete
loss , karyolysis .

cell injury
 deep blue colour

pyknosis
 fragmentation

Karyorrhexis
now
 &

t
←
q

to

hepatocytes):
Nuclear changes (fragmented),
(Karyorrhexis)
 ftp.ies/*wsW
Coagulative necrosis:
Increase cytoplasmic
cy¥iwÑ
"

"

eosinophilia:
Here is the gross
appearance of a
lung with
tuberculosis.
Scattered tan
granulomas are
present, mostly in
the upper lung
fields. Some of the
larger granulomas
have central
caseation
 clinical features → .MU -6
gross
cough with blood
tan
nodules firm "

irregular
" >

,
,
-

-
fever and sweating
caseous necrosis
-
loss of
weight
with whitish to

yellowish colour

and soft
consistency

T.B. Lung.
Caseous necrosis (cheese martial) yellowish whitish friable material
lymphocytes
epithelorioid

iÉ÷
iii.cells
caseous center
am

a-

Caseous necrosis: (lung T.B.)

caseous granuloma.(central cassation )
langhan’s giant cell
 necrotic
amorphous
center
microscopic :
-

-
presence
caseous

presence of
of

necrosis
granuloma
in

longhairs
the center

g.
aint
4.5 -2mm)

pink #
and amorphous
epithelioid
cells
nuclei arranged in
cells ✗ many

a hoarse shoe appearances , . ↳

Note the pink, amorphous region in the center of this granuloma at the upper right,
and ringed by epithelioid cells at the left and lower areas of this photomicrograph.
.This is the microscopic appearance of caseous necrosis
 alveolar

my
tissue
•

••÷o
of
lung
or
manana

Well-defined granulomas are seen here. They have

rounded outlines. The one toward the center of the
photograph contains several Langhans giant cells .
 •
langhanscells
gaint

w w.hourse shoe appearance

Lang hanz giant cell (horse show

)causes necrosis with TB bacilli
 with nonue_ gross
fat cells small sized mass ,
tender, sharply localized

micro

-
fat necrosis , steatocyte with no

nuclei
necrotic
-

pink amorphous intervening

materials .

lipo phage
-
interstitial fibrosis

Microscopically fat necrosis of breast consists of irregular

steatocytes with no peripheral nuclei and intervening pink
amorphous necrotic material and inflammatory cells, including
foreign body giant cells responding to the necrotic fat cells
 nonudei-Y.pl?pnages-
fat cells with

fat necrosis at high magnification, some lipid-laden

macrophages(lipophage) are seen between the necrotic adipose
tissue cells. The most common etiology is trauma,
This is the normal appearance of myocardial fibers in longitudinal
section. Note the central nuclei and the syncytial arrangement of
the fibers, some of which have pale pink intercalated disks.
 gross
well defined
the intruded area is ,

like n , pale in

geographic map
✗

with
color and surrounded

Impale
,
rim
hyperemia
.

narrow

÷ . .

This is the left ventricular wall which has been sectioned lengthwise to
reveal a large . myocardial infarction. The center of the infarct contains
necrotic muscle that appears yellow-tan. Surrounding this is a zone of red
hyperemia. Remaining viable myocardium is reddish- brown.
 microscopic
:

loss of nuclei .

loss
of striation .

eosinophilic cytoplasm
-
.

-
more

neutrophils infiltration .

The myocardial cell nuclei have almost all

disappeared. There is beginning acute
inflammation, loss of striation.
 Lab. four
acute inflammation
 at
neutrophils
of vessels
the margin

PMN's are marginated along the venule wall

(arrow) are squeezing through the basement
membrane (the process of diapedesis) and
spilling out into extravascular space .
 acute cholecystitis

gross intense dark red dark green

Gall stones enlarged
or
,

materials 90% of cases contain stone

in color, filled with purulent
 Microscopic
-
mucosal aberration
B.✓
congested " """ " " "
"
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-

"
" "" "
"" "
-
edema

t.es?essd
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good
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calculus 90%

acute cholecystitis yB → acakubis 10-1

.
This is the normal appearance of the
appendix (color is yellow)
acute appendicitis (grossly) brown in color
withfibrinoid exudatedark red
/ covered or

gross eywla.gg# ,
 mucosa Ig

%%Ño
inflammatoyc.tl#others--
microscopic
acute
neutrophil infiltration
→
-

-
subserosal vessels congestion .

