Necrosis

Background

  • Abnormal tissue (I.e. groups of cells) death during life
    • Always pathological and accompanied by inflammation (necrotic cells are phagocytosed by inflammatory cells)

Types

  • Coagulative (structured): most common; usually a result of interrupted blood supply; tissue architecture preserved
    • seen predominantly in organs with end arterial supply e.g. kidney, heart, liver, spleen
  • Liquefactive (colliquative): occurs in lipid-rich tissues where lysosomal enzymes denature the fat and cause liquefaction of the tissue e.g. brain
  • Caseous (unstructured): appears a soft, ‘cheesy’ and friable material with little tissue architecture
  • Fat necrosis: occurs after direct trauma to fatty tissue or via enzymatic lipolysis e.g. in pancreatitis
  • Fibrinoid: seen in walls of arteries subject to damage from high pressure e.g. in malignant hypertension- causes deposition of fibrin as the muscle wall necroses
  • Gangrenous: irreversible tissue death characterised by putrefaction; can be wet, dry or gaseous (often appears green or black)

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