Histopath Lec - Week 4 - Topic 5

SCHOOL OF MEDICAL
LABORATORY SCIENCE
HISTOPATHOLOGIC AND CYTOLOGIC TECHNIQUES (LEC.)
SAN PEDRO COLLEGE – MAIN
CAMPUS
Instructor’s Name: Ma’am. Doren Venus Otod, RMT
AY 2022 – 2023 - 2ND SEMESTER WEEK 03 - LESSON 04: ABNORMALITIES IN CELL GROWTH AND SOMATIC DEATH
− The organ failed to reach or achieve its full maturity or

OUTLINE adult size due to incomplete development
I. Abnormalities in Cell Growth ▪ Agenesia - complete non-appearance of an organ
A. Retrogressive − there is no organ present, or in other words, the tissue
B. Progressive itself is absent.
C. Degenerative ▪ Atresia - failure of an organ to form an opening
II. Somatic Death → Atrophy - acquired decrease of the size of a normally
A. Primary Changes developed organ
B. Secondary Changes
B. PROGRESSIVE
I. ABNORMALITIES IN CELL GROWTH
● The organs or the tissues are larger than normal. This one can
be due to the following changes:
→ Hypertrophy
▪ The tissue increases in size due to the increase in the size
of the individual cells.
→ Hyperplasia
▪ There is an increase in the sizeof an organ or tissue due
to increase in the number of cells.
C. DEGENERATIVE
● There is a change due to aberrations of cellular growth patterns

● There is a disturbance during the pattern of development
Figure 1. Abnormalities in Cell Growth
● The abnormalities in cell growth can be observed in tissues and

the organs. They can appear to be smaller or larger than the
normal, reflecting a disease or increase in the size or number of
their component cells.
● There are three categories of abnormalities in cell growth:
→ (1) Retrogressive Figure 2. Dysplasia
▪ Developmental
− Aplasia → Dysplasia - means “disordered growth;: presence of
− Hypoplasia abnormal cells within a tissue (reversible)
− Agenesia ▪ it can go back to its normal composition
− Atresia ▪ this is due to an alteration in the adult cells that are
▪ Atrophy ▪ manifested by variation in the size of the cell of a tissue or
→ (2) Progressive the shape of an organ and its orientation.
▪ Hypertrophy ▪ it will not lead to tumor formation
▪ Hyperplasia → Metaplasia - Reversible
→ (3) Degenerative ▪ It involves the transformation in one type of adult cell to
▪ Dysplasia another.
▪ Metaplasia − Ex. The airways of a smoker undergo metaplasia type
▪ Anaplasia of change or epithelial type of change on its
▪ Neoplasia composition.
A. RETROGRESSIVE
● The organs or a part of the tissue is smaller than normal

wherein it can be due to:
→ Developmental Defects:
▪ Aplasia - incomplete development of the organ
− The organ is only represented by a mass of fatty
tissues or it can be a fibrous tissue.
− This type of retrogressive development is most Figure 3. Anaplasia
commonly seen in paired structures such as the
kidneys, gonads and the adrenal gland → Anaplasia - lack of differentiation of cells (irreversible)
▪ Hypoplasia - failure of an organ to develop fully ▪ it cannot go back to its normal shape or size
BSMLS – 2G Team Writers: Bersabe, Lasaga 1 of 5

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▪ This is usually utilized as a criteria towards malignancy or slow. arrive a point

