You are on page 1of 3

Final Practical Gross Pathology 10/11

Cardiovascular system
Diagnosis C3 y Rheumatic endocarditis of the mitral valve with incompetence y Hypertrophy & dilatation of all cardiac chambers C 7-1 y Rheumatic endocarditis of the mitral valve with stenosis & tricuspid valve with incompetence y Hypertrophy & dilatation of all cardiac chambers Comment Specimen : Heart with open chambers Description : y Mitral valve shows : Thickened greyish white, opaque retracted cusps Thickened shortened chordae tendinae Widely patent mitral orifice y All cardiac chambers show hypertrophy & dilatation Specimen : Transversely cut heart showing Mitral & tricuspid valve Parts of atria [front view] & ventricles [back view] Description : y Mitral valve show : Thickened greyish white, opaque fused cusps Stenosed button hole-like mitral orifice Shortened chordae tendinae Hypertrophied papillary muscles [seen from back view] y Tricuspid valve shows : Thickened greyish white, opaque retracted cusps Widely patent mitral orifice y All cardiac chambers show hypertrophy & dilatation Specimen : Transverse slice of both ventricles & interventricular septum Description : y The wall of the left ventricle is hypertrophied y The interventricular septum is hypertrophied & is bulging towards the right ventricle y Wall of the right ventricle is hypertrophied Specimen : Heart with open left side Description : y Heart : reduce in size y Myocardium : dark brown y Coronaries : tortuous [seen at outer surface] y Pericardial fat : dissappeared & replaced by edematous tissue [serous atrophy of fat] y Aorta : yellow atherosclerotic patches

C 17-1 y Concentric hypertrophy of the left ventricle y Hypertrophy of the right ventricle C 18-1 y Brown atrophy of the heart y Aortic atherosclerosis

hz |1588

Final Practical Gross Pathology 10/11

Diagnosis C 36-2 y Aortic & coronary atherosclerosis y Arteriosclerotic heart disease

Comment Specimen : Heart with open left side Description : y Aorta : yellow atherosclerotic plaques & ulcers y Coronary wall : Atherosclerotic thickening Narrowed lumen y Left ventricle : Marked hypertrophy Dilatation y White fibrous streaks are seen within the left ventriclemyocardium Specimen : Heart with open left side Description : y Apex of the heart with adjacent parts of  The anterior wall of left ventricles &  Interventricular septum Appear thinned Replaced by greyish white fibrous tissue [healed infarct] Whitish left ventricular subendocardial fibrosis is also seen y Endocardial side of the infarct is covered by a large yellowish brown mural thrombus y Pericardial site show whitish fibrous adhesions Specimen : An aortic segment with the two common iliac arteries Description : y Intima of aorta & common iliac arteries shows multiple yellow irregular atherosclerotic patches y Some of these lesions are ulcerated y Small brownish thrombi are seen covering some of the atherosclerotic lesions Specimen : Left foot Description : y Left foot is Black shrunken Mummified with wrinkled skin [dry gangrene] y An irregular groove [line of separation] is seen at the level of malleoli y Cross section of anterior tibial artery shows Atherosclerotic wall An occluding thrombus

C 40-1 y Healed anterior infarct of left ventricle y Mural thrombus y Pericardial adhesions

C 68-10 y Atherosclerosis of abdominal aorta & common iliac arteries associated with ulceration & thrombosis

C 76-2 y Dry gangrene of left foot [ senile gangrene ] y Atherosclerotic & thrombosi of anterior tibial artery

hz |1588

Final Practical Gross Pathology 10/11

Diagnosis C 76-5 y Moist gangrene of the right upper limb [due to erroneously tightly applied tourniquet]

Comment Specimen : Right upper limb Description : y A groove [site of a tightly applied tourniquet] is seen at at the upper [proximal] aspect of the arm y The upper limb below this groove is dark brown, swollen with macerated skin y No line of demarcation or separation Specimen : Open left ventricle, thoracic aorta & thoracic part of vetebral column Description : y The aorta shows  Atherosclerotic patches : yellow, raised & irregular  2 fusiform aneurysm affecting the descending thoracic aorta The distal [lower] one is larger & has a laminated thrombus The adjacent thoracic vetebrae show pressure atrophy, but The intervening discs are normal y The left ventricle is hypertrophied Specimen : Heart with a segment of thoracic aorta [ascending aorta & arch] Description : y Aortic intima : shows multiple raised yellow atherosclerotic patches y A saccular aneurysm with a thin fibrotic wall & laminated thrombus is seen Specimen : Spleen Description : The cut section of the spleen shows a mass : The mass is subcapsular Non capsulated & more/less rounded About 2.5cm in diameter Cut section is spongy [vascular spaces] & brownish [blood]

C 77-4 y Aortic atherosclerotic associated with fusiform aneurysms causing pressure atrophy of thoracic vetebrae y Left ventricle hypertrophy

C 78-1 y Syphilitic aortitis y Aortic atherosclerotic & y Saccular aortic aneurysm

C 86-4 y Cavernous hemangioma of the spleen

hz |1588