There are basically six distinct patterns of necrosis.

Its important to know about these, because they can give you a clue as to why the tissue died. Well go through these in bullet form to make it easy to compare. Coagulative See this in infarcts in any tissue (except brain) Due to loss of blood Gross: tissue is firm Micro: Cell outlines are preserved (cells look ghostly), and everything looks red See this in infections and, for some unknown reason, in brain infarcts Due to lots of neutrophils around releasing their toxic contents, liquefying the tissue Gross: tissue is liquidy and creamy yellow (pus) Micro: lots of neutrophils and cell debris See this in tuberculosis Due to the body trying to wall off and kill the bug with macrophages Gross: White, soft, cheesy-looking (caseous) material Micro: fragmented cells and debris surrounded by a collar of lymphocytes and macrophages (granuloma) Fat necrosis See this in acute pancreatitis Damaged cells release lipases, which split the triglyceride esters within fat cells Gross: chalky, white areas from the combination of the newly-formed free fatty acidswith calcium (saponification) Micro: shadowy outlines of dead fat cells (see image above); sometimes there is a bluish cast from the calcium deposits, which are basophilic Fibrinoid necrosis See this in immune reactions in vessels Complexes of antigens and antibodies (immune complexes) combine with fibrin Gross: changes too small to see grossly Micro: vessel walls are thickened and pinkish-red (called fibrinoid because it looks like fibrin but has other stuff in there too Gangrenous necrosis See this when an entire limb loses blood supply and dies (usually the lower leg) This isnt really a different kind of necrosis, but people use the term clinically so its worth knowing about Gross: skin looks black and dead; underlying tissue is in varying stages of decomposition Micro: initially there is coagulative necrosis from the loss of blood supply (this stage is called dry gangrene); if bacterial infection is superimposed, there is liquefactive necrosis (this stage is called wet gangrene)

Liquefactive

Caseous

http://www.pathologystudent.com/?p=5770 3 Jan 2014