Path I

reversible retrogressive state in which cells/tissues adjust to sublethal conditions and demonstrate corresponding (gradation) losses of function, altered metabolism, and morphological changes

depends on type

sublethal injury to cells/tissues

• larger than normal (swollen)
• paler than normal
• softer than normal
• heavier than normal

• swollen cells
• intact nuclei
• intact cell membranes (loss of luxury functions)

accumulation of intracellular water

all tissues - especially liver/kidney, skeletal muscle, epithelia

disruption of cellular ATP (disruption of N-K ATPase pump)

• swollen
• wet
• heavy
• grayish color

• swollen cells
• increased cytoplasmic granularity
• cytoplasmic water spaces indistinct/irregular
• nuclei displaced to periphery (unaffected)

accumulation of triglycerides in non-adipose cells

liver, kidney, skeletal/cardiac muscle

• dietary
• fat mobilization disease
• hepatic disease
• hypoxia
• toxins

• swollen
• pale
• friable
• greasy
• yellow

• cytoplasmic vacuoles with clear margins
• remaining cytoplasm/organelles displaced - eosinophilic
• nuclei displaced by lipid droplets

accumulation of extracellular proteinic material (resembles embryonic CT)

adipose and connective tissue

• starvation
• malnutrition
• wasting
• chronic inflammation

• soft
• fluctuant
• watery
• shiny

looks like fetal CT (mesenchyme)

accumulation and denaturation of cytoplasmic proteins

connective tissue smooth muscle, epithelia, skeletal muscle (Zenker's necrosis)

buildup and coagulation of protein

• CT and smooth muscle - collagen condenses into extracellular, eosinophilic structureless proteinic material
• Epithelia - eosinophilic droplets in cytoplasm (often w/hydropic degeneration); PAS +
• Skeletal muscle - densely eosinophilic amorphous material in sarcoplasm (often w/hydropic, fatty degeneration)

disintigration of tissues following somatic death

all tissues

Anoxia causing rupture of lysosomes with enzymatic self-digestions and invasion of proteolytic microbes

• progressive deterioration of tissues
• coagulation (pools on down-side)
• discoloration
• gas/odor

• diffuse change
• loss of nuclear and cellular function
• microbes without inflammatory response