Dr Ranjita Singh

Department of Pathology
1. To define cell injury

2. To enlist causes of cell injury

3. To elaborate changes produced by cell

injury
Definition:
 Condition which results when cells are stressed so
severely that they are no longer able to adapt or

 When cells are exposed to inherently damaging

events or suffer from intrinsic abnormalities
 Hypoxia
Nutritional
imbalances
Physical agent

Causes of
Genetic cell injury Chemical
derangement
agent and
drug

Immunologic Infectious
reaction agent
a. Hypoxia:
Inadequate Decrease oxygen
Reduced blood
oxygenation of carrying capacity
flow
blood

Hypoxia

Adaptation Failure to adapt

Atrophy Cell injury

b. Physical trauma:
• Mechanical trauma
• Extreme of temperature
• Sudden changes in temeprature
• Radiation
• Electric shock
C. Chemical agent and drugs:
• Poison such as arsenic, cyanide, or
mercury salts
• Insecticides, herbicides occupational
hazhards carbon monoxides
• asbestos
D. Infectious agent
• Virus
• Worm
• Bacteria
• fungi
E. Immunologic derangments:
- SLE
- Immune reaction to infectious agents
- Immune reaction to viruses
F. Genetic derangements:
• Down syndrome
• Sickle cells anemia
• Thallassemia
f. Nutritional Imbalances:
- Protein Energy malnutrition
- Marasmus
- Obesity
- Atherosclerosis
- Diabetes
 Changes produced by cell injury
• Reversible Injury

1. Cellular swelling
2. Fatty changes

• Irreversible injury

1. Necrosis
2. apoptosis
a. Reversible cell injury:
– Cellular swelling

– Fatty swelling
a. Cellular swelling:

• First manifestation of almost all forms

of injury to cells.

• Difficult to appreciate with the light

microscope

• Causes some pallor, increased turgor,

and increase in weight of the organ.
On microscopic examination:

• Small clear vacuoles may be seen within

the cytoplasm

• These vacuoles are distended and pinched-off

segments of the ER: called hydropic change
or vacuolar degeneration.

• Swelling of cells is reversible.

• Cells may also show increased eosinophilic

staining.
Normal renal tubular Cell injury in renal tubular
epithelium epithelium
• The ultrastructural changes of reversible cell
injury include:

1. Plasma membrane alterations, such as

blebbing, blunting, and loss of microvilli

2. Mitochondrial changes, including swelling and

the appearance of small amorphous densities

3. Dilation of the ER, with detachment of

polysomes; intracytoplasmic myelin figures may
be present
4. Nuclear alteration: disaggregation of granular and
fibrillar elements
b. Fatty changes:
- Occurs in toxic injury
- Hypoxia
- Metabolic injury
eg. Fatty liver, atherosclerosis
2. Irreversible injury:
1. Necrosis

2. apoptosis
 Factors affecting cell injury
1. Cellular response to injurious stimuli depends on
nature of injury, duration and severity

2. Consequence of cell injury depends on type , state

and adaptability of injured cells

3. Cell injury results from different biochemical

mechanism acting on several cellular components
• Thank you….