Necrosis and Cellualr Adaptation

• Liquefaction or colliquative necrosis occurs commonly
due to ischemic injury and bacterial or fungal infections.

• It occurs due to degradation of tissue by the action of
powerful hydrolytic enzymes.
• The common examples are infarct brain
and abscess cavity
LIQUEFACTIVE NECROSIS OF BRAIN
Caseous necrosis
• Accumulation of amorphous (no
structure) debris within an area of
necrosis.
• Tissue architecture is abolished and
viable cells are no longer
recognizable.
• Characteristically associated with the
granulomatous inflammation of
tuberculosis. Also seen in some fungal
infections.
Caseous necrosis
Fat necrosis of Pancreas
Coagulative necrosis
Normal Necrosis
Cellular Adaptation
Under normal conditions, cells must constantly
adapt to changes in their environment
(physiological, pathological).
• Atrophy
• Hypertrophy
• Hyperplasia
• Dysplasia
• Metaplasia
38
Atrophy
Shrinkage of the size of the cells
by the lost of the cells
substance.
The entire tissue or organs
diminishes in size and function
May be due to
 decrease in W L ,
 lost of n______ innervations,
Lack of ? supply,
inadequate n________n,
lost of e_______ne stimulation
and
 a_ _ _ _g process.
42
Atrophy
Shrinkage of the size of the cells
by the lost of the cells
substance.
The entire tissue or organs
diminishes in size and function
May be due to
 decrease in workload,
 lost of nerve innervations,
Lack of blood supply,
inadequate nutrition,
lost of endocrine stimulation
and
 aging process.
43
Physiologic atrophy
Atrophy is a normal process of aging in some
tissues, which could be due to loss of endocrine
stimulation or arteriosclerosis.
For example:
•i) Atrophy of lymphoid tissue in lymph nodes,
, appendix and thymus.
•ii) Atrophy of gonads after menopause.
•iii) Atrophy of brain with age
Pathologic Atrophy
• Starvation atrophy
• Ischaemic atrophy: brain atrophy (cerebral
atherosclerosis)
• Disuse atrophy: atrophy of pancreas(obstruction of
pancreas)
• Neuropathic atrophy: poliomyelitis, motor neuron
disease
• Pressure atrophy: erosion of spine by tumor in nerve
root
• Endocrine atrophy: hypothyroidism – atrophy of skin
• Idiopathic atrophy : myopathies
Hypertrophy
• Hypertrophy is an increase in the size of
parenchymal cells resulting in
enlargement of the organ or tissue,
without any change in the number of
cells.
• Can be physiologic (ex;increase
workload during exercise, uterine
myometrium during pregnancy) and
pathologic (hypertrophy of myocardium
– hypertension/aortic valve disease)
• At ultrastructural level, there is increased
synthesis of DNA and RNA, increased
protein synthesis and increased number of
organelles like mitochondria, endoplasmic
reticulum and myofibrils.
46
Hyperplasia
Increase the number of cells in an organ or tissue.
(increase rate of cellular division)
Hypertrophy and hyperplasia are closely related
Physiological hyperplasia
Hormonal hyperplasia (exp : uterus during pregnancy)
compensatory hyperplasia (exp: regeneration of skin
after skin abrasion),
Pathological hyperplasia: due to excessive
stimulation of hormones or growth factors
Endometrial hyperplasia following oestrogen excess 48
Metaplasia
• Is a reversible change in which one adult cell type is replaced
by another cell type.
• Adaptation of cells that sensitive to particular stress to cell
types better able to withstand the adverse of environment
49
Types of metaplasia
• There are basically 2 types of metaplasia
• EPITHELIAL METAPLASIA
– Squamous metaplasia: changes in bronchus, uterine
endocervix, gallbladder, prostate, renal pelvis and urinary
bladder
• vitamin A deficiency: squamous metaplasia in the nose, bronchi,
urinary tract, lacrimal and salivary glands
– Columnar metaplasia: Intestinal metaplasia in healed
chronic gastric ulcer and Barrett’s oesophagus
• MESENCHYMAL METAPLASIA
– Osseous metaplasia.
– Cartilaginous metaplasia.
Schematic diagram of columnar to squamous
metaplasia
（ From ROBBINS BASIC PATHOLOGY ， 2003 ）

52
Dysplasia
• disordered cellular development.
• also referred to as atypical hyperplasia
• Epithelial dysplasia is characterised by cellular proliferation
and cytologic changes
– Increased number of layers of epithelial cells
– Disorderly arrangement of cells from basal layer to the surface
layer
– Loss of basal polarity i.e. nuclei lying away from basement
membrane
– Cellular and nuclear pleomorphism
– Increased nucleocytoplasmic ratio
– Nuclear hyperchromatism
– Increased mitotic activity.
• The two most common examples of dysplastic changes are the
uterine cervix and respiratory tract
Dysplasia
54
Differences between Metaplasia and
Dysplasia.

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• Liquefaction or colliquative necrosis occurs commonly

due to ischemic injury and bacterial or fungal infections.

（ From ROBBINS BASIC PATHOLOGY ， 2003 ）

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