CHAPTER 1
An Illustrated Glossary of Histological and Pathological Terms
7
Granulomatous Infl
ammation.
H&E,
3
99
Granulomatous infl
ammation
is a type of chronic infl ammation character-
ized by localized aggregates of macrophages called
epithelioid histiocytes
.
Collectively, these collections of histiocytes are termed
granulomas
. Granu-
lomatous infl ammation is characteristic of certain bacterial infections, par-
ticularly
Mycobacterium tuberculosis
, fungal infections with organisms like
Histoplasma capsulatum
, and many other disease processes. Granulomatous
infl ammation may contain areas of necrosis, as in mycobacterial or fungal
infections (caseous necrosis), or may be noncaseating as in the granulomatous
disease sarcoidosis.
Image:
This lymph node biopsy contains abundant noncaseating granulomas
in a patient with sarcoidosis.
Hyperplasia.
H&E,
3
99
Hyperplasia
represents the increase in the
number
, not size, of cells within an
organ or a tissue. Contrast this to
hypertrophy
below in which the cell
size
, not
number, increases. Hyperplasia and hypertrophy both may result in a larger
organ or tissue. Hyperplasia can be the result of hormonal stimulation, as seen
in hyperplasia of the endometrial cells of the uterus in response to estrogen
stimulation.
Image:
This is an endometrial biopsy showing hyperplasia of the glandular
endometrium. The glands are increased in number and are abnormally close
together. Endometrial hyperplasia is a risk factor for the development of adeno-
carcinoma of the endometrium.
Hypertrophy.
H&E,
3
497
Hypertrophy
is a compensatory mechanism by which the size of cells increases
because of various stimuli, resulting in the increase in the size of the correspond-
ing organ. Cardiac myocytes hypertrophy in response to increased workload
because of hypertension or valvular dysfunction. In systemic hypertension, as
the cardiac myocytes enlarge, the heart itself enlarges, producing left ventricular
hypertrophy with a thickened muscular wall.
Image:
This image of a hypertrophied cardiac myocyte in a patient with hyper-
tension shows an enlarged, hyperchromatic (deeply staining) nucleus, referred
to as a “
boxcar
nucleus
.
Hydropic Change.
H&E,
3
155
Hydropic change
is an early reversible cell injury characterized by cellular
swelling due to perturbations in cellular membrane ion-pump function.
Image:
This kidney biopsy shows swollen tubular epithelial cells with cytoplas-
mic clearing due to edema.
Karyorrhexis.
H&E,
3
747
Karyorrhexis
refers to a pattern of nuclear change seen in irreversibly damaged
cells, similar to pyknosis (below), in which the nucleus breaks apart and frag-
ments.
Image:
This image shows a nucleus undergoing karyorrhexis (
arrow
) in a malig-
nant
neoplasm.
previous page 22 Dongmei Cui -  Atlas of Histology with Functional and Clinical Correlations 2011 read online next page 24 Dongmei Cui -  Atlas of Histology with Functional and Clinical Correlations 2011 read online Home Toggle text on/off