one of the basis or starting baseline for diagnosing a where the size of the
malignancy tumor will stay in that
size)
Metastasis
(spread of
Absent Frequent
tumor to other
sites)
Figure 4. Neoplasia
Figure 5. Benign and Malignant
→ Neoplasia - means “new growth”; uncontrolled proliferation
of cells with no purpose: -> Tumor/Neoplasms Table 2. GENERAL TUMOR NOMENCLATURE
▪ There is a continuous abnormal proliferation.
GENERAL TUMOR NOMENCLATURE
▪ The proliferation is uncontrolled and there is an
overgrowth of the tissue Origin Benign Malignant
▪ This one can lead to formation of tumor Epithelial
-carcinoma
Tissue
NEOPLASIA: Tumor/Neoplasm Connective/ -oma
● Sometimes it can be unidentifiable and sometimes the degree Mesenchyme -sarcoma
of differentiation is identifiable Tissue
● That is the time where we submit ourselves for checkup
because of the presence of tumor Table 3. EXAMPLE
● Mass of neoplastic cells Example: Benign Malignant
● General Characteristics of Tumors Epithelial Lining
Adenoma Adenocarcinoma
→ (1) May resemble and function like a normal cell of Gland
→ (2) Autonomous: non-responsive to normal growth factors Lymph Vessels Lymphangioma Lymphangiosarcoma
→ (3) Parasitic nature: competes with cells for metabolic needs
▪ The tumor completely disregards their neighboring cells. ● Teratoma: monstrous tumor
▪ It will get nutrition and it will multiply while the normal cells → benign type of tumor
will undergo cell death or in a necrotic type of death. → termed as “monstrous” type of tumor because it can grow on
→ Parts of Tumor: any parts of the body
▪ (1) PARENCHYMA (actively dividing) → When you're going to a gross exam for this type of tumor
− active element of the tumor class, there is the presence of fat, hairs, teeth and nails that
▪ (2) STROMA (body) resembles a monster.
− the connective tissue framework with the lymphatic and
vascular channels Grading of Tumors
● For a malignant type of tumor, we are grading tumors for us to
Table 1. CLASSIFICATION OF TUMOR rule out and know if it is less malignant or if it is a severe type of
CLASSIFICATION OF TUMOR cancer.
Benign Malignant ● Attempts to establish an estimate of the level of malignancy of
Usually does not a tumor
cause death except Usually causes ● Based on cytologic differentiation of tumor cells and number
Death
for infants and brain death of mitoses
tumors → Well-differentiated: tumor cells resemble normal cells
Some lack of → Undifferentiated: tumor cells do not resemble normal cells
Differentiation Well-differentiated
differentiation ▪ If a person has an increase or there is more number of
Usually progressive well-differentiated cells, it means that the patient has a
and slow; may come good prognosis.
Erratic; may be
Rate of Growth to a standstill or − When we say good prognosis, the patient is more or
slow to rapid
regress (continuous most likely to recover compared with our
but slow but it is undifferentiated cells

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● Different from Staging Circulatory Failure

→ The difference between staging and grading of the ● Cardiac function ceases: flat electrocardiogram (ECG).
tumors is that staging refers to stage 1, stage 2 that is for and/or absence of heartbeat
the size of the tumor, extent of the spread of the cancer cells → This is implying immediate death, since all other functions in
to the lymph nodes. and also the presence of metastasis. our body are mainly dependent upon cardiovascular activity.
Those are the criteria under staging If you're going to base on medico legal steps during
→ While for the grading, we are looking for the resemblance or confirmation of death this is the number one criteria that
the appearance of the tumor cells they are looking for. Death can be classified as death when
● BORDER’S CLASSIFICATION OF TUMOR the cardiac function stops. They are going to look at the
pulse rate and the heartbeat. If both of these are absent it
Table 4. means that the patient has already started to have these
Grade Differentiated Cells Undifferentiated Cells primary changes.
I 100% - 75% 0% - 25%
II 75% - 50% 25% - 50% Respiratory Failure
III 50% - 25% 505 - 75% ● decrease O2 and increase CO2 absence of respiratory sounds
IV 25% - 0% 75% - 100% and movements
→ with the absence of this oxidative process of the respiratory
system can lead to death.
● Limitation of Grading:
→ (1) It is subjective
▪ It will depend on the readings of the pathologist and it can CNS Failure
vary from one section to another depending on what part ● loss of coordination and reflexes: absence of brain stem
that was checked by the pathologist. There are some reflex, and/or electroencephalogram (EEG) activity
instances that on the other area, there is an increased
number of undifferentiated cells B. SECONDARY CHANGES
→ (2) Higher grades of tumor have more tendency to
metastasize ● can usually be presented or we can observe this one using our
▪ Generally they have more tendency to metastasize thus naked eye
the grading will not be accurate ● secondary changes usually will follow after this and can be
→ (3) Most sarcomas cannot be graded observed during post-mortem examination
▪ Sarcomas are connective tissue type of tumor
Algor Mortis
II. SOMATIC DEATH ● body temp decreases by 7 Fahrenheit/hour
→ first demonstrable change observed in a dead body.
→ this type of change there is cooling of the body
▪ the temperature of the body is important in establishing
the time of death
Rigor Mortis
● Refers to the rigidity or stiffening of muscles due to lack of
ATP
→ ATP is responsible for driving calcium ions back to our
sarcoplasmic reticulum of the muscles. Because there is
no delivery of calcium ions, the body or the muscle will tend
to harden or be stiff.
→ the purpose of having this calcium ions class is to relax the
muscle, so if there is no ATP there is no relaxation of the
Figure 6. Changes During Somatic Death muscles
● First appears in the involuntary muscles of heart
● When we say somatic death, it means the person is dead → Observed in eyelids, followed by neck, then lower extremities
→ what are the changes our body will undergo during somatic → this type of change is first seen in the muscles of the head
death and on the neck and then after that it will spread towards the
● We have two levels: lower extremities and subsequently disappearing in the
same sequence
A. PRIMARY CHANGES (CRC) ● Starts 2-3 hours post mortem, completes 6-12 hrs post
mortem: persists for 3-4 days
● Occurs 4-6 minutes, then death follows ● After 3-4 days, relaxation occurs due to breakdown of
● This one will be experienced by the body during complete contracted muscles
cessation or loss of metabolic and functional activities of the → by this one they can identify how many days the body had
body died.

