Lab 2 CVS pathology بالتأكيد

Transcription

1 Lab 2 CVS pathology أعزائي الطلبة هذه الورقة تحتوي فقط عىل ما قيل عن هذه الصور زيادة عن النظري وأي معلومة ذكرت في النظري وتكررت في العمىلي لن تجدوها مذكورة هنا ولكنكم مطالبون بمعرفتها بالتأكيد

2 The aortic valve shows a large, irregular, reddish tan vegetation. Virulent organisms, such as Staphylococcus aureus, produce an acute bacterial endocarditis similar to the lesion shown here

3 Acute bacterial form of infective endocarditis can lead to serious valvular destruction, as shown here involving the aortic valve. Irregular reddish tan vegetations overlie valve cusps that are being destroyed by the action of the proliferating bacteria. Portions of the vegetation can break off and become septic emboli that travel to other organs, leading to foci of infarction or infection

4 In this case of the subacute form of endocarditis with the pyogenes group of streptococci, the infective endocarditis is not as florid

5 Healing of infective endocarditis may leave residual valve damage. Seen here are a smaller fenestration and a larger fenestration The result of this valvular damage is aortic insufficiency

6 vegetations composed of fibrin and platelets (pink) mixed with inflammatory cells and bacterial colonies (blue) infective endocarditis

7 Nonbacterial thrombotic Endocarditis small pink vegetation on the leftmost aortic cusp margin represents the typical finding with nonbacterial thrombotic endocarditis (NBTE), or so-called marantic endocarditis. This is one form of noninfective endocarditis. NBTE tends to occur in individuals with a hypercoagulable state (e.g., Trousseau syndrome, a paraneoplastic syndrome associated with malignancies) and in very ill patients. These vegetations are rarely larger than 0.5 cm. They are very prone to embolize

8 The valve is seen on the left, and a bland vegetation is seen to the right. It appears pink because it is sterile and composed of fibrin and Platelets NBTE

9 Libman-Sacks endocarditis, gross Flat, pale tan, spreading vegetations ( ) are seen over the mitral valve surface. They even spread onto the adjacent chordae tendineae. This patient has systemic lupus erythematosus These vegetations rarely cause problems because they are not large and rarely embolize

10 Acute rheumatic endocarditis Acute IE NBTE Libman-Sacks endocarditis..on both sides

11 Atherosclerotic plaques in coronary a.

12 Progressive thrombosis in plaque Narrowed lumen Atherosclerotic plaque Previous organization (recanalization in thrombus)

13 Atherosclerotic plaque (Foam macrophages) Thrombus due to rupture (fibrin) lumen

14 Thrombus on ruptured plaque

15 Thrombus on ruptured plaque the lumen is semi-closed Cholesterol clefts in plaque (formed when cholesterol crystals drop off due to preparation)

16 granulomas lumen Temporal arteritis Multinucleated giant cell

17 Elastin stain Internal elastic lamina Fragmented internal elastic lamina

18 Filling defect in left subclavian artery in a case of Takayasu

19 Patent foramen ovale

20 Atrial septal defect (ASD) the most common congenital heart disease in adults

21 Hair follicle Large vessels (cavernous) lined by bland endothelial cells epidermis Cavernous hemangioma (benign)

22 epidermis Lobular pattern of tumor growth Lobular capillary hemangioma (pyogenic granuloma)..see high power in the next slide Visit for references

23 Visit for references

24 Kaposi sarcoma (intermediate behavior) Cellular tumor composed of spindle cells many mitoses may be seen moderate atypia Extravasated RBCs Slit-like blood vessels Visit for references

25 Well to moderately differentiated angiosarcoma (worse than Kaposi) Arborizing blood vessels The lining cells and the cells in the wall are atypical (enlargement and hyperchromasia) Visit for references

26 Reference: Robbins and Cotran atlas of pathology 2 nd edition