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ChapterOne
IntroductiontoPathologySectionA:DifinitionofPathologySectionB:DevelopmentofPathologySectionC:ObjectivesofResearchSectionD:LearningofPathologyWilliamOslerAsisourpathology,soisourmedicine.病理為醫(yī)之本SectionA:DEFINITIONOFPATHOLOGYWithouttheconceptofsurgicaltreatment,oneisnotagoodphysician.Withouttheknowledgeofpathology,oneisnodoctor.Withouttheconceptofclinicaltreatment,oneisnotagoodpathologist.DefinitionofpathologyPathologyistostudydiseasesbyscientificmethods.Diseasemaybedefinedasanabnormalalterationofstructureorfunctioninanypartofthebody.Pathology:4aspectsofdiseaseETIOLOGY:Causeofdisease.PATHOGENESIS:Mechanismsofdevelopmentofdisease.MORPHOLOGY:Thestructuralalterationsinducedincellandtissues.FUNCTIONALCONSEQUENCES:Functionalconsequencesofthemorphologicchanges,asobservedclinically(clinico-pathologicalcorrelation,CPC).1.EtiologyKnowledgeofetiologyremainsthebackbone:DiseasediagnosesUnderstandingthenatureofdiseasesTreatmentofdiseases.1.EtiologyWhilemuchstillneedstobeuncoveredtolinkabnormalgenesandtheexpressionofdisease,gonearethetimewhenthemechanismsofmostdiseaseswereunknown?orobscure?ormysterious?Oneetiologicagent—onediseaseSeveraletiologicagents—onediseaseOneetiologicagent—severaldiseasesBASICRULESOFETIOLOGYCausesofcellinjuryanddiseaseOxygendeprivation(hypoxia,ischemia)NutritionalimbalancesPhysicalagentsChemicalagentsanddrugsInfectiousagentsImmunologicreactionsGeneticderangementsHYPOXIAIschemia(lossofbloodsupply)Inadequateoxygenation(cardiorespiratoryfailure)Decreaseofoxygen-carryingcapacityoftheblood(anemiaorCOpoisoning)HYPOXICINJURYLossofoxidativephosphorylationandATPgenerationbymitochondria.ResultinginaerobicglycolysisbydecreasedATP(withincreaseinAMP)Depletedglycogen.ReducedintracellularpH:Lacticacidandinorganicphosphate.MitochondrialdamageClumpingofnuclearchromatin.FourbiochemicalthemesOxygen-derivedfreeradicals.Lossofcalciumhomeostasisandincreasedintracellularcalcium.ATPdepletion.Defectsinmembranepermeability.PHYSICALAGENTSTraumaHeatColdRadiation(UV)ElectricshockCHEMICALAGENTSANDDRUGSEndogenousproducts:ureaExogenousagents:Therapeuticdrugs:hormonesNon-therapeuticagents:leadoralcoholMECHANISMSOFCHEMICALINJURYDirectly:MercuryofmercuricchloridebindstoSHgroupsofcellmembraneproteins,causingincreasedpermeabilityandinhibitionofATPase-dependenttransport.Indirectly:
Byconversiontoreactivetoxicmetaboliteswhichinturncausecellinjuryeitherbydirectcovalentbindingtomembraneproteinandlipid,ormorecommonlybytheformationoffreeradicals.MECHANISMSOFCHEMICALINJURY
