Block: GBMSIII (pathology lab)

Y1

Hemodynamic disorders
Dr. Abir Muftah
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 Intended Learning Outcomes:

By the end of this lab , you will be able to:

Describe the morphologic changes seen in hemodynamic disorders. Include :
1) The morphological changes of congestion in different organs. Lung- spleen-liver
2) The morphologic changes of gangrene. Dry- wet
3) The morphologic changes seen in infarction. Lung – kidney.
4) The morphology of thrombus.
5) The morphology of different types of emboli.
6) The morphology of hemorrhagic diseases. Cerebral hemorrhage
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Liver (Normal)

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Liver (Normal) Hepatocytes

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 Chronic venous congestion-Liver

Grossly
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(1) Central areas are congested red-brown (hemorrhage & necrosis)
(2) Yellow peripheral zone (fatty change in hepatocytes)/ Nutmeg Liver
 Chronic venous congestion-Liver
Histologically
(1) Congestion around the central veins

(1)

(2)

(2) Peripheral zone shows some fatty change in the hepatocytes

 Normal lung

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Histologically Alveolar septa
Chronic venous congestion-Lung

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Histologically
Chronic venous congestion-Lung
Histologically

(2) The alveolar septa are

widened and thickened

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(1) Heart failure cells
 Normal spleen

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Histologically
Chronic venous congestion-Spleen

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Histologically
 Chronic venous congestion-Spleen
Histologically

(1) Gamna-Gandy body

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(2) Congested splenic sinusoids

 Wedge-shaped

Base

Apex

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 Lung infarction
Grossly

(1) Lung tissue

(2) Wedge-shaped red

(hemorrhagic) infarction

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Renal infarction Grossly

(2) Wedge shape of this zone of coagulative (1) Congested renal

necrosis (pale/white infarct) tissue

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Renal infarction Histologically

(1) The pale infarcted kidney (2) Hyperemic zone of inflammatory

reaction

(1)
(2)

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Dry Gangrene

Grossly:
(1) It is dry, shrunken and dark black 17
(2) The line of separation (demarcation) present at the junction between healthy and gangrenous part
 Hematoma, toenail

Grossly
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(1) A localized collection of blood within tissues is known as a hematoma
(2) A small hematoma under the toenail which has a bluish appearance
 Ecchymoses

Grossly
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(1) Areas of hemorrhage in the skin of arm are called ecchymoses
(2) They are about 1 to 2 cm subcutaneous hemorrhage
Petechiae
Grossly
(1) Colonic mucosa (2) Punctate petechial hemorrhage

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 Intracerebral hemorrhage
Grossly
(1) Intracerebral hemorrhage (2) Brain tissue

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Coronary thrombosis
Grossly (2) The occlusive dark red
thrombus in the lumen of the
coronary artery

(1) The anterior surface of

the heart

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 Thrombus with lines of Zahn

(1) (2)

Histologically
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(1) Represent pale platelets and fibrin layer
(2) Darker red cell–rich (bands of RBC's ) layer
 Organized thrombus (2) Thrombus with
Histologically
recanalization

(1) The fibrous bands of

connective tissue

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Pulmonary embolus (2) Embolus lodged in a
Grossly
pulmonary artery branch
(1) Lung tissue

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Pulmonary thromboembolus
Histologically (2) Pulmonary artery
branch
(1) Pulmonary embolus

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Amniotic fluid emboli (2) Two small pulmonary arterioles
Histologically are packed with fetal squamous
(1) The lung is edematous and congested cells

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Thank you

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