Necrosis
Necrosis is a type of cell death that is characterized by inflammation.
Classic types - Robbins[1]
- Coagulative.
- Liquefactive.
- Gangreneous.
- Caseous.
- Fatty necrosis.
- Fibrinoid.
Coagulative
Features:[2]
- General: most common; proteinlysis > autolysis/heterolysis.
- Where/when: all tissue except the brain.
- Microscopic: cell outlines present.
Liquefactive
Features:[2]
- General: proteinlysis < autolysis/heterolysis.
- Where/when: infections, brain.
- Microscopic: nothing left.
Others
- Gangrenous: coagulative necrosis in ischemic limb.
- Caseous: chessy material; tuberculosis.
- Fat: adipose tissue, e.g. pancreatitis.
- Fibrinoid: immune complex mediated; bright-pink in vessel walls.
Other types
- Cystic medial necrosis.
- Acute tubular necrosis.
- Contraction band necrosis.
- Dirty necrosis.
Gross
- Soft.
- Grey or white.
Microscopic
Features:
- Dead cells - pink (on H&E).
- Anucleate cells ("Ghost cells")/outlines of cells - usu. subtle.
- Fluffy appearance.
- Anucleate cells ("Ghost cells")/outlines of cells - usu. subtle.
- Inflammation - typically neutrophils (very common).
DDx of necrosis:
- Fibrin.
Notes:
- Inflammation is a reactive phenomenon; it requires blood flow.
- Post-mortem it is not found.
Images (necrosis):
- Necrosis at the centre of a granuloma (sun.ac.za).
- Necrosis (biomedical-engineering-online.com).
- Necrosis (nature.com).
- Necrosis (ouhsc.edu).[3]
- Necrosis in cat scratch disease (WC).
- Necrosis in histiocytic necrotizing lymphadenitis (WC).
- Necrosis in SLE lymphadenopathy (WC).
Stains
- Martius scarlet blue stain - fibroid necrosis = red.
See also
References
- ↑ Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 21-22. ISBN 0-7216-0187-1.
- ↑ 2.0 2.1 Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 6. ISBN 978-1416054542.
- ↑ URL: http://moon.ouhsc.edu/kfung/jty1/Com08/Com801-1-Diss.htm. Accessed on: 3 November 2010.