Page 1
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VASCULAR INFLAMMATION. RESPIRATORY
SYSTEM. INFLAMMATION, TUMORS.
(Endocarditis, Cardiomyopathy, Aortal mukoid mediodystrophy, Nodose polyarteritis,
Lung emfysema, Bronchopneumonia, Lobar pneumoia, Small cell lung carcinoma.
Nasal polyp, Atherosclerosis.)
General Medicine
MUDr. Daniela Kobzová
MUDr.Michal Palkovič, PhD.
MUDr. Svetoslav Štvrtina, PhD.
MUDr. Pavol Janega, PhD.
Department of Pathology, Faculty of Medicine UK & FH
Branch : Staré mesto
Sasinkova 4, Bratislava
Page 2
Endocarditis
1. Non-rheumatic endocardits
non-infectious
atypical verrucous (Libman-Sacks) – „collagen disorders“; SLE
non-bacterial thrombotic (marantic, cachectic)
infectious
infective bacterial (BE)
acute - ulcerous
subacute – polypous
Complications : cardiac – valve insufficiency, perforation / rupture of valve
leaflets, abscesses formation
systemic – hematogenous spreading of the infection , septic
embolisation, Lőhlein nephritis, toxemia
2. Rheumatic endocarditis (rheumatic fever)
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VESCULAR INFLAMATION.
Page 3
Ulcerative endocarditis
Page 4
Ulcerative endocarditis
Page 5
Polypous endocarditis
Page 6
Polypous endocarditis (gram)
Page 7
Myocardial abscess
Page 8
Myocardial abscess
Page 9
Myocardial abscess (gram)
Page 10
Cardiomyopathies
Classification:
Primary cardiomyopathy
idiopatic hypertrophic cardiomyopathy
idiopatic dilated cardiomyopathy
idiopatic restrictive cardiomyopathy
cardiac amyloidosis, endocardial fibroelastosis,
Secondary cardiomyopathy
toxic (toxic chemical, drugs, chronic alcoholism)
metabolic diseases
nutritional disorders
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VESCULAR INFLAMATION.
Page 11
Hypertrophic cardiomyopathy
Page 12
Hypertrophic cardiomyopathy
Page 13
Dilated cardiomyopathy (FH)
Page 14
Medial dystrophy of aorta (227)
Pathogenesis : deposits of acid mucosubstancies in the vascular wall
focal separation of fibromuscular and elastic tissue of aortal media
cystic spaces in the media
elastic tissue fragmentation
fibrosis of the media
Complications : Erdheim idiopathic cystic medionecrosis and dissecting aneurysm
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VESCULAR INFLAMATION.
Page 15
Aortic dissecting aneurysm
Page 16
Normal aorta (staining for elastic fibers)
Page 17
Medial dystrophy of aorta (HE)
Page 18
Medial dystrophy of aorta (staining for elastic fibers)
Page 19
Medial dystrophy of aorta (alcian blue pH 0.5)
Page 20
Polyarteritis nodosa (90)
Necrotising vasculitis involving small and medium-sized muscular arteries
Pathogenesis : allergic reaction of immunocomplex type to various agents
Microscopic findings :
acute stage - fibrinoid necrosis of vascular wall with thrombosis, perivascular
inflammation
healing stage – fibroblastic proliferation, granulomas formation
healed stage – dense fibrosis
Complications : ischemic changes of affected tissues
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VESCULAR INFLAMATION.
Page 21
Polyarteritis nodosa (fibrinoid necrosis of vascular wall, HE)
Page 22
Polyarteritis nodosa (fibrinoid necrosis of vascular wall, HE)
Page 23
Polyarteritis nodosa (fibrinoid necrosis of vascular wall, HE)
Page 24
Polyarteritis nodosa (fibrinoid necrosis of vascular wall, FH)
Page 25
Polyarteritis nodosa (granulomas, HE)
Page 26
Polyarteritis nodosa (granulomas, FH)
Page 27
Pulmonary emphysema (141)
Forms : centrilobular, panlobular, distal, irregular, mixed
Microscopic findings : destruction of alveolar septum
Complication : Cor pulmonale chronicum
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VESCULAR INFLAMATION.
Page 28
Pulmonary emphysema
Page 29
Bullous pulmonary emphysema
Page 30
Rupture of emphysematous bulla
Page 31
Pulmonary emphysema
Page 32
Pulmonary emphysema
Page 33
Pulmonary emphysema (Chronic bronchitis)
Page 34
Pneumonias (86)
Forms : 1. Lobar pneumonia / 2. Bronchopneumonia (lobular) / 3. Interstitial pneumonia
A. Bacterial pneumonia / B. Primary atypical pneumonia (viral, chlamydias,
mycoplasmal pneumonia)
C. Special types (aspirative, hypostatic, ...)
Pathogenesis : inhalation pathway, aspirative, hematogenous dissemination,
Complication : pneumonia with abscess formation
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VESCULAR INFLAMATION.
