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Pigments, Infiltrates & Storage Diseases, Screenshot 2023-06-21 at 10…

- - - - Picked up by macrophages within alveoli & then transported through lymphatic channels to lymph nodes
    - - Localised, exogenous pigmentation of skin
      - Pigments inoculated are phagocytosed by dermal macrophages
  - - - Brown-black pigment formed when tyrosinase catalyses oxidation of tyrosine to dihydroxyphenylalanine in melanocytes
    - - Accumulates in non-dividing cells (neurons, cardiac muscle) & in hepatocytes
      - Insoluble pigment
      - Peroxidation of lipids
      - Free radical injury & lipid peroxidation
      - Yellow- brown, finely granular cytoplasmic pigment
    - - A hemoglobin (Hb)-derived, golden yellow-to-brown, granular pigment
      - Storage form of iron
      - Local or systemic excess of iron, ferritin forms hemosiderin granules
      - Localised - Haemorrhage/bruising, chronic congestion e.g. Lungs
      - Generalised - Haemochromatosis, Red cell transfusions, iron supplements, haemolysis
    - - Unconjugated
        
        Pre-hepatic ('haemolytic')
        
        Haemolysis
        
        RBC parasites
      - Mixed
        
        Hepatic 'toxic'
        
        Hepatic necrosis
      - Conjugated
        
        Post-hepatic, cholestatic ('obstructive')
        
        Intrahepatic - Hepatitis, Drug toxicity, alcoholism
        
        Extrahepatic - Gall stones, Pancreatitis
    - - Photodynamic molecule --> Free radical release --> Epithelial & dermal necrosis
      - Type I (primary)
        
        Photodynamic agent ingested, injected or absorbed
      - Type II (Aberrant metabolism)
        
        Inherited defects in enzymes involved in haeme synthesis resulting in porphyrin accumulation
      - Type III (secondary/hepatogenous)
        
        Liver disease resulting in build up of phylloerythrin (a porphyrin derived from breakdown of chlorophyll by GIT microflora - normally absorbed into circulation and is excreted by the liver into the bile)
- - - - Ig light chains produced by monoclonal cells
    - - Islet localised, human familial polyneuropathies
    - - Macs activated
        
        Macs release IL1 and IL6
        
        Serum amyloid A protein made in liver
  - - - Metabolic diseases
      - Glucocorticoid administration
      - Alcoholism
      - Liver diseases
      - Genetic glycogen storage diseases
  - - - Toxins
      - Protein malnutrition
      - Diabetes mellitus
      - Obesity
      - Alcohol abuse
      - Late term pregnancy
      - Liver disease
  - - - Impaired purine metabolism (alcoholics)
      - High protein diets (dalmations)
      - Uric acid/urates
      - Deposits in joint or viscera
      - Chronic inflammation
    - - Oxalate rich plants
      - Ethylene glycol
      - Oxalate crystals
      - Deposits in nephron