ATHEROSKLEROSIS

MorfologiFatty dotslesi sub endotel 1 mmLunakKekuningan

Fatty streaks elevasi 3 mm s/d 1,5 cm axis vessel

Histologifoam cellsSMCsfew T-limfositekstraseluler lipid debris

Atheromatous plaquefibrous capbentuk iregulerputih keabuan Lokasi :lower aorta abdominala. coronarya. popliteadescending aorta thoracalisinternal carotid artericircle of Willis

Complicated plaque Calcification Fissuring or ulceration Cholesterol emboli / thrombosis Hemorrhage Aneurysma aorta

Fatty streaks

Figure 11-6 Fatty streak-a collection of foam cells in the intima. A, Aorta with fatty streaks (arrows), associated largely with the ostia of branch vessels.

Figure 11-7 Schematic depiction of the major components of well-developed intimal atheromatous plaque overlying an intact media.Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 20 June 2006 08:17 AM) 2005 Elsevier

Figure 11-9 Histologic features of atheromatous plaque in the coronary artery. A, Overall architecture demonstrating fibrous cap (F) and a central necrotic (largely lipid) core (C). The lumen (L) has been moderately narrowed. Note that a segment of the wall is plaque free (arrow). In this section, collagen has been stained blue (Masson's trichrome stain). Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 20 June 2006 08:17 AM) 2005 Elsevier

Figure 11-9 Histologic features of atheromatous plaque in the coronary artery. B, Higher-power photograph of a section of the plaque shown in A, stained for elastin (black), demonstrating that the internal and external elastic membranes are destroyed and the media of the artery is thinned under the most advanced plaque (arrow). Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 20 June 2006 08:17 AM) 2005 Elsevier

Figure 11-9 Histologic features of atheromatous plaque in the coronary artery. C, Higher-magnification photomicrograph at the junction of the fibrous cap and core, showing scattered inflammatory cells, calcification (broad arrow), and neovascularization (small arrows).Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 20 June 2006 08:17 AM) 2005 Elsevier

2. FIBROUS PLAQUE

2. FIBROUS PLAQUE

2. FIBROUS PLAQUE

2. FIBROUS PLAQUE & COMPLICATED LESIONS Fibrosis kristal KolesterinBercak kuning melebar/ luas/membesar

3. COMPLICATED LESIONSFibrosis luas di intimaKalsifikasi pembuluh darah Bercak meluas menonjolulkus

HEMANGIOMANeoplasma jinak pembuluh darah / limfe

Histopatologi :Hemangioma cavernosaHemangioma capillaris

Hemangioma cavernosaLokasi :KulitMukosavisera : HatilienPancreascerebellum (von Hippel-Lindau) + lesi red-blue, spongious 2-3 cmbatas jelastidak berkapsul

Hemangioma capillarisLokasi :KulitSubkutanmukosa mulut/bibirBeberapa mm cmmerah sampai biruMudah berdarahTraumaulserasi

Figure 11-30 Hemangiomas. A, Hemangioma of the tongue. B, Histology of juvenile capillary hemangioma. C, Histology of cavernous hemangioma. D, Pyogenic granuloma of the lip. (A and D, courtesy of John Sexton, M.D., Beth Israel Hospital, Boston; B, courtesy of Christopher D.M. Fletcher, M.D., Brigham and Women's Hospital, Boston; and C, courtesy of Thomas Rogers, M.D., University of Texas Southwestern Medical School, Dallas, TX.)Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 20 June 2006 08:17 AM) 2005 Elsevier

Figure 11-30 Hemangiomas. B, Histology of juvenile capillary hemangioma. (courtesy of Christopher D.M. Fletcher, M.D., Brigham and Women's Hospital, Boston)Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 20 June 2006 08:17 AM) 2005 Elsevier

Figure 11-30 Hemangiomas.C, Histology of cavernous hemangioma. C, courtesy of Thomas Rogers, M.D., University of Texas Southwestern Medical School, Dallas, TX.)Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 20 June 2006 08:17 AM) 2005 Elsevier

MIOKARD INFARKIschemis Heart Disease Nekrosis iskemi akut miokard2 macam : transmural sub endokard

Transmural> 2,5 cmseluruh lapisan miokard

Sub endokard1/2 s/d 1/3 lapisan miokard

MORFOLOGIDimulai dari nekrosis koagulasi dan keradanganDiikuti pembentukan jaringan granulasi, resorbsi nekrosis miokardiumDiakhiri dengan organisasi granulasi sampai fibrosis

0 2 jam:perubahan macros (-)4 8 jam :pucat18 24 jam:pucat, kadang hiperemi24 72 jam:hiperemi, perlunakan10 hari:sangat kuningMgg 7 8 :fibrosis

URUTAN PERISTIWA INFARK JANTUNG

WAKTUMAKROSKOPISMIKROSKOPISPERUBAHAN15 DETIK--EKG30 60 MENIT-OEDEMAELEKTRON MIKROSKOPE (+)2 JAM-HIALINISASI SERABUT (EOSINOFLIK HOMOGEN)Ca ++ HILANG3 JAM-PENGELOMPOKAN SARCOPLASMA DEBLEMAU Na+ ENZYM ASAM SITRAT 4 JAMREAKSI TTC (-) NEKROSISCPK SERUM

URUTAN PERISTIWA INFARK JANTUNG

WAKTUMAKROSKOPISMIKROSKOPISPERUBAHAN6 JAMPUCAT*REAKSI LEUKOSITCPK SERUM9 JAMKUNING KENYALNEKROSIS MELUAS18 24 JAMKUNING KENYALNEKROSIS LENGKAPENZYM SERUM2 3 MINGGU JARINGAN GRANULASIJARINGAN GRANULASI5 MINGGUJARINGAN PARUTJARINGAN PARUT2 BULANPUTIH KENYAL FIBROSISJARINGAN PARUT

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