71. Acute inflammation: definition, causes, types. Pathological anatomy of acute productive inflammation, outcomes, clinical significance, examples of diseases.

Acute productive inflammation

Types of acute proliferative inflammation: interstitial (interstitial), granulomatous, inflammation around animal parasites and foreign bodies. The inflammatory hyperplastic growths sometimes mentioned — polyps and genital warts — are essentially a hyperregenerative reaction of the epithelium to chronic exudative (catarrhal or purulent) inflammation.

Interstitial inflammation is caused by various infectious agents or it is possible as a reaction of the body to pronounced toxic effects or microbial intoxication. It occurs in all parenchymal organs and is localized in their stroma, where inflammatory and immunocompetent cells accumulate. The infiltrate consists of histiocytes, monocytes, lymphocytes, plasma cells, labrocytes, single neutrophils, eosinophils. The features of this inflammation in the acute phase are a significant number of mononuclears (monocytes) in the infiltrate and dystrophic and necrobiotic changes in the parenchymal elements of the organ, since the functions of blood and lymphatic vessels and nerve endings passing through the stroma are impaired. At the same time, the organ does not change much externally. The progression of interstitial inflammation leads to the development of mature fibrous connective tissue — sclerosis. Granulomatous inflammation is characterized by the formation of granulomas (nodules) as a result of proliferation and transformation of cells capable of phagocytosis. Granulomatous inflammation as an independent form of inflammatory reaction occurs mainly in the chronic course of inflammation. However, it can also occur acutely, as a rule, in acute infectious diseases: typhoid fever, typhoid fever, rabies, epidemic encephalitis, acute anterior polio. In typhoid fever, granulomas occur in the lymphoid formations of the small intestine and are clusters of phagocytes transformed from reticular cells — "typhoid cells". Upon recovery, acute granulomas disappear either without a trace, as in typhoid fever, or leave glial scars, as in neuroinfections. In this case, the outcome of the disease depends on the location and volume of these scars. Productive inflammation around animal parasites and foreign bodies

It is aimed at separating them from the surrounding tissues by a connective tissue capsule, since they cannot be phagocytized and eliminated. Granulation tissue and infiltration from fibroblasts, macrophages and giant cells of foreign bodies are formed around foreign bodies (shell fragments, etc.). The outcome of productive inflammation varies depending on its type, the nature of the course and the structural and functional characteristics of the organ and tissue. Acute productive inflammation often ends in the formation of a scar in the area of inflammation

72. Chronic inflammation: definition, causes, types. Pathological anatomy, outcomes, clinical significance, examples of diseases.

Chronic inflammation is a pathological process characterized by the persistence of a pathological factor and the development of immunological insufficiency. A common morphogenetic sign of chronic inflammation is the constant layering of the stages of alteration and exudation at the stage of proliferation. Chronic inflammation can be exudative and productive.

Chronic exudative inflammation is characterized by a moderate amount of exudate, more often purulent, often purulent-fibrinous, mainly lymphoplasmocytic infiltration of inflamed tissues. Neutrophilic leukocytes are also present in the infiltrate, and monocytes, macrophages and fibroblasts are located along the periphery of the inflammatory zone. Chronic exudative inflammation is observed in osteomyelitis, chronic abscess, chronic purulent salpingitis and in chronic wounds and ulcers — trophic ulcers, bedsores, inflammation in peptic ulcer disease, ulcerative colitis. Chronic productive inflammation can be diffuse (chronic hepatitis, ideopathic fibrosing alveolitis), granulomatous and inflammation occurring around animal parasites and foreign bodies. Inflammatory hyperplastic (hyperregenerative) growths also occur chronically.1

An example of diffuse chronic inflammation is variants of chronic hepatitis and interstitial pneumonia. Their pathogenesis and morphogenesis develop according to the principle of a vicious circle, are characterized by the progression of productive inflammatory reactions and end with cirrhosis of the liver and septoalveolar sclerosis of the lung tissue. Chronic granulomatous inflammation develops in cases when, for some reason, damaging factors cannot be removed from the body. All granulomas are formed according to a single histogenetic plan. The main structural unit of any granuloma is a macrophage. Chronic inflammation can occur for months, years, manifested by granulomas, but infiltrates can have a diverse appearance: tubercles, papillomas, gummas.