MechanismofCCl4injuryCCl4inSERoflivercell(P-450)–CCl3.–lipidperoxidationandautocatalyticreactions–swellingandbreakdownofER,dissociationofribosome,anddecreasedhepaticproteinsynthesis(lossoflipidacceptorprotein–fattychangeoflivercell)–progressivecellularswelling,plasmamembranedamage,andcelldeath.FREERADICALINITIATIONAbsorptionofenergy(UVlightandx-rays)OxidativemetabolicreactionsEnzymaticconversionofexogenouschemicalsordrugs(CCl4>CCl3.)Oxygen-derivedradicalsSuperoxideCellinjurycausedbyfreeradicalsPeroxidationoflipids.Crosslinkingproteinsbytheformationofdisulfidebonds.InductionofDNAdamagethathasbeenimplicatedbothincellkillingandmalignanttransformation.INFECTIOUSAGENTSPrionVirusesRickettsiaeBacteriaFungiParasites肺---CMVGeneticdisorders:670per100050%ofspontaneousabortusesduringearlymonthsofgestation(chromosomalabnormalities)Chromosomalabnormalities:Trisomy21Single-genedisorders(APC)DisorderswithmultifactorialinheritanceGeneticderangementsAdenomatous
polyposiscoliAPCloci,5q21Adenomatous
polyposisincolons(inteens).100%malignanttransformation(40ys).NormalAPCproteininthecytoplasm.Severalpartners,including-catenin.Causingdegradationof-cateninmaintaininglowlevelof-catenininthecytoplasm.AbnormalAPC:-catenin
enteringthenucleusactivatingtranscriptionofgrowth-promotinggenes.PolymeraseChainReaction
DetectionofAPCDNAinFeces家族性高膽固醇血癥靶基因低密度脂蛋白受體基因技術(shù)方法單鏈構(gòu)象多態(tài)性分析溫度梯度凝膠電泳測序應(yīng)用范圍雜合子患者
(人群中1/500)
純合子患者
(人群中1/1,000,000)
A606T(hmz)infamilyANormalcontrol2.PATHOGENESISThecoreofthescienceofpathology—thestudythepathogenesisofthedisease.PATHOGENESISPathogenesisThesequenceeventsintheresponseofthecellsortissuestotheetiologicagent,fromtheinitialstimulustotheultimateexpressionofthedisease.PathogenesisImmunologic,cytogeneticandmolecularanalysesoftissuesandcellsareincreasinglybecomingguidestorenderdiagnoses,toassessprognosis,andtosuggesttherapy.ABCD117CD34GIST:發(fā)病機制受體偶聯(lián)的酪氨酸激酶基因功能獲得性突變(gainoffunctionmutation)是主要的致癌事件1,2-KIT:80%-85%1-PDGFRA:7%2-野生型(無法檢測到的突變):10-15%1
突變導(dǎo)致激活的酪氨酸激酶受體持續(xù)的異常表達(dá)(KIT或PDGFRA)3伊馬替尼(格列衛(wèi))治療PDGFRA,血小板源性生長因子受體;PDGFRA,血小板源性生長因子受體基因1.CorlessCLetal.JClin
Oncol.2004;22:3813-3825.2.HeinrichMCetal.Science.2003;299:708-710.3.TrentJCetal.Curr
Opin
Oncol.2006;18:386-395.3.MORPHOLOGY大葉性肺炎Morphologicchange
CharacteristicforthediseaseDiagnosticfortheetiologicproceessFunctionalderangementsClinicalsignificanceMORPHOLOGYMorphologyremainsattheheartofdiagnosticpathology.
