Title: General Pathology
1General Pathology
- Basic Principles of Cellular and Organ Pathology
- Inflammation - III
http//www1.lf1.cuni.cz/jdusk/
Jaroslava Dušková Inst. Pathol. ,1st Med.
Faculty, Charles Univ. Prague
2Inflammation
- Definition
- complex reaction of organism to damage
-
- (aim homeostasis maintenance)
3Inflammation
- Sense
- defensive agent elimination
- reparative damage reparation
4Inflammation - Classification
- Time view
- acute
- subacute
- chronic
5Inflammation - Classification
- According to the dominant phase
- alterative
- EXSUDATIVE
- proliferative
6Inflammation - Classification
- According to the dominant phase
- alterative
- exsudative
- PROLIFERATIVE
7Inflammation - Classification
- Type of granulation tissue
- nonspecific
- specific
- GRANULOMATOUS
8Granuloma
- Def.
- Accumulation of macrophages transformed into
epithelioid and multinucleated giant cells
9infected macrophage
intracellular parasites
Macrophage activation
mature Th clone creation
interferon receptor
interferon receptor
interferon ?
cytokins bactericid subst. secretion
activated macrophage
10Granuloma - composition
- MACROPHAGES
- lymphocytes
- fibrous deposits of collagen
- central necrosis
11Granuloma - development
- fibrosis
- hyalinosis
- dystrophic calcification
- progressive necrosis
- cavity formation
- spread with generalisation or metastatic foci
12Granulomatous Inflammatory Diseases 1.
- TUBERCULOSIS
- sarcoidosis
- syphilis
- leprosy
- Lyme borreliosis
- inf. scleroma (rhinoscleroma)
13Granulomatous Inflammatory Diseases 2.
- lymphogranuloma venereum (inguinale)
- anthropozoonoses brucelosis, listeriosis,
tularemia,.. - cat scratch disease (Afipia felis)
- mycoses histoplasmosis, coccidiodomycosis
- parasites leishmaniasis, schistosomiasis,
toxoplasmosis - large antigen antibody complexes rheumatoid
arthritis
14TUBERCULOSIS
- Mycobacterium tuberculosis
- (Koch 1882)
- Mycobacterium bovis
- acidoresistance
- M. avium,intracellulare, Kansasii
- atypical mycobacterioses
15TUBERCULOSIS
- killing 30 patients with AIDS
- killing 23 mill. people per year
- next 10 years
- 90 millions infected
- 30 millions deaths
- dev. countries - 26 preventable
deaths
16TUBERCULOSIS
- countries with combined therapy deaths
lowered by70 - death rate in Europe lowered to 1/10
- 12,5 / 100 000
- Asia 40x more 500 / 100 000
- 95 patients unable to pay for therapy
17TUBERCULOSIS
- portae invasionis
- respiratory tract
- gastrointestinal tract
- skin
- types of disease (clinicoepidemiol. view)
- open tbc
- closed
18TUBERCULOSIS
- Type of infection
- childhood (primary, preimmune)
- adult (postprimary, immune)
19TUBERCULOSIS
- Morphological features
- primary infect (Ghon focus) primary
complex - caseification
- isolated organ metastasis
- tubercle, exsudate, cavity
- early and late generalisation
- milliary spread
20TUBERCULOSIS
- Type of infection
- childhood (primary, preimmune)
- adult (postprimary, immune)
21TUBERCULOSIS
- Terms Forms Locations
- phtisis gallopans
- scrofulosis
- meningitis basillaris
- lupus vulgaris
- mallum Potti, cold absces
22SARCOIDOSIS
- etiology ?????
- Pathogenesis
- changed Th and Ts ratio
- modified immune reaction
-
23SARCOIDOSIS m. BesnierBoeckSchaumann
- morphology similar to tbc
- (and important dif. dg.)
- forms
- localised
- generalised
24Syphilis
- Treponema pallidum
- (F.Schaudin 1905)
- argyrophilia
- Syphilis acquisita
- Syphilis congenita
25Syphilis acquisita
- Stages (1)
- I. ulcus durum bubo indolens
- II. exanthema syphiliticum, angina
syphilitica, condylomata lata
26Syphilis acquisita
- Stages (2)
- III. gumma
- Late syphilis (quarterly, meta)
- neurosyphylis
- paralysis progressiva
- tabes dorsalis
- panaortitis syphilitica
27Syphilis congenita
- Forms
- fetus maceratus (hepatosplenomegalia)
- hepatitis pericellularis pericholangitis
syphilitica, - pancreatitis
- pneumonia alba
- pseudogummata
- osteochondritis et periostitis syphilitica
- coryza et exanthema syphiliticum
28Syphilis congenita tarda
- Trias Hutchinsoni
- keratitis parenchymatosa
- labyrinthitis
- Hutchinsons teath
- gummata
- periostitis syphilitica tibiae
- paralysis progressiva infantilis, iuvenilis
- panaortitis syphilitica
29LEPROSY
- 700 000 new cases/year
- more than 10 mil. cases in the world
- mostly warm climates
- related to living conditions
- zoonosis - armadillo (Dasypus novemcinctus)
- primates, cultivation on a nude mice
- CURABLE !!!! (combination of antibiotics)
30LEPROSY
- Mycobacterium leprae (Hanseni) 1873
- Port of entry respiratory tract
- Intracellular parasitism
- macrophages, later Schwann cells
- Reduced genom
- (comparing to Mycobacterium tbc)
31LEPROSY
- Classification
- lepromatous
- (in nonimmune. Virchow lepra cell)
- tuberculoid (granulomatous, immune
patients) - indeterminate (early stage)
- borderline (combined)
-
32Rhinoscleroma infectious scleroma
- Klebsiella rhinoscleromatis
- chronic granulomatose inflammation
- Mikulicz cells macrophages
- scaring
- curable - antibiotics