Lab 1 CVS pathology

ي الطلبة أعزائ

هذه الورقة تحتوي فقط على ما قيل عن هذه الصور زيادة عن النظري وأي معلومة ي لن تجدوها مذكورة هنا ولكنكم مطالبون بمعرفتها ي العملى

ي النظري وتكررت ف

ذكرت ف بالتأكيد

Mitral valve leaflet Warty (verrucous) vegetations 1-2mm in size at the closure line

Acute rheumatic endocarditis

Normal cardiac muscle Normal cardiac muscle

Aschoff body lymphocytes

Caterpillar cell: Bulky cytoplasm, large nucleus with open chromatin and central ribbon of dark chromatin

Multinucleated giant cell

Acute rheumatic myocarditis

Left atrium, dilated

Commissural fusion

Thickening and irregularity (fibrosis)

Chronic rheumatic heart disease (fishmouth/buttonhole mitral stenosis)

Chronic rheumatic heart disease (shortening, thickening and fusion of chordae tendineae)

Neovascularization on mitral leaflet (a chronic change)

Chronic rheumatic heart disease (fishmouth/buttonhole mitral stenosis)

Chronic rheumatic heart disease in aortic cusps (thickening and irregularity)

White areas of MI in ventricular wall

Surrounding areas of congestion

Normal muscle

White area of MI in the anterior left ventricular wall and in the septum

The MI involves the 3 wall layers (transmural MI)

Thick dark eosinophilic wavy lines in the cytoplasm of cardiac myocytes (contraction bands…abnormal

proteins) = contraction band necrosis

No nuclei (ghost cells)…coagulative necrosis These nuclei are of WBCs carried in

blood

Early MI

Contraction bands…contraction band necrosis

Acute inflammatory cells in MI

MI…necrotic myocytes with blood in between

Severe inflammation in necrosis of cardiac myocytes…too many neutrophils

Nuclear fragments of neutrophils (karyorrhexis)…due to high activity of neutrophils and increased apoptotic activity in them

Area of MI

Rupture site in MI

Large clot surrounding the heart due to the hemorrhage due to the rupture

Normal cardiac muscle

Granulation tissue started to form in an area of MI (repair (organization) process)

Small thin-walled newly formed blood vessels

Inflammatory cells like macrophages in addition to fibroblasts in between the vessels …little amount of new collagen

Fibrosis (mature collagen and small nuclei of fibrocytes)

Remaining cardiac myocytes

This area was MI in the past

Like slide 15

Like slide 15

Cardiomegaly due to dilation of all champers (dilated cardiomyopathy)…the heart appears globular

Thinned area of ventricular wall due to previous MI (fibrosis)

Dilated cardiomyopathy

Thinned wall due to previous MI (fibrosis)

Aneurysm is formed due to the weak wall

Nonspecific changes in dilated cardiomyopathy Variable fibrosis

Hypertrophic myocytes

atrophic myocytes

Hypertrophic cardiomyopathy Hypertrophy is more in the septum (if it is equal in all parts it’s described: concentric)

Banana shaped luminal narrowing

Perl’s or Prussian blue stain showed positivity (blue) in a case of hemosiderosis in dilated cardiomyopathy (may also cause restrictive)

Amorphous pink material suggestive of amyloidosis

Congo red stain under polarized light microscopy (apple green light is positive for amyloid)

These dark nuclei are those of lymphocytes in between the myocytes (lymphocytic myocarditis)…typical of viral myocarditis

Reference: Webpath