Objectives

Define necrosis and apoptosis

List the different types of necrosis,

examples of each and its features

List the different conditions associated
with apoptosis, its morphology and its
mechanism
Know the difference between apoptosis
and necrosis

Objectives
Define necrosis and apoptosis
List the different types of necrosis,

examples of each and its features

List the different conditions associated
with apoptosis, its morphology and its
mechanism
Know the difference between apoptosis
and necrosis

Cell Death
Death of cells occurs in two ways:
1. Necrosis--(irreversible injury) changes produced by
enzymatic digestion of dead cellular elements
2. Apoptosis--vital process that helps eliminate unwanted
cells--an internally programmed series of events
effected by dedicated gene products

Objectives
Define necrosis and apoptosis
List the different types of necrosis,

examples of each and its features

List the different conditions associated
with apoptosis, its morphology and its
mechanism
Know the difference between apoptosis
and necrosis

Morphology of necrosis :
1. Cellular swelling or rupture
2. Denaturation and coagulation of
cytoplasmic proteins
3. Breakdown of cell organelles
4. Breakdown of nuclear DNA

Patterns of Necrosis In Tissues or Organs

As a result of cell death the tissues or organs display
one of these six macroscopic changes:
1.
2.
3.
4.
5.
6.

Coagulative necrosis
Liquifactive necrosis
Caseous necrosis
Fat necrosis
Gangrenous necrosis
Fibrinoid necrosis

Patterns of Necrosis In Tissues or Organs

1. Coagulative necrosis:
the outline of the dead cells are maintained
and the tissue is somewhat firm.
Example: myocardial infarction
1. Liquefactive necrosis:
the dead cells undergo disintegration and
affected tissue is liquefied.
Example: cerebral infarction.

Patterns of Necrosis In Tissues or Organs

3. Caseous necrosis:
a form of coagulative necrosis (cheese-like).
Example: tuberculosis lesions.
4. Fat necrosis:
enzymatic digestion of fat.
Example: necrosis of fat by pancreatic enzymes.
5. Gangrenous necrosis:
Necrosis (secondary to ischemia) usually with superimposed
infection.
Example: necrosis of distal limbs, usually foot and toes in diabetes .

6. Fibrinoid necrosis: typically seen in vasculitis

and glomerular autoimmune diseases

Coagulative Necrosis

Changes in the cytoplasm

and the nucleus
Karyorrhexis

Pyknosis

Karyolysis

Necrosis of the liver induced by herpesvirus.

Herpesvirus invades liver cell nuclei producing nuclear ('ground
glass') mildly basophilic inclusions.

Acute renal tubular necrosis (ischemia) :

increased eosinophilia and pyknosis in necrotic cells

Normal

Necrotic

Ischemic neuronal injury:acidophilic cytoplasm & nuclear pyknosis

Necrotic myocardium

a mess - so many
cells have died - the
tissue is not
recognizable. Nuclei
have become pyknotic
(shrunken and dark),
undergone karorrhexis
(fragmentation) and
karyolysis(dissolution)

Coagulative necrosis

Kidney: ischemia and infarction

(loss of blood supply and resultant
tissue anoxia).

Removal of
the dead
tissue
leaves
behind a
scar

Coagulative necrosis: is due to loss of blood supply

Infarcts (vascular distribution) are wedge-shaped

with a base on the organ capsule.
Spleen

Depending on circumstances:
1. necrotic tissue may be walled off by scar tissue,
2. totally converted to scar tissue,
3. get destroyed (producing a cavity or cyst),
4. get infected (producing an abscess or "wet gangrene"),
5. or calcify.
If the supporting tissue framework does not die, and the dead
cells are of a type capable of regeneration, you may have
complete healing.
Remember: True coagulation necrosis involves groups of cells, and is
almost always accompanied, by acute inflammation (infiltrate)