II-Non suppurative Inflammation

1- Serous Inflammation
Acute inflammation characterized by
excess serous exudate
This is characterized by an outpouring
of a thin fluid that is derived from
either the blood serum or secretion of
mesothelial cells lining serous cavities.
e.g. burns and herpes simplex which
show epidermal vesicles full of serous
containing few inflammatory cells.
Serous inflammation usually observed
in the serous membranes
e.g. pleura, pericardium, synovial
membrane and peritoneum.

2. Catarrhal Inflammation

Definition: Mild acute inflammation of the mucous

membranes characterized by excess mucus secretion
e.g. catarrhal rhinitis, bronchitis, ... etc.
Gross Picture:

(a) Early the mucous membrane appears red, hot,

swollen and dry. Dryness is due to temporary
cessation of mucus secretion.

(b) Then excess watery mucoid discharge appears,

composed of inflammatory fluid exudate, mucus,
small number of polymorphonuclear leucocytes and
shaded epithelial cells. When the polymorphs
increase the discharge becomes thick and yellowish.

Microscopic Picture
Microscopic Picture:

(a) Mucosal cells appear

swollen and rounded due to
mucus
accumulation
(mucoid change) and may
rupture or desquamate.
(b) The submucosa shows
hyperaemia, inflammatory
oedema
and
mild
polymorphonuclear
leucocytic infiltration.

3-Fibrinous Inflammation
Acute
inflammation
characterized by an
exudate
rich
in
fibrinogen
which
converted to fibrin.
The fibrin mixed with
inflammatory
cells
mainly
neutrophils,
macrophages
and
plasma cells.
Occurred in mucous
and serous membrane.

4- Membranous Inflammation
(Pseudomembranous or Diphtheritic)

Definition:
Severe
acute
inflammation
characterized
by
the
formation
of
a
pseudomembrane on the affected surface e.g.
diphtheria
Pathogenesis: The bacteria produce powerful
exotoxin which causes patchy mucosal necrosis.
The exotoxin is absorbed in the blood stream
causing severe toxaemia.
Gross Picture:
Early the mucosa is congested and shows small
grayish yellow patches of necrosis.
Next a yellowish white slightly elevated
pseudomembrane is formed on the surface.
The membrane is adherent and its removal leaves
a bleeding surface

Diphtheroid
pseudomem
brane

Pseudome
mbranous
colitis

Microscopic Picture
(a) The pseudomembrane is formed of
necrotic

cells,

bacteria

and

acute

inflammatory cells held together by a

fibrin network.
(b) The submucosa shows hyperaemia,
inflammatory oedema, fibrin network
and acute inflammatory cells in the
form of polymorphonuclear leucocytes,
pus cells, macrophages and RBCs.

5- Sero-Fibrinous Inflammation
Definition: Acute inflammation
characterized by the formation of
excess fluid exudate rich in fibrin
e.g. inflammation in serous sacs
(pleura,
pericardium
and
peritoneum).
Gross Picture:
(a) Early the serous surfaces show
many hyperaemic vessels.
(b) Next the visceral and parietal
layers become thickened, opaque,
grayish yellow
(c) An inflammatory serous fluid
collects in the serous sac.

Microscopic Picture

(a) The fibrinogen changes

to

fibrin

forming

network on visceral and

parietal layers entangling

acute

inflammatory

(polymorphs,

pus

cells,

macrophages and RBCs).

(b)

The

serosa

shows

hyperaemia, inflammatory
oedema, fibrin and acute
inflammatory cells.

Polymorpho-nuclear leucocytes
fibrin network

6- Haemorrhagic Inflammation
Acute
inflammation
characterized by cellular
exudate rich in the blood
cells due to vascular
damage
e.g.
smallpox
and
streptococcal hemolyticus
infection.

7- Necrotizing Inflammation
Acute inflammation
characterized
by
marked
tissue
necrosis e.g. Viral
hepatitis,
Typhoid
fever.

Appendix

Gallbladder

8-Allergic Inflammation
It is a type of acute
inflammation characterized
by cellular reaction mainly
eosinophils and mast cells.
The main cause of allergy is
progressive
reaction
of
human body against certain
foreign
protein
e.g.
bronchial asthma, drug,
food, pollution.
Eosinophilic myositis

COURSE OF ACUTE INFLAMMATION

1) Resolution: Means complete restoration of the
inflamed area to normal.
(2) Regression and Healing: The body defense
overcomes the irritant. Part of the necrotic tissue, dead
cells and fibrin are removed by the macrophages. The
liquefied part together with the fluid exudate are
drained by the lymphatics and veins.

(3) Progression and Spread: The bacteria overcome

the defense mechanism and inflammation spreads
directly, by lymphatics and by blood causing fatal
septicaemia.
(4) Chronicity: The causative agent is partially
overcome, but the body is unable to get rid of it
completely. It remains as a weak irritant acting on the
tissue for a long time, thus acute inflammation changes
to a chronic one.

(3) Neurofibromatosis
A
hereditary
familial
disease transmitted as a
dominant trait. The disease
is characterized by:
(a) Multiple neurofibromas
which appear as small firm
nodules in the skin along
the
course
of
the
cutaneous nerves.
(b) Cafe au lait skin
pigmentation.
(c)
Pigmented
iris
hamartomas called Lisch
nodules.
Malignant
tumours:
Malignant
Schwannoma
(neurofibrosarcoma).

Multiple neurofibromas

Cafe au lait skin

Plexiform Neurofibroma

Malignant Neurofibroma