-
mucosal ulceration

exudate lumen
purulent
-
in

-
smooth muscle fibers are

separated by edema .

congested
BN
↳

Microscopically, acute appendicitis is

marked by mucosal inflammation
and necrosis.
 £4 pus
mucosa

pus
pus pus

Acute appendecitis at high power the

mucosa shows ulceration and
undermining by an extensive
 A closer view of
the lobar
pneumonia
demonstrates
the distinct
Consolidated difference
lobe
between the
upper lobe and
gross gray
in color the
dry ,

firm in consistency consolidated

lower lobe.
 F-
plasma
cells

→
congestion
of B V

Lobal pneumonia(vascular congestion and an

outpouring of fluid with fibrin into the alveolar
spaces seen here, along with PMN's.
 microscopic

alveolar wall capillary congestion

gyyfi0§Ñ&
••

alveolar space is filled with

-•

and fibrin
neutrophils , RBCs ,

numerous neutrophils and RBCs fill the

alveoli in this case of lobar pneumonia.
Note the dilated capillaries in the alveolar
walls
affected normal

At the left the alveoli are filled with a neutrophilic exudate

that corresponds to the areas of consolidation seen grossly
with the bronchopneumonia. This contrasts with the
aerated lung on the right of this photomicrograph
At higher magnification can be seen a patchy area of alveoli that
are filled with inflammatory cells. The alveolar structure is still
maintained, which is why a pneumonia often resolves with
minimal residual destruction or damage to the lung.
 Lab. Five
chronic
inflammation
The histologic appearance of normal salivary gland
(submandibular) with both serous and mucinous acini,
as well as ducts, is shown here.
 gross
reduced size

an

fibrosis
inflammation
infiltrate microscopic
• lymphocytes and macrophages infiltration
duets
-
atrophy in acini and

-
interstitial fibrosis

atrophic
←duet
¥É

Seen here at low power are chronic

inflammatory cell infiltrates along with
fibrosis and acinar atrophy
 duet
lymphocytes
At higher magnification, the numerous lymphocytes comprising
the inflammatory infiltrates of chronic sialadenitis are seen
adjacent to a duct at the lower right.
 -
eki-niaaa.mn
.

nucturea
poly
urea ,

normal
-

hypertension
-
poly urea ,
late gluuueruli→
indicate glomerular
membrane damage

gross →
reduced kidneys ffiibbrrottie
ggµµe¥÷
size ,

and asymmetrically
contracted

microscopic
- interstitial fibrosis

lymphocytes macrophage
atrophied
-
and

gµwWÑ
infiltration
of tubular cells
-

atrophy -
•

)
hyalinieation tufts
"

-
of
glomerular .

www.wti
g.
↳

*
*⇐
o5

pelvis kidney

This is chronic pyelonephritis .The large

collection of chronic inflammatory cells seen
here bacterial usually
 ÷
•
:O lymphocytes
→
ing -aÑ
ix.
↳

g-Id
-0£
.

§ large +
↳↳
I
"Ñ
plasma
cell

chronic int . →
reduced siee
except amyloidosis no increase in size

Both lymphocytes and plasma cells are seen at

high magnification in this case of chronic but

pyelonephritis
not disease
stage of fibrosis it the advanced
a
cation is
hyalini is ,

a description .
 Lab. six
healing and repair
 ;÷F÷ñÑ:# rose

At high magnification, granulation tissue has

capillaries, fibroblasts, and a variable amount of
vascular inflammatory cells
granulation
tissue
vasculargranulation tissue
The normal histologic appearance of the skin . At the top is the
epidermis. A thin layer of keratin overlies the epidermis.
Beneath the epidermis is the dermis containing connective tissue
with collagen and elastic fibers. At the center can be seen a hair
follicle with surrounding sebaceous glands.
gross
soft , pale , granular area

.fid
micro
"""
"*"
"
- re -

epithelialisntion of
surface
- fibroblast and
macrophage presence
-
angiogenesis
granulation
,%
deposition of collagen
fibrous
-
"
" " scar
fibrosis
"

tissue

cap

This is a healing biopsy site on the skin seen a week

following the excision, The skin surface has re-
epithelialized, and below this is granulation tissue
with small capillaries and fibroblasts forming
collagen.
 keratin

epi

fibrous
tissue

Skin scar, Healed skin

micro

"
-
angiogenesis
""" "* "" "
and collagen deposition .

infiltration
macrophage
.

fibroblast
deposition
angiogenesis
Cbs

macrophage -

an acute myocardial infarction is seen healing.

