Complete_Pathomorph_Slides.pdf

Slide collection: English Program class of 2010

Compilation / Editing: Daniel Habashi

.1: THROMBUS ORGANISATUS

 A thrombus, or blood clot, is the final product of the blood coagulation step in haemostasis

 Virchow's Triad describes the conditions necessary for thrombus formation: endothelial injury, abnormal blood flow, hypercoa gulability

From atlas:

 A cross sectioned tissue with an organized thrombus. If thrombus in artery we can find following wall layers: Internal elastic membrane,

media , external elastic membrane, and adventitia .

 In a vein we cannot find the internal elastic membrane.

 Note the vessels which re-canalize the thrombus.

 In the organized thrombus we can note the fibroblasts, capillaries, and lymphocytic infiltrate.

 At high power view of the organized thrombus we can see the capillaries lymphocytes, plasma cells, macrophages and the fibroblasts.

This picture to the left Is a part of the organization of thrombus.

 New vessel formation

ThiswasadifficultslideformypartIactuallydon’tknow

where the thrombus is. I am guessing maybe the whole

thingy is a thrombus. I cannot find structures of a vessel

wall. On the left side of the gross pictures you can find

glands and skin structures.

2: THROMBUS RECENS PARIETALIS

 It means it is a fresh thrombus.

 Same morphology as for clot, but difference is that is surrounded/attached to a vessel wall fx.

 The principal components of a clot: Fibrin, erythrocytes and leukocytes

 Zoom in to the thrombus core (the circular red part of slide)

 At 40x resolution you will find following structures:

o Red cells= Erythrocytes

o Purple cells= Leukocytes

o Pink structures= Fibrin

3: ATHEROSCLEROSIS

 ATH are intimae lesions called atheromas/atheromatous plaques that protrude into and obstruct vascular lamina, weaken the media, and

can undergo serious complications.

 Black arrow in south of slide represents atheromatous plaque.

 Red arrow: Here we can see the layers of arterial wall, starting from the lumen: tunica intima (slightly thickened), internal elastic

membrane, tunica media, and the outermost adventitia.

(Lowest magnification)

A plaque is composed of:

1. A central core which contain lipids, cholesterol clefts, cellular

debris, lipid laden foam cells and calcium salts.

2. Peripherial fibrous cap composed of foam cells, smooth muscle

cells, lymphocytes, collagen and profile. Of small blood vessels.

Between peripheral and central part we can find spindle shaped

cholesterol clefts surrounded by foreign body multinucleated giant

cells.

Picture below:

 Red arrow: proliferation. Small blood vessels.

 F: peripheral fibrous cap with foam cells and smooth muscle

cells

 C: central core

 Blue arrow: Spindle shaped cholesterol clefts with

surrounding multinucleated and foam cells

 Black arrow: Cholesterol cleft

Morphologic complications:

 Thrombus, hemorrhage, plaque rupture, calcification,

weakened vessel wall.

4: POLYARTERITIS NODOSA

 PAN is a systemic vasculitis of small/medium sized muscular (renal, visceral) arteries (not arterioles, capillaries, venules) , but sparing the

pulmonary circulation.

 Here we have tissue section of testis.

 We have two stages, acute phase(infl.) and chronic phase (fibrosis) which may coexist in different vessels, and even the same vessel

 Have encircled a small artery in the acute phase of the vasculitis.

 Note the fibrinoid necrosis (orange ring), which is char. For auto immunologic diseases.

 If there is thickening of the vessel wall you will find granulocytes, macrophages and lymphocytes.

 The vessel wall is irregularly thickened and the lumen narrowed. Lymphocytic infiltration in adventitia and in neighboring tissue.

 Thrombus formation and obturation of vessel can occur.

Fibrinoid necrosis. Granulocytes, lymphocytes? and maybe some macrophages infiltrating vessel wall.

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