Chronic Inflmmation 3

Question 1

The term chronic inflammation implies two underlying and often concurrently occurring processes:

Answer 1

1. Fibroplasia
2. Cellular Infiltration

Question 2

_____________ : composed primarily of macrophages, lymphocytes, and plasma cells.

Answer 2

Cellular infiltration

Question 3

__________ : The formation of fibrous connective tissue.

Answer 3

Fibroplasia

Question 4

Grossly: chronic inflammatory lesions are often

Answer 4

1. Gray to white due to:
   - infiltration of macrophages and lymphocytes = gray
   - proliferation of fibroblasts and deposition of fibrous connective tissue = white
2. Firm due to
   - fibrous connective tissue and the consolidation of leukocytes in exudate.
3. Have either nodular surface (in case of granulomas) or pitted surface (in case of fibrosis)

Question 5

The irregular shape occur because of:

Answer 5

haphazard accumulation of leukocytes and fibrosis/scarring and contraction of the lesion by myofibroblasts within fibrous connective tissue.

Question 6

Example 1:

Answer 6

The lungs of dogs with Blastomyces dermatitidis infection have a nodular appearance because of formation of numerous
granulomas and/or pyogranulomas.

Question 7

Example 2:

Answer 7

with chronic pyelonephritis have pitted surfaces:
caused by the presence of myofibroblasts during fibroplasia. These cells perform contraction that pulls the renal capsule toward the parenchyma as part of the healing process.

Question 8

In chronic pyelonephritis,

Answer 8

• inflammatory bands often radiate from renal medulla into cortex
  هاذ الاشي بعمل ال pitted surface
• Fibrous adhesions between renal cortex and capsule occurs.

Question 9

Grossly: chronic inflammatory lesions are often

Answer 9

Scar (gray to white), abscess (round with fibrous capsule and central area of pus), granulomas (gray to white, round to oval and firm to hard)

Question 10

Grossly there are three main differential diagnosis for a white, firm, oval, to irregular nodular mass are:

Answer 10

• Abscess.
• Granuloma.
• Neoplasm

Question 11

Chronic inflammatory response are classified into categories based on the types and distribution of inflammatory exudate:

Answer 11

1. Chronic inflammation.
2. Chronic active inflammation.
3. Granulomatous inflammation.
4. Pyogranulomatous inflammation.
5. Granuloma.
6. Pyogranuloma.

Question 12

1. Chronic inflammation (simplest type)

Answer 12

• basic cellular exudate consisting of: lymphocytes with lesser macrophages and plasma cells.
• This types of inflammatory response is characteristic for early stages of chronic inflammatory response and in response to viruses.

Question 13

Sometimes lymphocytes and macrophages predominate over plasma cells and such lesion are called: ________

Answer 13

lymphohistocytic
ولو كان ال lymphocyte لحاله predominant بتسمى lymphocytic

Question 14

________: term used for macrophages.

Answer 14

Histocytic

Question 15

Chronic-active inflammation:

Answer 15

• cellular components contains: neutrophils, fibrin, plasma proteins in acute inflammation + lymphocytic+ macrophage
• occurs when inciting stimulus has not been removed from exudate and it continues to elicit acute inflammatory response.

Question 16

Granulomatous inflammation:

Answer 16

• Has a basic cellular exudate consisting predominately: activated macrophage, epithelioid cell, multinucleated giant cell and lesser number of lymphocytes and plasma cells.
• Can be arranged in a diffuse or haphazard manner as seen in thickened intestinal mucosa of cattle with: Johne’s disease.
  Called: granulomatous enteritis
• Granulomatous inflammation is characteristic of types of infection caused by Nocardia, Brucella, Mycobacterium spp and protozoal infections.

Question 17

Pyogranulomatous inflammation:

Answer 17

• Has the same cellular exudate as granulomatous inflammation but with infiltrates of neutrophils, fibrin, and plasma proteins. + activated macrophage+ epithiloid cell+ multinucleated gint cell
  seen in infection with: Blastomyces dermatitidis.

Question 18

Granuloma:
- distincet type of granulomatous inflammatory response

Answer 18

• occurs when macrophages infiltration is present in a well-defined area and thus forms a distinct mass on gross observation.
• Granulomas can occurs as: noncaseating and caseating types.

Question 19

Noncaseating granuloma:

Answer 19

• round to oval
• composed of numerous macrophages with variable number of epithelioid cells, perhaps multinucleated giant cells with a peripheral zone of fibroblasts, lymphocytes, and plasma cells.

Question 20

Pyogranuloma:

Answer 20

A granuloma with a central area of neutrophils.

Question 21

Caseating granuloma:

Answer 21

the center is formed by a core of gray-white-yellow pasty necrotic debris resembling cheese, occurs in TB