Page 123 - Textbook of Pathology, 6th Edition

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CHAPTER 5

Figure 5.11 Nutmeg liver. The cut surface shows mottled
appearance—alternate pattern of dark congestion and pale fatty change.

HAEMORRHAGE Derangements of Homeostasis and Haemodynamics
organised structures are termed as Gamna-Gandy bodies
or siderofibrotic nodules.
Haemorrhage is the escape of blood from a blood vessel. The
v) Firmness of the spleen in advanced stage is seen more bleeding may occur externally, or internally into the serous
commonly in hepatic cirrhosis (congestive splenomegaly) cavities (e.g. haemothorax, haemoperitoneum, haemoperi-
and is the commonest cause of hypersplenism (Chapter cardium), or into a hollow viscus. Extravasation of blood into
14). the tissues with resultant swelling is known as haematoma.
Large extravasations of blood into the skin and mucous
membranes are called ecchymoses. Purpuras are small areas
CVC Kidney
of haemorrhages (upto 1 cm) into the skin and mucous
membrane, whereas petechiae are minute pinhead-sized
Grossly, the kidneys are slightly enlarged and the medulla haemorrhages. Microscopic escape of erythrocytes into loose
is congested. tissues may occur following marked congestion and is known
Microscopically, the changes are rather mild. The tubules as diapedesis.
may show degenerative changes like cloudy swelling and
fatty change. The glomeruli may show mesangial ETIOLOGY. The blood loss may be large and sudden (acute),
proliferation. or small repeated bleeds may occur over a period of time
(chronic). The various causes of haemorrhage are as under:

Figure 5.12 CVC liver. The centrilobular zone shows marked degeneration and necrosis of hepatocytes accompanied by haemorrhage while
the peripheral zone shows mild fatty change of liver cells.