病理学-神经系统

enlarged nuclear with binuclei, multinuclei or bizarre nuclei(close to cytoplasmic membrane)
GFAP
gemistocytic astrocytes
ASTROCYTE
❖Corpora amylacea(淀粉样小体）: ❖round, faintly basophilic,concentrically lamellated structures
the end process of astrocytes , esp. subpial and perivascular zones degenerative change increase with aging
OLIGODENDRO CYTE (少突胶质细胞 )
Myelin formation cells in CNS (in PNS: Schwann cells) HE : in size and shape like lymphocyte
uncertain significance
OLIGODENDROCYTE
❖Demyelination (脱髓鞘病变) formed myelin sheath destroyed due to allergy, anoxia or toxification
❖Leucodystrophy (白质营养不良) myelin sheath formation disturbance different congenital enzyme deficiency
DISEASE OF CENTRAL NERVOUS SYSTEM
The nervous system（神经系统）
central nervous system(CNS) brain spinal cord
peripheral nervous system(PNS)
Characters of CNS
OLIGODENDROCYTE
Perivascular demyelination (Luxol fast blue
staining )
Microglia (小胶质细胞）
• monocyte lineage • resting microglia MΦ • antigen-presenting cells in inflammatory conditions
abscess or tumor. Fibroblast
ASTROCYTE
❖ Hypertrophy and hyperplasia ：
homogeneous eosinophilic cytoplasm multiple stout, ramifying processes
no extracellular matrix
scanty perinuclear cytoplasm with multiple fine process
Oligodendrocyte
In grey matter:
Satellite phenomenon 卫星现象
>5 oligodendrocytes surrounding one neuron
normal
NEURON（神经元）
4 Neurofibrillary Tangle (NFTs, 神经原纤维 缠结)
marker of dying neuron composed by double spiral strands of neurofibils with abnormal
phosphorylated tau protein seen in Alzheimer’s Dis, boxer brain, post-encephalitis, Parkinsonism
usually mixed type
Cerebral Edema
Morphology: brain volume↑, weight↑, narrow sulci, widened gyri, small ventricle
Cerebral Edema
widened gyri narrowed sulci
Microglia
FOCAL PROLIFERATION FORMING MICROGLIAL NODULE
Microglia
RODLIKE MICROGLIA
SEEN IN ADVANCED
SYPHILIS
------
ROD CELLS
Microglia
Neuronophagia( 嗜 神 经 元 现 象 ） Dead neuron engulfed and
Astrocyte
（星形胶质细胞）
The major supporting
glial cells in the brain
Immunofluorescence
Anti – glial fibrillary acid protein (GFAP)
Sliver impregnation
BBB blood –brain barrier
Cause: ischemia, anoxia, hypoglucemia, lower blood pressure, epilepsy Morphology： red neuron
(cytoplasmic acidophilic, nuclear pyknosis and karyolysis)
Multiple small metastases
Cerebral Edema
Loose brain parenchyma
widened V-R space (Virchow-Robin space)
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HYDROCEPHALUS （脑积水)
Accumulation of excessive CSF within the ventricular system CSF—
phagocytosed by microglial cells.
Microglia
GITTER CELLS FOAM/ CELLS
Foamy macrophages
Part II Common Complications
COMMON COMPLICATIONS
skull and spinal canal little room for brain expansion
cerebrospinal fluid
Circulation of CSF
Negri Body
Neuron（神经元）
3. Inclusion Bodies (包涵体) neurodegenerative
disease
Ali
Lewy body Parkinson Dis.
Parkinson Dis.
P.D.
Substantia nigra 黑质
Pigmented nerve cell dopamine
edema, hydrocephalus, mass lesion
• Cerebral edema (脑水肿) • Hydrocephalus (脑积水) • Herniation (脑疝)
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CEREBRAL EDEMA （脑水肿)
• the accumulation of excess fluid within the brain parenchyma.
cells in CNS
Cells in CNS
Neuron
glial cells
(astrocyte oligodendrocyte ependyma)
blood vessels
microglia
Neuropil 神经毡
process of the cells in the CNS to form a delicate fibrillary background
deficiernocuygohf eVnidt.oBp,lansmoxiicar.eticulum (RER)
reversible change
尼氏体 (Nissl bodies)
Normal Neuron
Central Chromatolysis
NEURON（神经元）
2. Coagulation Necrosis
1.Unique Structural and Cellular Characters 2. Lesions may have location indication ( selective dysfunction)
----- signal to and from different regions of the body are controlled by very specific areas within the nervous system
7
DISEASE OF CNS
• Basic pathologic changes of cells • Common complications • Hemodynamic Derangement & Cerebral Vascular
Disorders • Tumor
Part I Basic pathologic changes of
Red Neuron dissolve
ghBiblioteka Baidust cell
NEURON（神经元）
red neuron ghost cell
NEURON（神经元）
3. Inclusion Bodies (包涵体)
viral infections HSV; Encephalitis B Jap.virus; Poliovirus Rabies: Negri body
NEURON（神经元）
1.Central Chromatolysis (中央性尼氏小体溶解)
dispersion of Nissl substance and swelling of neuron cell body
Morphology:
Cause： axonal injury, Viral infection,
ASTROCYTE
The principal cells responsible for repair and scar formation in the CNS---gliosis
reactive astrogliosis:
repair process after insults forming glial scar Seen in local anoxia, edema, infarct and at the periphery of
Cause: anoxia, infarction, inflammation, injury, toxification and tumor.
CEREBRAL EDEMA
Mechanism : 1. Vasogenic: disrupted BBB
interstitial edema
2. Cytotoxic: cytomembranous pump↓ (ATPase) intracellular edema
Characters of CNS
3.Dual influences of some structures
skull and dura: protection of brain facilitate increased intra-cranial pressure
Characters of CNS
4. Special disease :
Degenerative disease: Parkinson Dis. Alzheimer Dis.
Demyelination disease: multiple sclerosis Psychiatric diseases less understanding Congenital anomalies: high incidence 3% newborns
Sliver stain
ALZHEIMER’S DIS.
cerebral atrophy
Senile Plaque (老年斑) the core composed with β-amyloid protein, surrounded by a halo and swollen degenerative axons