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Fibrinoid necrosis is a pathological lesion that affects blood vessels, and is characterized by the occurrence of endothelial damage, followed by leakage of plasma proteins, including fibrinogen, from the vessel lumen; these proteins infiltrate and deposit within the vessel walls, where fibrin polymerization subsequently ensues. [1] [2] [3] [4]
Others may become Anitschkow cells or "caterpillar cells," so named because of the appearance of their chromatin. They are pathognomic foci of fibrinoid necrosis found in many sites, most often the myocardium. Initially they are surrounded by lymphocytes, macrophages, and a few plasma cells, but they are slowly replaced by a fibrous scar.
In malignant hypertension these hyperplastic changes are often accompanied by fibrinoid necrosis of the arterial intima and media. These changes are most prominent in the kidney and can lead to ischemia and acute kidney failure. In the brain, a small cavity called a lacune is an ischemic cavity that can arise due to brain necrosis, due to ...
Thermal effects (extremely high or low temperature) can often result in necrosis due to the disruption of cells, especially in bone cells. [16] Necrosis can also result from chemical trauma, with alkaline and acidic compounds causing liquefactive and coagulative necrosis, respectively, in affected tissues. The severity of such cases varies ...
From Fibrinogen to Fibrin with the help of Thrombin and Factor XIII.. Excessive generation of fibrin due to activation of the coagulation cascade leads to thrombosis, the blockage of a vessel by an agglutination of red blood cells, platelets, polymerized fibrin and other components.
There is fibrinoid necrosis of vessel walls with extravasation of fibrinoid material into adjacent parenchyma present in both necrotic and non-necrotic tissue. Vessels can exhibit obliterative fibrosis in all the layers of vessel walls, as well as perivascular, adventitial fibrosis with limited intimal thickening.
Necrotizing vasculitis (14-42% of cases) involves transmural (involving the entire blood vessel wall) fibrinoid necrosis. This type is associated with a high risk of intracerebral hemorrhage. [ 5 ]
The macroscopic appearance of an area of coagulative necrosis is a pale segment of tissue contrasting against surrounding well vascularized tissue and is dry on cut surface. The tissue may later turn red due to inflammatory response.