د.سرى

Hemodynamic disorders(practice)

Dr. Zainab Waleed Aziz

University of Ninevah

Pitting edema of the ankle joint

Lymphadema : non pitting edema of the legs

Here is an example of a "nutmeg" liver seen with chronic passive congestion of the liver. Note the dark red congested regions that represent accumulation of RBC's in centrilobular regions. the natural nutmeg is at right.

Microscopically, the nutmeg pattern results from congestion around the central veins, as seen here. This is usually due to a "right sided" heart failure.


Pulmonary congestion with dilated capillaries and leakage of blood into alveolar spaces leads to an increase in hemosiderin-laden macrophages, as seen here.

Mural thrombi of the heart

Coronary artery thrombosis

Cross section through the coronary artery showing the thrombus obstructing the whole lumen.


Microscopic appearance of thrombus' the line of Zahn’ These lines represent layers of red cells, platelets, and fibrin which are laid down in the vessel as the thrombus form.

Fates of thrombus : propagation, resolution, organization, recanalization & embolization. Note the organization & the recanalization of the thrombus in these two slides.


Fate of thrombus: organization of thrombus by granulation tissue formation, here this organized thrombus is totally occluding the lumen in this cross section through a coronary artery. The wall is showing a built up of an atheromatous plaque.


An organized thrombus at high power view showing a thrombus with recanalization & organization by granulation tissue formation (newly formed capillaries , fibroblast and collagen matrix). The wall is showing a built up of an atheromatous plaque.

Pulmonary embolism

Pulmonary embolus obstructing the main pulmonary artery

Saddle embolus of main pulmonary trunk

This is the microscopic appearance of a pulmonary thromboembolus in a large pulmonary artery. There are interdigitating areas of pale pink and red that form the "lines of Zahn" characteristic for a thrombus .

Paradoxical embolus through a patent foramen ovale

Pulmonary infarction produced by a medium-sized thromboembolus to the lung. This infarction forms a wedge- shaped area & has begun to organize at the margins.

Infarctions of the spleen produce wedge –shaped pale areasAnd caused by obstruction of spleenic artery