CHAPTER TWO

INFLAMMATION

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 CHAPTER TWO
• INFLAMMATION
• is a protective response which includes host
cells, blood vessels, and proteins
• Goals are:
- Eliminate the initial cause of cell injury
- Remove necrotic cells and tissue
- Initiate the process of repair

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 Inflammation
 Also a potentially harmful process

• Components of inflammation that are capable

of destroying microbes can also injury the
passerby normal tissue

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 Inflamm . . .
 Components of the inflammatory
process

- Include white blood cells and plasma proteins

- Normally present in the blood
- The inflammatory reaction’s goal is to bring these
blood cells to the site of infection.

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• Inappropriate inflammatory response, when
there are no foreign substances to fight off
leads to autoimmunity.

• Inflammatory process must be tightly

regulated by the immune system to avoid
excessive tissue damage and spillover to normal
tissue

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 Inflamm . . .
 Signs of Inflammation:

 Heat
 Redness
 Swelling
 Pain
 Loss of function

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 Inflamm . . .
• There are two types of Inflammation:

1- Acute inflammation and

2- Chronic Inflammation

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 Inflamm. . .
• Acute Inflammation

• Main components: are vascular changes and

cellular events

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Vascular changes Cellular events
• Vasodilation • Cellular recruitment and
• Vascular activation of neutrophils
permeability (polymorphonuclear
• Increased adhesion leukocytes)
of white blood cells

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 Acute inflammation- Appendicitis

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 NEOPLASIA
• Neoplasia, which is the abnormal growth and
proliferation of abnormal cells or abnormal
amounts of cells due to a benign or malignant
process.
• Neoplasia can be benign or malignant.

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 Neoplasia
• A benign neoplasm, or a benign tumor, has
several general characteristics, including the
fact that:
• It does not invade or destroy the surrounding
tissue it is growing on.
• It does not spread to other parts of the body.

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 NEOPLASIA
• It usually doesn't come back after surgical
removal because the tumor itself has well-
defined margins that help in its surgical
removal.

• Typically, benign tumors grow slowly and have

normal-looking cells and structures or are
well-differentiated.

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• A malignant neoplasm is in general:
• Grows quickly
• May metastasize, which is when cancer cells
spread around the body

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• May come back after surgical removal due to
irregular margins
• Invades and destroys surrounding tissues
• Has abnormal-looking cells or structures,
which is also called 'poorly differentiated' or
'undifferentiated'

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• Examples of Benign vs. Malignant Tumors
• Some examples of benign tumors include
• Papillomas
• Polyps
• Meningioma

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• Sometimes benign tumors causes death
• For instance, a meningioma that grows to be
too large in the brain can compress
downwards onto your brain, resulting in
seizures and death.
• Even though the meningioma may not spread
around the body or invade the local tissue,
only compress it, it can still kill you.

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• Examples of malignant tumors, or cancer,
include
• Lymphoma
• Liver cancer
• Breast cancer

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 CELL ADAPTATION, INJURY AND DEATH
• Cell Injury is the common denominator in almost
all diseases. It is defined as:

• an alteration in cell structure or biochemical

functioning resulting from some stress that
exceeds the ability of the cell to compensate
through normal physiologic adaptive
mechanisms

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• Hypoxia – not enough oxygen to run; usually
due to ischemia, but other causes include
severe anemia and cyanide poisoning.

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• Chemical/Traumatic injury – Chemicals include a
lot of toxins that act like free radicals, but in
addition, there are specific chemicals that get in
and screw up the organelles.

• Example: Gram positive bacteria make exotoxins

that cause serious damage.
• Anthrax – it grows and produces toxins that
DESTROY cell membranes. That will cause cell
death.
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• Injury by infectious agents – most common
form of cell injury and it happens in all kinds
of ways.

• Viruses get in and screw up the cell’s normal

function; bacterial toxins can sure damage
cells. Some of the bacterial toxins act like free
radicals.

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 A cell responds to a stress depends on:

• The degree of severity and duration of the

injury.

• Basically, how bad is the insult and how long

does it last?

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Cellular Response to Stress

• The normal cell has a limited range of function

and structure, which is determined as a result
of an attempt to keep in balance with the
challenges presented by the environment, i.e.
genetic

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• When the cell is in balance with its environment it is
considered to be in a homeostatic balance or "steady
state".

