Cellular Alteration

ATROPHY
Decrease in cell size resulting from decreased

workload, loss of nerve supply, decreased blood supply, inadequate nutrition, or loss of hormonal stimulation
Physiologic atrophy occurs due to aging

Disuse atrophy dec workload on muscle ->

shrinkage Loss of nerve supply gradual atrophy -> muscle wasting Chronic Ischemia Starvation and malnutrition

HYPERTROPHY
Increase in the size of individual cells =

increasing mass without increasing the number of cells

HYPERPLASIA
Common condition seen in cells under increased

physiologic workload or stimulation Capable of dividing and increasing their number

Physiologic hyperplasia puberty and pregnancy Compensatory hyperplasia regenerates lost

substance Pathologic hyperplasia abn stimulation of a gland or other hormones

METAPLASIA
Reversible change in which one type of adult cell

is replaced by another type

Cellular Injury and Death

 May be caused by microorganisms, lack of

oxygen, physical agents and radiation Anoxia lack of oxygen Apoptosis program cell death/ suicide

ISCHEMIA
Critical lack of blood supply to a localized area

Reversible when O2 supply is back

May precede infarction of the tissue pathologic

change Associated with atherosclerosis Classical conditions: Angina pectoris and Intermittent claudification

THROMBOSIS
Formation of a clot on

the intimal lining of the blood vessels May increase or totally occlude blood flow in the vessel

EMBOLISM
Broken thrombus

travelling mass in the blood Obstruction caused by an embolus embolic occlusion Occludes the arterial tributary, compromises blood flow to the area supplied

INFARCTION
Occlusion of blood supply from an artery causes,

localized area of tissue death due to lack of blood supply Infarcted tissue has red appearance due to hemorrhage Bacterial growth is common and may be present in the area

NECROSIS
Cell or tissue death

Cell dies mitochondria swells >

disrupted organelle function > membranes rupture > lysosomal enzymes released to the tissues Nucleus undergoes specific changes shrinking, fragmenting, gradual fading

Coagulative Necrosis
Usually results from lack of blood

supply to an area most common pattern of necrosis Cell structure may be preserved but nucleus, organelles are lost

Caseation Necrosis
Also known as caseous necrosis

Long been described related to

tuberculosis Structureless necrosis Center is soft and friable with a cheesy and crumbly appearance

Liquefactive Necrosis
Most frequently occurs in brain

tissue > results from fatal injury of the neuron Breakdown of neuron > releases lysosomes > lysosomes causes liquefaction leaving pockets of liquids, debris, cystlike structures

Fat Necrosis
Specific form of cellular death that

occurs when lipases escape into fat storages Causes patchy necrosis of the pancreas and surrounding tissues

Gangrenous Necrosis
Combination of coagulative and

liquefactive necroses gangrene black, foul-smelling area that is adjacent to the liver tissue Cause of tissue death is ischemia but bacteria and leukocytes causes liquefaction Coagulant necrosis is dominant dry gangrene Liquefactive necrosis is dominant wet

APOPTOSIS
Distinctive type of cell death in

which single or small groups of cells are deleted from their tissue of origin Can be normal or programmed cell death May be initiated by an endogenous endonuclease that causes destruction of the DNA in the cell

SOMATIC DEATH
Is death of the body

Irreversible changes occur in cells

and organs due to lack of oxygen supply Rigor mortis develops due to deplation of ATP in the muscles Liver Mortis reddish blue Algor Mortis

Etiological and Predisposing Factors of Cancer

 The etiology of cancer is multifactorial, with genetic, environmental, medical, and lifestyle factors interacting to produce a given malignancy. Most cancer is caused by genetic mutations often, by a series of mutations.

Abnormalities in the genetic material due to:

Error in DNA replication (randomly acquired). Effects of carcinogens, such as tobacco smoke, radiation, chemicals, or infectious agents.

Inheritance, and thus present in all cells from birth.

tobacco
Polycyclic aromatic, hydrocarbons, nitrosamines,

aromatic amines, aldehydes (carcinogenic agents) Duration of smoking and number of cigarettes smoked are + correlated with cancer risk Oral cavity, pharyngeal, laryngeal, lung and esophageal cancers are increased among cigarette smokers Alcohol exhibits synergistic effects further inc. oral cancers Passive smoking, inhaling second-hand smoke increases the risk of lung cancer

alcohol
Plays a role in induction of cancer by increasing

effectiveness of carcinogens Chronic alcohol consumption commonly lead to cirrhosis Moderate alcohol ingestion breast cancer, pancreatic cancer

diet
High in fat and low- fiber diet large bowel,

breast, prostate, ovary, endometrium, pancreas, colorectal Single diet preference High temperature cooking Direct ingestion of Aflatoxin B (molds found in corn, barley, peas, rice, soybeans) Pickled, salt- cured, processed, canned foods (nitrates) Vitamin deficiencies

reproductive and sexual behavior

Multiple sexual partners

Intercourse at a young age

Multiparity Uncircumcised men HIV decreasing immune system

chemicals
Asbestos, Chromium, Nickel, Cadmium

Pollution

pharmaceutical agents
Arsenic compounds

Diethylstilbestrol adenocarcinoma in preg

women Estrogens endometrial and breast cancers Androgens, oral contraceptives hepatic tumors Alkylating agents Immunosuppresive agents

radiation
X- ray

Uranium radioactive substances

Ionizing radiation Ultraviolet radiation

infectious agents
Carcinogenic or oncogenic viruses (DNA & RNA

virus)
- Hepa B, Hepa C - Herpes simplex type 2 - Epstein Barr

- Human T- cell leukemia

- Human papillomaviruses

endegenous hormones
Estrogen

Testosterone

genetics
Autosomal recessive disorders

Autosomal dominant disorders

X-linked recessive disorders