Immunopathology

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Immunopathology
SYLLABUS RBP(Robbins Basic Pathology)
Chapter Diseases of immunity
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Immunopathology

• Polyarteritis nodosa
• 108a Glomerulonephritis
• Rheumatic myocarditis
• 209 Hashimoto thyroidits

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Polyarteritis nodosa

• early phase degeneration of arterial wall with
  fibrin deposition and partial or complete
  destruction of external and internal elastic
  laminae
• inflammatory infiltration within and around
  vessels predominantly composed of PMNs with
  leukocytoclasia (fragmentation of their nuclei)
• intermediate phase intimal proliferation,
  thrombosis, and chronic inflammation in vessels
  and perivascular tissue
• healed phase fibrosis and recanalization

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Polyarteritis nodosa
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Polyarteritis nodosa
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Glomerulonephritis

• Possible lesions
• diffusely enlarged hypercellular glomeruli
• mesangial cell proliferation
• infiltrating leukocytes
• lobular accentuation
• thickening of glomerular capillary wall

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Glomerulonephritis
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Glomerulonephritis
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Rheumatic myocarditis

• Aschoff bodies
• foci of swollen eosinophilic collagen
• surrounded by lymphocytes (primarily T cells),
  occasional plasma cells, and Anitschkow cells
  (pathognomonic for RM plump macrophages with
  abundant cytoplasm and central round-to-ovoid
  nuclei with the chromatin disposed in a central,
  slender, wavy ribbon ("caterpillar cells")
• larger macrophages become multinucleated to form
  Aschoff giant cells

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Rheumatic myocarditis
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Rheumatic myocarditis
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Hashimoto thyroidits

• lymphocytic infiltration of parenchyma with
  follicles and prominent germinal centers
• plasma cells, histiocytes, and scattered
  multinucleated giant cells may be present
• small, atrophic follicles with widespread
  Hürthle cell change (epithelial cells
  distinguished by the presence of abundant
  eosinophilic, granular cytoplasm)
• in about 12 of case extensive fibrosis
  (fibrous variant)

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Hashimoto thyroidits
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Hashimoto thyroidits