• A variety of systems protects cellular integrity

• If more excessive external stimuli occur, the cell may be

able to adapt to the changes.
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 CELL ADAPTATION
• Within limits, most cells have the ability to adapt
to changes in their environment by altering their
morphology, pattern of growth, and/or metabolic
activity.

• These adaptive responses may be part of the

normal physiology of a cell or tissue, or they may
represent an attempt to limit the harmful effects
of a pathological stress.
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• Common examples include: atrophy,
hypertrophy, hyperplasia, metaplasia and
dysplasia.

• ATROPHY
• Cellular atrophy – decrease in cell size
• Organ atrophy – decrease in size of the organ

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• HYPERTROPHY
• increase in cell size accompanied by an increase
in functional capacity

• Appearance:
• Cells are bigger than normal which makes the
organ look bigger than normal

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 What causes Hypertrophy

• Physiologic hypertrophy is a normal process that

occurs in tissues under the influence of trophic
hormones. In late pregnancy, the mammary
glands hypertrophy in response to prolactin
secretion.

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• Pathologic hypertrophy occurs when an
increase in organ workload occurs secondary to a
disease process.

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 Hypertrophy can be a compensatory
process.
• When one paired organ or a portion of that
paired organ fails, the other organ or portion
of the organ compensate the task of the other.

• For instance: Unilateral ovariectomy of a rat.

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• The opposite ovary can undergo compensatory
hypertrophy and secrete sufficient estrogen for
the mouse’s needs. This is the result of the
pituitary detecting the loss of the removed ovary
and causing the remaining ovary to undergo
hypertrophy to take up the slack.

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 Hyperplasia
• Hyperplasia
• Hyperplasia takes place if the cell population is
capable of replication; it may occur with
hypertrophy and often in response to the same
stimuli.

• Hyperplasia can be physiologic or pathologic

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 Metaplasia
• Metaplasia is a reversible change in which one
adult cell type (for example; epithelial) is
replaced by another adult cell type.

• Epithelial metaplasia is exemplified by the

squamous change that occurs in the
respiratory epithelium in habitual cigarette
smokers.

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• The normal ciliated columnar epithelial cells of
the trachea and bronchi are focally or widely
replaced by stratified squamous epithelial cells.

• Vitamin A deficiency may also induce squamous

metaplasia in the respiratory epithelium.

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 Dysplasia
• an abnormality of development; in pathology,
alteration in size, shape, and organization of
adult cells.

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 NECROSIS
• The death of living cells or tissues.

 Six types of necrosis

• Coagulative necrosis.
• Liquefactive necrosis.
• Caseous necrosis.
• Fat necrosis.
• Fibroid necrosis.
• Gangrenous necrosis.
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 Check your breast

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 Cancer Terminology
• Cancer is classified in to two ways:
- Cancer origin and adenocarcinoma glandular
tissue,
- Histological type

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 Histological type
• Carcinoma
• Sarcoma
• Myeloma
• Leukemia
• Lymphoma
• Mixed type

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 Carcinoma
• Refers to malignant neoplasm of epithelial
origin or cancer of internal and external lining
of the body

• Sarcoma
- Refers cancer of supportive and connective
tissue (cartilage, muscle)

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 Myeloma
• Myeloma- Refers to blood cancer

• Lymphoma - Refers from lymphatic system

• Mixed type
• adenocarcinoma

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 ASSIGNMENT- ONE
1-Mention any disease you like and discuss the change in
morphology and function caused by the infection.

2-Organs are composed of four tissue types they are:

Epithelial, Connective, Nervous and Muscular. Discuss the
function and give one organ example of each.

3-Mention one disease and discuss the signs and symptoms

of the infection.

4-Why is important to check the breast at every month by a

woman?
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 ASSIGNMENT - TWO
1- What is cold ischemia? What is its importance?

2- What is the difference between fixed and unfixed tissue?

3- In what thickness trimming and sectioning to be cut at

Microtome? Why?

4- Discuss how to prevent cervical cancer.

5- Define Hematoxylin and Eosin. And what is the

difference between these two dyes?
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