Necrosis

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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.
  • Neutrophils (very common).

DDx of necrosis:

  • Fibrin.

Images (necrosis):

See also

References

  1. 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. 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.
  3. URL: http://moon.ouhsc.edu/kfung/jty1/Com08/Com801-1-Diss.htm. Accessed on: 3 November 2010.