Pathology Lab 2

Front 1

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Back 1

Bread and butter pericarditis

Friction rub--> fluid is rich in protein

See strands of fibers in the pericardial space

Epicardium is course and rough
"fibrinous" characteristics

Front 2

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Back 2

Fibrinous Pericarditis
Bread and butter
Dry epidcardium

Front 3

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Back 3

Fibrinou Pericarditis
Surface is projections of fibrins
serum protins

Pink= acellular, no nuclei or inflammatory cells

Front 4

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Back 4

Hemorrhagic Pericarditis
Abundant blood
2 main things
-malignancy (metastatic carcinoma lung)
-Tubercolosis (

Front 5

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Back 5

Suppurative Pericarditis
Purulent exudate
rich in neutriphils

thick and yellow
- acute bacterial infection with pyogenic character

Front 6

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Back 6

Dilated Cardiomyopathy
round, heavy

Front 7

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Back 7

Dilated Cardiomyopathy
large, round, incompetent valve

Front 8

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Back 8

Dilated Cardiomyopathy

Front 9

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Back 9

Histology of dilated cardiomyopathy

Enlarged myocytes
nuclei become big (dark stain)= hyperchromatic
and fibrosis "separated instead of next to each other

fibrosis in between muscle cells

Front 10

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Back 10

Hypetrophic Cardiomyopathy
young adult
otherwise healthy
collapse and die

hypertrophy is typically underlying etiology

hypertrophic heart wall
banana shaped chamber

Main problem--> decreased compliance --> diastolic dysfunction

character--> assymetric hypertrophy
septum is bulgin into the LV
(thickened septum)

Causes distortion of the valve

Front 11

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Back 11

Hypetrophic Cardiomyopathy

Front 12

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Back 12

Hypetrophic Cardiomyopathy
Character of hypertrophy

myocardial dissarray

arrangment of myocytes in all directions

"haphazard array"

Front 13

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Back 13

Hypertrophic Cardiomyopathy

Front 14

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Back 14

Cardiac Amyloidosis
Restrictive cardiomyopathy
abnormal deposits of abnormal proteins aka amyloid

B-pleated sheets

proteins vary--> common is immunoglobin light chains

malignant lymphocytes-->lymphoma

senile cardiac amyloidosis -->transthyretin (transport protein for thyroid hormone)

heart becomes firm
decreased compliance

EKG--low volatage QRS

Front 15

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Back 15

Cardiac Amyloidosis
pink acellular material is the amyloid

looks like in H & E stain

Front 16

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Back 16

Cardiac Amyloidosis
Apple green infringement apperance

due to the stain in the b-sheet

tells us that it is amyloidosis

Front 17

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Back 17

Cardiac Hemochromoatosis

Typically causes dilated cardiomyopathy
excessive iron storage in the heart

damages the tissue in the heart

blue granules---> indicative of iron overload and therefore hemochromocytosis

Front 18

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Back 18

Acute Bacterial Endocarditis
Virulent organism
staph aureous

vegetations (growth on the endocardium of the valve, "like a thrombus")

Infection + inflammatory cells --> damage

Aortic valve present with vegetations

Front 19

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Back 19

Acute Bacterial Endocarditis

Front 20

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Back 20

Acute Bacterial Endocarditis

Front 21

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Back 21

Acute Bacterial Endocarditis
holes in valve leaflets

Front 22

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Back 22

Subacute Bacterial endocarditis

Front 23

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Back 23

Vegetation of bacterial Endocarditis

Front 24

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Back 24

vegetations of bacterial endocarditis

Fibrin- pink material
bacteria (dark purple) and white blood cells

Front 25

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Back 25

Manifestations of bacterial endocarditis

A=splinter hemorrhages
B=conjuctival petechia
C=(osler) subcutaneous nodules
D=Janeway lesions

Front 26

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Back 26

splinter hemorrhages

Front 27

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Back 27

janeway lesion

Front 28

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Back 28

roth spots

Front 29

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Back 29

Rheumatic Fever
Small, multiple 1-2 mm

other infective endo--> larger and few

Front 30

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Back 30

Aschoff Nodules/ Anitschkow cells

anitschokow cells

mono/bi/multinucleated cells

with characteristic nuclei

cleared out nuclei with dense center chromatin

looks like eyeball

Front 31

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Back 31

Aschoff Nodules

Front 32

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Back 32

Aschoff Nodules

Front 33

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Back 33

Chronic Rheumatic Heart Disease
Mitral valve
leaflets are thickened
chrodea is thickened and fused

Front 34

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Back 34

Chronic Rheumatic Heart Disease
Typically mitral stenosis

"fish mouth apperance"
due to fused valves

enlarged atrium

Front 35

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Back 35

Chronic Rheumatic Heart Disease

Front 36

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Back 36

Chronic Rheumatic Heart Disease
thickened leaflets and chordea

Front 37

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Back 37

Chronic Rheumatic Heart Disease
Commisures fused

Front 38

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Back 38

Non-Bacterial Thrombotic Endocarditis

no bacterial cells, no inflammatory cells
just platelets and stuff

Typically,
Patient with cancer
or
severley ill ( ICU)
or
tendency to form clots

Front 39

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Back 39

Non-Bacterial Thrombotic Endocarditis

because vegetation are sterile we dont get destruction of the valve

main manisfestation is the emboli

medium sized vegetation 2-5 mm

Front 40

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Back 40

Non-bacterial thrombotic Endocarditis

almost all pink

just fibrin and platelets
no bacterial or PMNS

Front 41

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Back 41

Non bacterial Thrombotic Endocarditis
vegetation that is platelets and fibrin

again no bacteria or neutrophils

Front 42

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Back 42

Libman-Sacks Endocarditis
Caused by systemic lupus
and as a result can infect anywhere on the endocardium

very tiny, no valve destruction
problem is with the emboli

overtime, this can damage and scaring

Front 43

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Back 43

RHD=multiple and small
IE=one/few and large
NBTE=medium sized no valve destruction
LSE= vegetations anywhere