Persistent prelethal stress leads to cellular adaptation.

1-Adaptation of growth.
a) Increased growth and cellular activity e. g.Hypertrophy & Hyperplasia
b) Decreased growth and cellular activity e.g. Atrophy.
c-Disturbances of cellular differentiation and morphology e.g.
Metaplasia
2-Intra and Extra cellular accumulations e. g.
a) Lipids as in fatty change & Cholesterol deposits.
b) Proteins as in Hyaline change& Amyloidosis.
c) Calcium as in Pathologic Calcification
d) Pigments as in Pathologic pigmentation.
 Intracellular Accumulations

 Endogenous
 normal substance produced at normal or increased rate/rate of
metabolism inadequate for removal (fatty liver)

 Exogenous
 cell cannot degrade substance (carbon)
 Intracellular Accumulations

 Fatty Change (Steatosis)

 the liver is one of the main organs of the body involved in pathways involving
metabolism of fats or lipids.
 Accumulation of lipids in hepatocytes is termed fatty change (also known
as, hepatic steatosis, fatty liver,.
 Another example of accumulation of lipids in cells is atherosclerosis
characterized by the accumulation of lipid-laden foam cells in the walls
 of arteries. The significance of atherosclerosis in
 humans is obviously reflected in the high incidence of myocardial and cerebral
 infarction (heart attack and stroke).
 Intracellular Accumulations

 Fatty Change (Steatosis)

 Liver
 increased weight, yellow color
fat vacuoles within
cytoplasm of hepatocytes
 Another example of accumulation of an endogenous
substance, is the accumulation
 of protein in tubular epithelial cells of the kidney known
as,amyloidosis
 Glycogen:
 Abnormal accumulation occurs in liver, muscles and
kidney in case of:Diabetes mellitus ( hyperglycemia)
defect in metabolism of glucose or glycogen
 Pigment disorders:
 Pigments are colored substances, synthesized within
the body (endogenous) or coming from outside
(exogenous).
 Endogenous pigments: include melanin, lipofuscin and
Hemosiderin
 Intracellular Accumulations

 Endogenous Pigments
 Lipofuscin (“wear and tear pigment)

 ..) It contains complexes of lipid and protein derived from

peroxidation of lipids by free radicals. insoluble brownish-yellow
granular intracellular material that accumulates in a variety of
tissues (particularly the heart, liver, and brain) as a function of age
or atrophy( ageing pigment) when appear in tissue grossly
it is called brown atrophy


 Intracellular Accumulations

 Endogenous Pigments
 Melanin
 brown-black pigment produced in melanocytes

 It is synthesized exclusively by melanocytes located in the

epidermis and acts as a screen against harmful ultraviolet
radiation
 Albinism: absence of melanin. Such individuals
have melanocytes but are unable to synthesize
melanin. These patients are vulnerable to cancer.
 Intracellular Accumulations
 Endogenous Pigments
 Hemosiderin
 golden-yellow pigmen accumulate in tissues when there is local
or systemic excess of iron
 Local excesses of iron and hemosiderin result from
hemorrhages or vascular congestion,. With lysis of the
erythrocytes, the hemoglobin eventually undergoes
transformation to hemosiderin.
 hemosiderin

 hemosiderosis
 hemosiderin is systemic deposited in many organs and tissues [ liver, bone marrow,
spleen, and lymph nodes
 occurs in
1. increased absorption of dietary iron,
2. hemolytic anemias,
3. transfusions

 hemochromatosis
 hereditary more extensive accumulations of iron with tissue injury including liver
fibrosis, heart failure, and diabetes mellitus.
 Intracellular Accumulations

 Exogenous Pigments

 Carbon (anthracosis)
 When inhaled, it is phagocytosed by alveolar macrophages and
transported by lymphatics to lymph nodes
 mild accumulations usually are of no consequence--heavy
accumulations may induce a fibroblastic response
 Exogenous pigments

 Most of these are dust particles in the inhaled air,

deposited in the lungs and associated lymph nodes.
 The dust particles act as mild irritants and induce
proliferation of fibrous connective tissue( FCT)-
(fibrosis) and collection of macrophages.