7. Parenchymal fatty degeneration: definition, causes, mechanisms of development, macro-microscopic signs. Disease examples.

These dystrophies are characterized by a violation of the metabolism of fats, mainly neutral, in the cytoplasm of cells. The predominance of one or another mechanism of occurrence of lipidosis depends both on the cause that caused it and on the structural and functional characteristics of the organ. Most often, the development of fatty dystrophy is associated with hypoxia, which occurs in chronic diseases of the cardiovascular system, respiratory organs, diseases of the blood system, as well as with the action of toxic substances (various infections and intoxication) and an increase in the level of fatty acids in blood plasma (general obesity). Metabolic disorders of cytoplasmic lipids are manifested by an increase in their content in cells, where they are found normally, the appearance of lipids where they usually do not occur, and the formation of fats of unusual chemical composition. Most often, neutral fats and phospholipids accumulate in cells. Usually, fatty degeneration develops in the heart, liver, and kidneys.

There is a group of hereditary systemic lipidoses, which are accumulation diseases (thesaurismoses). These diseases are associated with hereditary defects in enzymes that carry out the metabolism of complex fats. These include: cerebrosidolipidosis (Gaucher's disease), sphingomyelinlipidosis (Niemann-Pick disease), gangliosidlipidosis (Tay-Sachs disease or early amaurotic idiocy), generalized gangliosidosis (Norman-Landing disease), etc. The liver, spleen, bone marrow and central nervous system are most often affected. Morphological diagnosis is assisted by cells found in tissues characteristic of a particular type of lipidosis (Gaucher cells, Peak cells).

8. Fatty degeneration of the liver: terminology, causes, mechanisms of development, macro- and microscopic changes, clinical manifestations, outcomes, complications.

It can occur with an increase in the level of fatty acids in blood plasma (diabetes mellitus, general obesity), as a result of decomposition (with infections and intoxications), transformation (with chronic alcoholism), with malnutrition due to a lack of protein in food, with genetic defects of enzymes. Micro-: Small droplets of fat appear in the cytoplasm of hepatocytes (pulverized obesity), which merge into large droplets (small-drop obesity). As a result, the drop fills almost the entire cytoplasm, pushing the nucleus to the periphery of the cell (large-drop obesity).Macro-: the liver increases, becomes flabby, acquires an ochre-yellow or yellow-brown color (“goose liver"). Outcome and complications: Liver function decreases dramatically. Upon termination of the damaging factor (for example, alcohol, for more than 1 month), it is possible to restore the normal structure of the cell. Large-drop obesity leads to the death of hepatocytes, mesenchymal reaction and the development of fibrosis with the outcome of cirrhosis.