1. Persistent prelethal stress leads to cellular adaptation.
1-Adaptation of growth.
a) Increased growth and cellular activity e. g.Hypertrophy & Hyperplasia
b) Decreased growth and cellular activity e.g. Atrophy.
c-Disturbances of cellular differentiation and morphology e.g. Metaplasia
2-Intra and Extra cellular accumulations e. g.
a) Lipids as in fatty change & Cholesterol deposits.
b) Proteins as in Hyaline change& Amyloidosis.
c) Calcium as in Pathologic Calcification
d) Pigments as in Pathologic pigmentation.

2. Intracellular Accumulations
Endogenous
normal substance produced at normal or increased rate/rate of metabolism inadequate for removal (fatty liver)
Exogenous
cell cannot degrade substance (carbon)

3. Intracellular Accumulations
Fatty Change (Steatosis)
the liver is one of the main organs of the body involved in pathways involving metabolism of fats or lipids.
Accumulation of lipids in hepatocytes is termed fatty change (also known as, hepatic steatosis, fatty liver,.
Another example of accumulation of lipids in cells is atherosclerosis characterized by the accumulation of lipid-laden foam cells in the walls
of arteries. The significance of atherosclerosis in
humans is obviously reflected in the high incidence of myocardial and cerebral
infarction (heart attack and stroke).

4. Intracellular Accumulations
Fatty Change (Steatosis)
Liver
increased weight, yellow color

5. fat vacuoles within cytoplasm of hepatocytes

6. Another example of accumulation of an endogenous substance, is the accumulation
of protein in tubular epithelial cells of the kidney known as,amyloidosis
Glycogen:
Abnormal accumulation occurs in liver, muscles and kidney in case of:Diabetes mellitus ( hyperglycemia) defect in metabolism of glucose or glycogen

7. Pigment disorders:
Pigments are colored substances, synthesized within the body (endogenous) or coming from outside (exogenous).
Endogenous pigments: include melanin, lipofuscin and Hemosiderin

8. Intracellular Accumulations
Endogenous Pigments
Lipofuscin (“wear and tear pigment)
..) It contains complexes of lipid and protein derived from peroxidation of lipids by free radicals. insoluble brownish-yellow granular intracellular material that accumulates in a variety of tissues (particularly the heart, liver, and brain) as a function of age or atrophy( ageing pigment) when appear in tissue grossly it is called brown atrophy

9. Intracellular Accumulations
Endogenous Pigments
Melanin
brown-black pigment produced in melanocytes
It is synthesized exclusively by melanocytes located in the epidermis and acts as a screen against harmful ultraviolet radiation

10. Albinism: absence of melanin
Albinism: absence of melanin. Such individuals have melanocytes but are unable to synthesize melanin. These patients are vulnerable to cancer.

11. Intracellular Accumulations
Endogenous Pigments
Hemosiderin
golden-yellow pigmen accumulate in tissues when there is local or systemic excess of iron
Local excesses of iron and hemosiderin result from hemorrhages or vascular congestion,. With lysis of the erythrocytes, the hemoglobin eventually undergoes transformation to hemosiderin.

12. hemosiderin hemosiderosis
hemosiderin is systemic deposited in many organs and tissues [ liver, bone marrow, spleen, and lymph nodes
occurs in
increased absorption of dietary iron,
hemolytic anemias,
transfusions
hemochromatosis
hereditary more extensive accumulations of iron with tissue injury including liver fibrosis, heart failure, and diabetes mellitus.

13. Intracellular Accumulations
Exogenous Pigments
Carbon (anthracosis)
When inhaled, it is phagocytosed by alveolar macrophages and transported by lymphatics to lymph nodes
mild accumulations usually are of no consequence--heavy accumulations may induce a fibroblastic response

14. Exogenous pigments
Most of these are dust particles in the inhaled air, deposited in the lungs and associated lymph nodes.
The dust particles act as mild irritants and induce proliferation of fibrous connective tissue( FCT)- (fibrosis) and collection of macrophages.