NECROSIS

Definition:
Death of large group of cells followed by acute inflammation. It is always due to some underlying
pathologic process.

General features of necrosis:

Necrotic cells show increased eosinophilia.
The morphological hallmark of cell death is loss of the nucleus, which occurs via:
 Nuclear condensation (pyknosis)
 Fragmentation (karyorrhexis)
 Dissolution (karyolysis)
 TYPES OF NECROSIS
 Necrosis is divided into following types based on gross features:
 Coagulative necrosis
 Liquefactive necrosis
 Gangrenous necrosis
 Caseous necrosis
 Fat necrosis
 Fibrinoid necrosis
 Necrotic tissue that remains firm; cell shape and organ
structure are preserved by coagulation of proteins, but the
nucleus disappears.
 This type of necrosis occurs :
COAGULATIV
o Myocardium
E NECROSIS
o Liver
o Kidney
o Characteristic of ischemic infarction of any organ except
brain
 Gross picture of coagulative Histological picture of kidney
necrosis in kidney

Green star shows normal cells which are

less pink and have nuclei. Yellow stars
Yellow area shows coagulative necrotic show necrotic cells with prominent cell
part boundaries and no nucleus
 Necrotic tissue becomes liquified; enzymatic lysis of cells
and protein results in liquefaction.
 Necrotic area is soft and filled with fluid.
LIQUEFACTIV
 It occurs in:
E NECROSIS
 Localised fungal and bacterial infections
 Brain infarction
Liquifactive necrosis in brain
 Coagulative necrosis that resembles mummified tissue (dry
gangrene) GANGRENOUS
 Characteristic of ischemia of lower limb and GI tract NECROSIS
Dry gangrene of lower limb
 Combination of coagulative and liquefactive necrosis
 Soft and friable necrotic tissue with ‘cottage cheese’ like
appearance
CASEOUS
 Characteristic of granulomatous inflammation due to fungal NECROSIS
or tuberculous infection
Lung specimen showing caseous necrosis due to
tuberculosis. The yellow white and cheesy
necrotic area visible
 FAT NECROSIS
Enzymatic fat necrosis Traumatic fat necrosis

 Seen in acute pancreatitis  Occurs in adipose tissue and breast tissue

 Due to action of pancreatic lipases  Due to mechanical or hypoxic injury to fat
cells
 Gross examination: chalky white areas
(due to saponification)
 Histologically: necrotic fat shows
shadowy outlines of cells with basophilic
stippling as a result of dystrophic
calcification
Fat necrosis of pancreas. White chalky areas show where
saponification has occurred
 Necrotic damage to blood vessel wall
 Leaking of proteins (including fibrin) into vessel wall results
in bright pink staining of wall microscopically
FIBRINOID
 Characteristic of:
 Malignant hypertension
NECROSIS
 Vasculitis
Fibrinoid necrosis in artery
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