CVC Liver,Lung

1
CVC Liver,Lung Thrombus
2
CVC

• Chronic venous congestion (passive venous
  congestion) occurs due to prolonged impairment
  of venous drainage.
• Almost always associated with edema.

3

• CVC Liver--- Nut Meg Liver.
• CVC Lung--- Brown Induration.
• CVC Spleen--- Bantis Spleen.

4
CVC Liver--- Nut Meg Liver.

• Each lobule will show zonal alterations.
• Central veins and surrounding sinusoids are
  dilated and congested.
• If severe, microhemmorrhages and pressure atrophy
  or necrosis of centrilobular hepatocytes occur.
  

5
(No Transcript)
6
(No Transcript)
7
(No Transcript)
8
Nutmeg" liver seen with chronic passive
congestion of the liver. Note the dark red
congested regions that represent accumulation of
RBC's in centrilobular regions.
9
nutmeg pattern results from congestion around the
central veins usually due to a "right sided"
heart failure.
10
(No Transcript)
11

• If chronic hepatic passive congestion continues
  for a long time, a condition called "cardiac
  cirrhosis" may develop in which there is fibrosis
  bridging between central zonal regions, so that
  the portal tracts appear to be in the center of
  the reorganized lobule.
• This process is best termed "cardiac sclerosis"
  because, unlike a true cirrhosis, there is
  minimal nodular regeneration.

12
(No Transcript)
13
(No Transcript)
14
CVC Lung--- Brown Induration

• Edema in alveoli, congestion of Septal vessels,
  micro hemorrhages, Haemosiderin laden Macrophages
  (HEART- FAILURE CELLS), and Septal fibrosis.
• No inflammatory cells
• (DD-Pneumonia).

15
(No Transcript)
16
(No Transcript)
17
(No Transcript)
18
(No Transcript)
19

• Pulmonary congestion with dilated capillaries and
  leakage of blood into alveolar spaces leads to an
  increase in Haemosiderin-laden macrophages.
• Brown granules of Haemosiderin from break down of
  RBC's appear in the macrophage cytoplasm.
• These macrophages are sometimes called "heart
  failure cells" because of their association with
  pulmonary congestion with congestive heart
  failure.

20
CVC Spleen---Bantis Spleen

• Enlargement of Spleen due to marked expansion of
  the red pulp, widely separating the lymphoid
  follicles of the white pulp.
• Sinusoids are dilated and congested.
• Fibrosis of the septae.
• Perivascular Hemorrhages results in Organization
  with Haemosiderin laden macrophages and fibrosis
  (SIDEROTIC NODULE, GAMMA GANDI BODIES) .
• Giant cell rn, Calcification may occur.

21
(No Transcript)
22
Thrombus

• Thrombosis an intravascular mass of blood
  constituents, formed in intact circulation.
• Thrombus formed of clumped platelets, fibrin
  strands and entangled RBCs.
• It is attached to the BV at the point of
  initiation of thrombogenesis.
• May or may not occlude entire lumen.

23
End result of Thrombus

• Infarction- Ischemic necrosis.
• Organization
• Recanalization
• Embolism

24
(No Transcript)
25
(No Transcript)
26
(No Transcript)
27
(No Transcript)
28
(No Transcript)
29
(No Transcript)
30
(No Transcript)
31
(No Transcript)
32
(No Transcript)
33
(No Transcript)
34
(No Transcript)
35
(No Transcript)
36
(No Transcript)
37
(No Transcript)
38
(No Transcript)
39
(No Transcript)
40
(No Transcript)
41
(No Transcript)
42
(No Transcript)
43
The fibrous bands of connective tissue across
this branch of pulmonary artery indicate
organization of a remote pulmonary thromboembolus
44
"lines of Zahn" which are the alternating pale
pink bands of platelets with fibrin and red bands
of RBC's forming a true thrombus.
45
(No Transcript)
46
(No Transcript)
47
(No Transcript)
48
(No Transcript)
49
Acute renal arterial obstruction in this case led
to massive renal infarction in which the entire
cortex is pale yellow, with Medullary hemorrhage.
50
(No Transcript)
51
(No Transcript)
52
(No Transcript)
53
(No Transcript)
54
(No Transcript)
55
(No Transcript)
56
(No Transcript)
57
Thank u