Chronic Peptic Ulcer
The patient, a 52 yr old man, had a long history of indigestion
and gastroscopy revealed an ulcer which was biopsied and found to
be benign. The ulcer was resected.
The surfce of the ulcer shows a pink layer of amorphous material
(fibrinoid) and deep to this is a layer of granulation tissue in
which capillaries, fibroblasts and lymphocytes can be identified.
in the deeper layers there is considerable fibrosis as shown by
relatively acellular fibrous tissue. The inflammatory reaction is
extending deeply between muscle layers.
At the edge of the ulcer, the mucosa is showing evidence of regeneration
and beneath the epithelium there is chronic inflammatory reaction
similar to that present in the ulcer.
46763 x 27284
Healing Myocardial Infarcts
A 67 yr old man with a history of previous myocardial infarct was
admitted with severe chest pain. This subsided but another episode
of chest pain occurred a week later. He developed congestive heart
failure and died three weeks after admission.
At autopsy old and more recent infarcts were noted in the left
ventricle. The coronary arteries showed severe atherosclerotic narrowing.
Infarcts in varying stgaes are present in this section. In the most
recently infarcted area the dead muscle can be recognised by the
absence of nuclei and the dense cytoplasmic staining. Note the formation
of granulation tissue at the margins. The majority of cells are
macrophages and fibroblasts. This stage was preceded by an infiltrate
of neutrophils. In other areas of the sections there are densely
scarred zones and small focal areas where there is loss of muscle
cells but little fibrosis.
48672 x 37098
healed Myocardial Infacrt
A 68 yr old man with a previous history of a myocardial infarct
was admitted with severe chest pain and died 2 hours later. At autopsy
an old healed infarct was found and a recent thrombus was present
in the left coronary artery, which also showed severe atherosclerotic
The pale area of the section is the healed infarct. Microscopically
the healed infarct consists of dense hyaline collagen. Small groups
of fibres have survived in the scarred areas.
Why was there no microscopic evidence of a recent infarct?
41037 x 35470
Organising Fibrinous Pericarditis
This is from a pateint with uremia who developed a fibrinous pericarditis.
The surface of the heart shows a layer of deep pink staining amorphous
material that is fibrin. Beneath the fibrin is the visceral pericardium.
There is a cellular iniftrate mainly of macrophages, fibroblasts,
and new capillaries. At the interface between the fibrin and the
pericardium, small tongues of tissue containing capillaries, macrophages
and fibroblasts can be seen penetrating the fibrin. The parietal
pericardium is not present but it showed similar changes. When organisation
of the fibrin is complete the pericaridal laters become fused forming
42946 x 31970
This 79 yr old man had several bouts of pneumonia before he died
of congestive heart failure.
Many of the open alveoli contain macrophages and red cells. In
focal areas previous pneumonia exudates have been organized into
loose cellular fibrous tissue. the alveolar walls can still be recognized.
Between the fibrotic areas, the alveoli are sometimes dilated. Small
focal areas of metaplastic bone can be seen.
44855 x 37859