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.

 


M15

M15
46763 x 27284 @ 20X

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.


M16

M16
48672 x 37098 @ 20X

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 narrowing.

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?


M17

M17
41037 x 35470 @ 20X

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 "adhesions".


M18

M18
42946 x 31970 @ 20X

Unresolved pneumonia

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.


M19

M19
44855 x 37859 @ 20X