Clinical pathomorphology

Pages: 1 2 3 4

The extreme stage of disorganization of collagen is its glycemy decay, called by some authors fibrinoid necrosis.
Non-specific component of inflammation appears tissue oedema, soaking plasma proteins, including fibrin, infiltration tissue lymphocytes, neutrophil and eosinophilic white blood cells. Especially bright this process with III degree of activity of rheumatism.
Ashoff-talalaevsky granuloma currently, all researchers are seen as a reaction to processes disorganization of the connective tissue, so they are grouped around glycotope the collapse of the collagen fibers.
Rheumatic granuloma first described Ashoff (1904) and studied in detail Century So Talalaeva (1929), histologically presents major basophilic the histiocytes, a giant multi-core cellular elements, myocytes, and fat, plasma and lymphoid cells. R the process of its development it undergoes a number of changes, the outcome of which is sclerosis. In its structure, cell composition, and metabolic and functional activity granuloma varies considerably depending on the location, the stage of formation and activity of rheumatic process (N. N. Gritsman, 1971). When the maximum activity of rheumatic process has been a considerable violations of collagen complex, which was reflected in the changes tinctorial properties clumps broken collagen fibers (the yellow tint in the color pikrofusin).
Decided to allocate the flowering and cicatrizing rheumatic granulomas that differ in the character of cell reaction, the size and shape of cells, tinctorial properties. In addition, often the "erased" forms of granulomas (I. Century Vorob'ev, G. C. Orlov, N. N. Gritsman, 1965), consisting of small clusters of single-histiocytes, smaller than a typical cell granuloma, focusing on glybki broken collagen to the rule, at the same time there are all the variants of granulomas.
Rheumatic granulomas at autopsy found recently significantly less than in pre-war years, due to changes in the clinical and morphological form of rheumatism, i.e., the so-called phenomena of pathomorphosis (J. of L. Rapoport, 1962).
For clinicians important data N. N. Grisman (1971) that with minimal activity rheumatism typical ashoff-talalaevsky granulomas are very rare on the material of the opening and quite often In the study of heart ears (61,8% of cases 118 biopsy). According to the author, granuloma is a measure of the overall reactivity, high level of protective mechanisms and reactivity of connective tissue cells and therefore usefulness of the response to the disease process.
Currently accumulates more information giving grounds to consider granulomas from the standpoint of the state of cellular immunity. So, the link specified cell responses with immune mechanisms is confirmed by the discovery in the granuloma of immunoglobulins and fixed immune complexes. These observations, as well as some experimental data that can serve as a proof of concept, according to which ashoff-talalaevsky granuloma is one of the manifestations of delayed Allergy and autoimmunity that occur in response to inflammatory damage to the connective tissue.