第一章細(xì)胞、組織上的適應(yīng)與損傷

1、P7壓迫性腦萎縮壓迫性腦萎縮The testis at the right has undergone atrophy and is much smaller than the normal testis at the left圖注：心肌細(xì)胞間距加寬，心肌細(xì)胞變細(xì)，呈波浪狀。圖注：心肌細(xì)胞間距加寬，心肌細(xì)胞變細(xì)，呈波浪狀。細(xì)胞核兩端胞漿內(nèi)大量脂褐素沉著細(xì)胞核兩端胞漿內(nèi)大量脂褐素沉著圖注：心肌纖維明顯增粗，核大，染色較深，與正常心肌組織比較更明顯。心肌細(xì)胞的肥大是心肌壁增厚、心臟體積增大的基礎(chǔ)病變。Here is one of the nodules of hyperplastic prosta

2、te. The cells making up the glands are normal in appearance, there are just too many of themMetaplasia of esophageal squamous mucosa has occurred here, with gastric type columnar mucosa at the left圖注：肝細(xì)胞腫脹，呈球形，胞漿疏松化為水樣變性圖注：肝細(xì)胞腫脹，呈球形，胞漿疏松化為水樣變性This liver is slightly enlarged and has a pale yellow app

3、earance, seen both on the capsule and cut surface. This uniform change is consistent with fatty metamorphosis (fatty change).This is the histologic appearance of hepatic fatty change. The lipid accumulates in the hepatocytes as vacuoles. These vacuoles have a clear appearance with H&E staining.

4、The most common cause of fatty change in developed nations is alcoholism. Here are seen the lipid vacuoles within hepatocytes. The lipid accumulates when lipoprotein transport is disrupted and/or when fatty acids accumulate. Alcohol, the most common cause, is a hepatotoxin that interferes with mitoc

5、hondrial and microsomal function in hepatocytes, leading to an accumulation of lipid.An Oil Red O stain demostrates the fat globules within the pulmonary arterioles. The globules stain reddish-orange. The cumulative effect of these gobules is similar to a large pulmonary embolus, but the onset is us

6、ually 2 to 3 days following the initiating event, such as the trauma with bone fractures結(jié)締組織玻璃樣變性結(jié)締組織玻璃樣變性圖注：膠原纖維呈均勻粉染狀，殘存少數(shù)細(xì)胞核，失去纖維狀結(jié)構(gòu)圖注：膠原纖維呈均勻粉染狀，殘存少數(shù)細(xì)胞核，失去纖維狀結(jié)構(gòu)（2）類型）類型Here are splenic infarcts in a patient with infective endocarditis. Portions of the vegetations have embolized to the spleen. Th

7、ese infarcts are typical of ischemic infarcts: they are based on the capsule, pale, and wedge-shaped.圖注：肝右葉上方大片狀黃白色梗死區(qū)，周邊明顯充血出血帶。梗死灶內(nèi)也可見(jiàn)小片狀由出血帶圍繞的小梗死區(qū)，形成地圖狀結(jié)構(gòu)。肝臟貧血性梗死肝臟貧血性梗死This is an acute renal infarction. Note the wedge shape of this zone of coagulative necrosis resulting from loss of blood suppl

8、y with resultant tissue ischemia that produces the pale infarct. The small amount of blood supply from the capsule supplies the immediate subcortical zone. The remaining cortex is congested, as is the medulla.This is the microscopic appearance of an acute renal infarct. At the far right is normal ki

9、dney, then to the left of that hyperemic kidney that is dying, then to the left of that pale pink infarcted kidney in which both tubules and glomeruli are dead.Microscopically, caseous necrosis is characterized by acellular pink areas of necrosis, as seen here at the upper right, surrounded by a gra

10、nulomatous inflammatory process腦膿腫腦膿腫 At high magnification, liquefactive necrosis of the brain demonstrates many macrophages at the right which are cleaning up the necrotic cellular debris. The job description of a macrophage includes janitorial services such as this, particularly when there is lip

11、id圖注：腦組織灶性組織分解液化（圖注：腦組織灶性組織分解液化（N），細(xì)胞結(jié)構(gòu)消失，周圍組織網(wǎng)化，），細(xì)胞結(jié)構(gòu)消失，周圍組織網(wǎng)化，出現(xiàn)小膠質(zhì)細(xì)胞的吞噬現(xiàn)象。一側(cè)仍可見(jiàn)正常腦組織（出現(xiàn)小膠質(zhì)細(xì)胞的吞噬現(xiàn)象。一側(cè)仍可見(jiàn)正常腦組織（T）。）。圖注：小動(dòng)脈壁結(jié)構(gòu)消失呈強(qiáng)嗜酸性無(wú)結(jié)構(gòu)物，狀似纖維素，實(shí)為組圖注：小動(dòng)脈壁結(jié)構(gòu)消失呈強(qiáng)嗜酸性無(wú)結(jié)構(gòu)物，狀似纖維素，實(shí)為組織壞死，也稱纖維素樣壞死。本例為惡性高血壓病的腎臟小動(dòng)脈?？棄乃?，也稱纖維素樣壞死。本例為惡性高血壓病的腎臟小動(dòng)脈。圖注：結(jié)核的壞死破壞到腎盂組織，形成與輸尿管道相同的腔洞，壞死圖注：結(jié)核的壞死破壞到腎盂組織，形成與輸尿管道相同的腔洞，壞死組織隨尿排出體外形成空洞。組織隨尿排出體外形成空洞。動(dòng)脈血栓形成伴早期機(jī)化動(dòng)脈血栓形成伴早期機(jī)化圖注：淋巴結(jié)干酪性結(jié)核，壞死組織含有大量脂質(zhì)難以吸收，藍(lán)染的鈣質(zhì)沉積圖注：淋巴結(jié)干酪性結(jié)核，壞死組織含有大量脂質(zhì)難以吸收，藍(lán)染的鈣質(zhì)沉積三、三、細(xì)胞凋亡與細(xì)胞壞死的區(qū)別細(xì)胞凋亡與細(xì)胞壞死的區(qū)別Apoptosis is a more orderly process of cell death in which there is individual cell necrosis, not necrosis of large numbers of cells. In