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CELL ADAPTATION,
CELL INJURY,
AND CELL DEATH
Ni Putu Sriwidyani
CELL ADAPTATION
1. Atrophy
2. Hypertrophy
3. Hyperplasia
4. Metaplasia
Atrophy
• Definition : shrinkage in the size of the cell
• Organ : Endometrial atrophy in menopausal
women
• Morphology :
Thinning of endometrial layer
Small gland with low cuboids epithelium
Endometrial atrophy
Hypertrophy
• Definition : an increase in the size of cell
• Organ : Myocardium hypertrophy in
congestive heart failure
• Morphology :
– Enlarge of myocardium around fibrosis (compare
with the normal myocardium)
Myocardium hypertrophy
Hyperplasia
• Definition : an increase in number of cells
in an organ
• Organ : Benign prostate hyperplasia in
elderly, Endometrial hyperplasia
• Morphology :
– Increase number of cells, stratified epithelium &/
papillary gland
– Increase number of gland
Endometrial hyperplasia Prostate hyperplasia
Metaplasia
• Definition : a reversible change in which one adult
cell type (epithelial cell or mesenchymal) is
replaced by another adult cell type
• Organ : Squamous metaplasia in cervical uterine
with uterine prolapsed
• Morphology :
– Endocervix contains surface epithelium, gland and
stromal component
– The surface epithelium and gland epithelium lined by
stratified squamous cells (normal: a single layer
cylindrical cells)
Squamous metaplasia of uterine cervix
CELL INJURY
Reversible injury
1. Cellular swelling
2. Fatty change
Irreversible injury
1. Necrosis
a. Coagulative necrosis
b. Liquefactive necrosis
c. Caseous necrosis
d. Enzymatic necrosis
2. Apoptosis
Cellular swelling
• Cellular swelling appears whenever cells are in
capable of maintaining ionic and fluid
homeostasis.
• Organ : Hepatocyte swelling in high dose
paracetamol uptake
• Morphology :
– Enlarge of hepatocyte
– Granular cytoplasm
Cellular
swelling of
hepatocyte
Fatty change
• Organ : Hepatocyte in alcoholisms
• Morphology :
– Clear (lipid containing) vacuoles in cytoplasm
– Eccentric located nuclei
Fatty change
Coagulative necrosis
• Cause : ischemia
• Organ : Hepatocyte in septic shock,
tumor cells
• Morphology :
Para central necrosis of hepatocyte
Necrotic cells show eosinophilic cells
Cell outline (+)
Coagulative necrosis of tumor cells
1. Lipids
– Steatosis (Fatty change)
– Cholesterol
2. Protein
– Hyaline change
3. Glycogen
– Glycogen storage disease
4. Pigment
– Melanin
– Carbon
– Hemosiderin
Steatosis
• Organ : Fatty change of hepatocyte
• Morphology :
Clear (lipid containing) vacuoles in the cytoplasm
Eccentric located nuclei
Steatosis (fatty change) of the liver
Cholesterol deposition
• Organ : Atherosclerosis in coronary artery
• Morphology :
Subintimal cholesterol deposition
Intimal thickening
Dystrophic calcification
ATHEROSCLEROSIS