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Livor Mortis
Shape Assumes blood Seldomly assumes
● purplish discoloration of skin due to blood stasis: differentiated vessel shape blood vessel shape
from ecchymosis
→ What if the patients’ cause of death is due to beating or
she/he has several hematomas, how are we going to Consistency Rubbery Non-rubbery
differentiate it with Livor Mortis?
Table 5. LIVOR MORTIS VS ECCHYMOSIS

Livor Mortis Ecchymosis
Cause Post-mortem stasis Trauma

blood
After application Discoloration No disappearance

of pressure disappears
(Blanching test)
After incision Has oozing (blood No oozing

will come out in
that area)
Figure 8. Post-Mortem clotting
The next 3 stages of death occurs simultaneously and leads to the

total digestion of cells
Desiccation
● General drying and wrinkling of fluid-filled organs
→ This is most evident in the cornea and in the anterior
chamber of the eye. The reason for this is due to
absorption of the aqueous humour. There is drying and
wrinkling of the fluid in the eye.
Putrefaction
● Greenish-blue discoloration with odor
→ the dead body will have this foul smell and will release a
gas due to the invasion of the tissue by a bacteria called
clostridium welchii which is responsible for the odor of the
dead body
Figure 7. Livor mortis during autopsy ● Hydrogen sulfide + Hemoglobin = sulfhemoglobin/
sullphahemoglobin (green)
● this discoloration, if you are going to touch that specific area,
and if you're going to put a pressure it will reappear again when Autolysis
the pressure is released just like in the picture ● “Self-destruction”: self-digestion of the cells by their own
enzymes
Post-mortem Clotting → first external sign is the whitish appearance of cornea
● Occurs immediately after death: apparent only in autopsy
Table 6. POST-MORTEM CLOT VS ANTE-MORTEM

Post-Mortem Clot Ante-Mortem (due
(due to death) to ecchymosis)
Appearance Upper layer is clear Has tangles,

(resembles chicken irregular fibrin (not
fat): RBC settles at clear)
the lowest part of
the blood vessel
(resembles currant
jelly)

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Figure 9. Autolysis in the eye
REFERENCES
● Kumar, V., Abbas, A. K., & Aster J. C. (2015). Robbins and

Cotran Pathologic Basis of Disease (Tenth Edition).
Philadelphia, PA: Elsevier/Saunders
● Shedge, R., Krishan, K., Warrier, V., & Kanchan, T. (2019).
Postmortem Changes. In StartPearls [Internet]. StartPearls
Publishing

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SCHOOL OF MEDICAL

− The organ failed to reach or achieve its full maturity or

● There is a change due to aberrations of cellular growth patterns

Figure 1. Abnormalities in Cell Growth

● The abnormalities in cell growth can be observed in tissues and

● The organs or a part of the tissue is smaller than normal

BSMLS – 2G Team Writers: Bersabe, Lasaga 1 of 5

▪ This is usually utilized as a criteria towards malignancy or slow. arrive a point

BSMLS – 2G Team Writers: Bersabe, Lasaga 2 of 5

● Different from Staging Circulatory Failure

BSMLS – 2G Team Writers: Bersabe, Lasaga 3 of 5

Table 5. LIVOR MORTIS VS ECCHYMOSIS

Cause Post-mortem stasis Trauma

After application Discoloration No disappearance

After incision Has oozing (blood No oozing

Figure 8. Post-Mortem clotting

The next 3 stages of death occurs simultaneously and leads to the

Table 6. POST-MORTEM CLOT VS ANTE-MORTEM

Appearance Upper layer is clear Has tangles,

BSMLS – 2G Team Writers: Bersabe, Lasaga 4 of 5

Figure 9. Autolysis in the eye

● Kumar, V., Abbas, A. K., & Aster J. C. (2015). Robbins and

BSMLS – 2G Team Writers: Bersabe, Lasaga 5 of 5

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