第一章细胞、组织上的适应与损伤

1、P7压迫性脑萎缩压迫性脑萎缩The testis at the right has undergone atrophy and is much smaller than the normal testis at the left图注：心肌细胞间距加宽，心肌细胞变细，呈波浪状。图注：心肌细胞间距加宽，心肌细胞变细，呈波浪状。细胞核两端胞浆内大量脂褐素沉着细胞核两端胞浆内大量脂褐素沉着图注：心肌纤维明显增粗，核大，染色较深，与正常心肌组织比较更明显。心肌细胞的肥大是心肌壁增厚、心脏体积增大的基础病变。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图注：肝细胞肿胀，呈球形，胞浆疏松化为水样变性图注：肝细胞肿胀，呈球形，胞浆疏松化为水样变性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结缔组织玻璃样变性结缔组织玻璃样变性图注：胶原纤维呈均匀粉染状，残存少数细胞核，失去纤维状结构图注：胶原纤维呈均匀粉染状，残存少数细胞核，失去纤维状结构（2）类型）类型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.图注：肝右叶上方大片状黄白色梗死区，周边明显充血出血带。梗死灶内也可见小片状由出血带围绕的小梗死区，形成地图状结构。肝脏贫血性梗死肝脏贫血性梗死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脑脓肿脑脓肿 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图注：脑组织灶性组织分解液化（图注：脑组织灶性组织分解液化（N），细胞结构消失，周围组织网化，），细胞结构消失，周围组织网化，出现小胶质细胞的吞噬现象。一侧仍可见正常脑组织（出现小胶质细胞的吞噬现象。一侧仍可见正常脑组织（T）。）。图注：小动脉壁结构消失呈强嗜酸性无结构物，状似纤维素，实为组图注：小动脉壁结构消失呈强嗜酸性无结构物，状似纤维素，实为组织坏死，也称纤维素样坏死。本例为恶性高血压病的肾脏小动脉。织坏死，也称纤维素样坏死。本例为恶性高血压病的肾脏小动脉。图注：结核的坏死破坏到肾盂组织，形成与输尿管道相同的腔洞，坏死图注：结核的坏死破坏到肾盂组织，形成与输尿管道相同的腔洞，坏死组织随尿排出体外形成空洞。组织随尿排出体外形成空洞。动脉血栓形成伴早期机化动脉血栓形成伴早期机化图注：淋巴结干酪性结核，坏死组织含有大量脂质难以吸收，蓝染的钙质沉积图注：淋巴结干酪性结核，坏死组织含有大量脂质难以吸收，蓝染的钙质沉积三、三、细胞凋亡与细胞坏死的区别细胞凋亡与细胞坏死的区别Apoptosis is a more orderly process of cell death in which there is individual cell necrosis, not necrosis of large numbers of cells. In