There are numerous capillaries, and collagen
(fibtovascular granulation tissue) . Non-infarcted
myocardium is present at the far left.
 A"
fibrous
granulation
tissue

Fibrous granulation tissue.

There is pale white collagen within the
interstitium between myocardial fibers
 Lab. Seven
Hemodynamic disturbance
Oedema and Thrombosis
Normal microscopical picture of the lung
 gross
their
the lungs are 2-3 folds weight ,
on

congested↳ sectioning oozing frothy

blood

nowoÑ¥É
> >

capillary stained fluid -

pinged
it

Pulmonary edema
dilated blood vessels , engorge capillary with RBC,
oxidative material (pink in color )
 microscopic
- tortuous , engorged alveolar
wall capillaries
alveolar space contain
pink homogenous fluid
.

heart failure cells

hemosidren particles
.

or
-

infection
of superimposed bacterial
.

infiltration
neutrophils in case
-

The pulmonary alveoli are full of amorphous

eosinophilic fluid which has leaked from the congested
capillaries. Afew eosinophilic strands are also present in
the lumen of some of the alveoli
 heart
failure
cells
☒
✓

÷¥:*

Pulmonary congestion with dilated capillaries and leakage of blood into

alveolar spaces leads to an increase in hemosiderin-laden macrophages,
as seen here. Brown granules of hemosiderin from break down of RBC's
appear in the macrophage cytoplasm. These macrophages are sometimes
called "heart failure cells" because of their association with pulmonary
congestion with congestive heart failure.
"heart failure cells" because of their association with
pulmonary congestion with congestive heart failure.
This is a normal coronary artery with no atherosclerosis and
a widely patent lumen that can carry as much blood as the
myocardium requires.
 gross
adherent
gray
-
white ,
friable , firmly
arterial wall superimposed
to the injured
.

on an atherosclerotic plague
.

1¥

This is coronary thrombosis, one of the complications of

atherosclerosis. The dark red thrombus is seen in the
anterior descending coronary artery.
 fibrin
pale →
platelets +

- di seated
the
reveal
artery

thrombus
Here is the coronary thrombosis at higher magnification.
The thrombus occludes the lumen and produces ischemia
and/or infarction of the myocardium.
lines of zhan → artery
 ÷⑤ Cholesterol
clefts

Coronary artery thrombosis (complicate A.S).

 microscopic
BBC
's
RBCs ,
aggregation
of
platelet ,

pyifebets leukocytes , fibrin .

fibrin

Mixed thrombus
(line of zahn)
 Lab. eight
Infarct and Embolism
normal adult
kidney irregular

Ji
wedge shaped

⑨ occluded artery
the apex

heart
is

other organs in
in
In cross section, this normal adult kidney
demonstrates the lighter outer cortex and
darker medulla with central pelvis.
 gross intraeted area that
defined wedge shaped
,

sharply with hyperemia margins

appear pale

0
Q.jn.r-n.in
artery
hyperemia
IgA 2£10

This is an acute renal infarction. Note the wedge shape of

this zone of coagulative necrosis resulting from loss of
blood supply. (white infarct)
 infraeteel area

lighter staining

micro
but preserved
architecture
hyperemia
→

-
lighter staining zones

margined by hyperemia
interacted
is
area
-

fractal area and

-
neutrophils band between in

hyperemia
area
tissue and fibrosis .

lately formation
of granulation

§É¥
-
,

pond
yid

This is the microscopic appearance of an acute renal

infarct. At the far right is normal kidney, then to the
left of that hyperemic zone, then to the left of that is
neutrophil infiltration, then to the left is pale pink
infarcted kidney
 Two large infarctions (areas of
coagulative necrosis) are seen in this
sectioned spleen
 pulmonary
infarction (Red
infarct)

¥
 Seen in the
^
pulmonary
artery to the left
"
"

lung on cut
section is a large
pulmonary
thromboembolus
Pulmonary
Embolism snake
like
embolism
This is the microscopic appearance of a
pulmonary thromboembolus in a large
pulmonary artery.
 Lab. nine
neoplasia
Benign tumor