Page 38
Bronchopneumonia with abscess formation
Page 39
Lobar pneumonia (83)
Stages : 1. Stage of congestion (inflammatory oedema)
2. Red hepatisation (early consolidation)
3. Grey hepatisation (late consolidation)
4. Resolution
Pathogenesis : inhalation pathway
Complications : organisation(repair) - lung carnification, empyema, abscess formation,
hematogenous dissemination of the infection
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VESCULAR INFLAMATION.
Page 41
Lobar pneumonia (inflammatory oedema)
Page 42
Lobar pneumonia (red hepatisation)
Page 43
Lobar pneumonia (gray hepatisation)
Page 44
Lobar pneumonia (resolution)
Page 45
Tumors of lungs
Classification:
I. Epithelial tumors
Benign
Papilloma
Adenoma
Malignant
II. Soft tissue tumors (chondroma, myoepithelioma, ...)
III. Lymphohistiocytic tumors (lymphoma, ...)
IV. Tumors of ectopic origin (malignant melanoma, teratoma, ...)
V. Secondary tumors
KARDIOVASKULÁRNY SYSTÉM. CHOROBY PERIKARDU,
ENDOKARDU, MYOKARDU. ATEROSKLERÓZA,
DYSTROFIE A ZÁPALY CIEV. RESPIRAČNÝ SYSTÉM.
ZÁPALY. NÁDORY.
Page 46
Malignant epithelial tumors
a) Adenocarcinoma (lepidic adenocarcinoma, ...)
b) Squamous cell carcinoma
c) Neuroendocrine tumors (small cell carcinoma, ...)
d) Large cell carcinoma
e) Adenosquamous carcinoma
f) Carcinosarcoma
g) ...
Localisation: central (often hilous), peripheral, „Pancoast tumor“ in apex of lungs
Etiology: smokers
Komplikácie : rapid lympho- and hematogenous dissemination
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VESCULAR INFLAMATION.
Page 47
Periferal carcinoma of lungs
Page 48
Central carcinoma of lungs
Page 49
Small cell (oat-cell) carcinoma of lungs
Page 50
Small cell (oat-cell) carcinoma of lungs
Page 51
Small cell (oat-cell) carcinoma of lungs
Page 52
Small cell (oat-cell) carcinoma of lungs
Page 53
Small cell lung carcinoma overgrowth on epicardium and into myocard
Page 54
Small cell lung carcinoma overgrowth on epicardium and into myocard
Page 55
Metastasis of small cell lung carcinoma into the liver
Page 56
Metastasis of small cell lung carcinoma into the liver
Page 57
Squamous cell lung carcinoma with central necrosis
Page 58
Squamous cell lung carcinoma
Page 59
Squamous cell lung carcinoma with squamous „pearls“
Page 60
Squamous cell lung carcinoma with squamous „pearls“
Page 61
Squamous cell lung carcinoma with individual cell keratinisation
Page 62
Squamous cell lung carcinoma (atypic mitosis)
Page 63
Lepidic adenocarcinoma (bronchiolo – alveolar carcinoma) (279)
• cuboidal to tall columnar cells growing along the existing alveoli
• numerous papillary structures
KARDIOVASKULÁRNY SYSTÉM. CHOROBY PERIKARDU,
ENDOKARDU, MYOKARDU. ATEROSKLERÓZA,
DYSTROFIE A ZÁPALY CIEV. RESPIRAČNÝ SYSTÉM.
ZÁPALY. NÁDORY.
Page 64
Lepidic adenocarcinoma (bronchiolo - alveolar lung carcinoma) (279)
Page 65
Lepidic adenocarcinoma (bronchiolo - alveolar lung carcinoma) (279)
Page 66
Lepidic adenocarcinoma (bronchiolo - alveolar lung carcinoma) (279)
Page 67
Lepidic adenocarcinoma (bronchiolo - alveolar lung carcinoma) (279)
Page 68
Nasal polyps (238)
• usually associated with chronic hypertrophic rhinosinusitis
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VESCULAR INFLAMATION.
Page 71
Atherosclerosis (66)
• changes occurs on the intima of elastic and muscular arteries
Stages : 1. Fatty streaks and dots
2. gelationous lesions
3. atheromatous plaques (fibromuscular, fibrolipid, atheromas)
4. complicated plaques (calcification, ulcers, thromosis, bleeding in the plaque,
aneurysms formation)
Complications : ischemic changes of the affected tissues and organs
CARDIOVASCULAR SYSTEM. DISEASES OF THE PERICARDIUM,
ENDOCARDIUM & MYOCARDIUM. ATHEROSCLEROSIS,
DYSTROPHIES AND VESCULAR INFLAMATION.
Page 72
Atherosclerosis of abdominal aorta
Page 73
Atherosclerosis of abdominal aorta (ulcers)
Page 74
Atherosclerosis of coronary arteries
Page 75
Diseminated myofibrosis of heart
Page 76
Diseminated myofibrosis of heart
Page 77
Atherosclerosis of the coronary arteries and myofibrosis of heart (FH)
Page 78
Scar after an acute myocardial infarction
Page 79
Scar after an acute myocardial infarction