Page 89 - Concise Pathology for Exam Preparation ( PDFDrive )

74 SECTION I General Pathology

Congested
capillaries
in alveolar
wall

Heart failure
cells

FIGURE 4.2. CVC lung showing congested and widened alveolar septae with hemosiderin-
laden macrophages in the alveolar spaces (H&E; 2003).

Gross morphology
• �The lungs are heavier and firmer than normal.
o
f

s
• �Cut surface dark brown colour (brown induration) with oozing frothy, blood-tinged
n
i
i
material.
Microscopic features
• �Dilatation and congestion septal capillaries
of
of
• �Intra-alveolar haemorrhage (occurs due rupture congested capillaries)
to

is

• �RBC breakdown produces hemosiderin which taken up by alveolar macrophages.

These hemosiderin-laden macrophages present in alveolar lumina are called heart

failure cells (siderophages).
of
is
• �Thickening and fibrosis alveolar septae eventually seen.
Q. Write briefly on the pathogenesis and clinicopathological features
of congestive splenomegaly.

to

Ans. Long-term venous outflow obstruction leads congestive splenomegaly (splenic

enlargement and congestion). Its causes include portal hypertension (may be due to

to
of
thrombosis hepatic veins; also called Budd-Chiari syndrome), cirrhosis, congestive
or
of
or
heart failure stenosis/thrombosis the portal splenic veins.
Gross morphology
Enlarged, tense and cyanotic spleen with thickening and fibrosis capsule
of
Microscopic features (Fig. 4.3)
of
• �Congestion red pulp and sinusoids ultimately causing haemorrhage
f
f
i
n
o

• �Organization haemorrhage results formation siderotic nodules (Gamna-Gandy

o
bodies)
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