DevelopmentofPathologySectionBOrganpathologyCellpathologyMolecularpathologyCellPathologyRudolfWirchow(1821-1902),AGermanpathologistThefounderofmoderncellpathologySectionCOBJECTIVESANDMETHODSOFRESEARCH
AutopsyBiopsyCytologyExperimentalstudies
Invitro:
TissuecultureOrgancultureCellculture
Invivo:
ExperimentalanimalsNudemiceAutopsy(尸檢):(A5800)主述:F/46工人?;颊咭蚝粑щy1天,神志不清12小時,急診入院?,F(xiàn)病史:患者自覺呼吸困難,全身不適,意識模糊,幾小時后神志不清,入三院診治。查體實驗室檢查:血壓低,心率快,體溫進(jìn)行性升高。雙肺中小水泡音。肛試子白血球15-20個/HPF,RBC2-3個/HPF,潛血(+)。末梢血WBC2-3萬/mm3。診斷:考慮為痢疾、感染性休克。2002年7月11日下午心臟驟停,搶救無效死亡。檢查腸系膜血管脾靜脈血栓AVPancreas診斷腸系膜靜脈、脾靜脈、門靜脈血栓性靜脈炎伴阻塞性血栓形成,小腸出血性壞死,急性腹膜炎感染中毒性休克死亡Biopsy-活體組織檢查1)Macroscopicobservation2)MicroscopicobservationFormalin-fixedparaffin-embedded
Freshtissue:FrozensectionFrozensectionBreastmass:Benignlesion:localresectionInfiltratingductalcarcinoma:mastectomy+removalofregionalLN病理學(xué)檢查申請單臨床醫(yī)師向病理醫(yī)師發(fā)出的會診邀請單疾病診治過程中的有效醫(yī)學(xué)文書各項信息必須真實,應(yīng)由主管臨床醫(yī)師親自逐項認(rèn)真填寫并簽名臨床醫(yī)師向病理醫(yī)師傳遞關(guān)于患者的主要臨床信息:癥狀、體征、各種輔助檢查結(jié)果和手術(shù)所見、診斷意向和對病理學(xué)檢查提出的某些特殊要求TheimportanceofclinicaldataAge:SLLrareinpatientslessthan20ysMFHmainlyinagedpeopleLocation:LiposarcomaindeepertissueplainAngioblastoma同一戰(zhàn)壕的戰(zhàn)友診斷意向:腹部腫快?發(fā)燒待查?結(jié)腸腫物?重要化驗結(jié)果:
PSA、AFPCytology-細(xì)胞學(xué)ExperimentalstudyRESEARCHMETHODSMacroscopicobservationMicroscopicobservation(HE)EMImmunohistochemistryHybridizationPCRFlowcytometryMicroarray1.ElectronicmicroscopyCelljunctionCytoskeletonNeuroendocrinegranulesMelanosomesMitochondria
HER2(紅色)/CEP17(綠色)無擴增有擴增2.Hybridization:FISH,CISHALKBREAKAPARTPROBES,FISH彌漫性間變性大細(xì)胞性淋巴瘤,t(2;5)(NPM-ALK)In-situHybridizationEBERinNasopharyngealcarcinoma3.ImmunohistochemistryDiagnsticMarkersPrognosticmarkersPredictivemarkers(Targetchemotherapy)Follicularlymphoma
T(14;18)(q32;q21)t(14,18)(q32,q21)抗凋亡的bcl2基因持續(xù)表達(dá)2021Predictivemarkers
(Targetchemotherapy)
Breastcarcinoma:HerceptinGIST(gastrointestinalstromaltumor):
Gleevec(格列衛(wèi))Bcelllymphomas:CD20amtibodies(美羅華)1+2+3+Immunohistochemistry
Treatment:HER-2/neuinbreastcarcinomaO+4.PCRPolymeraseChainReaction
ChromosomalTranslocation靶基因:
SYT-SSX1,t(x;18)(p11.23;q11)
SYT-SSX2,t(x;18)(p11.21;q11)
技術(shù)方法:RT-PCR
應(yīng)用范圍:
90%以上的滑膜肉瘤,特別是不常見部位的、發(fā)生于老年的滑膜肉瘤滑膜肉瘤病歷1病歷2M75bp100bp107bp通
III通
III5.MicroarrayscDNAMicroarrayDiffuselargecelllymphomaNEJM2002;346:1937-476.FLOWCYTOMETRYGeneticHallmarkofCompleteMoleDiploidDNAcompositionPaternal/androgenicgenome46XpXp23XSpermEmptyEggCOMPLETEMOLEPaternalChromosomeOnly(Androgenetic)PARTIALMOLE23XSperm23XSperm23XEgg69XpXpXmPaternalandMaternalChromosome(Triploid)FLOWCYTOMETRYFORPLOIDYLEARNINGOFPATHOLOGYSectionDGeneralpathologyisconcernedwiththebasicreactionsofcellsandtissuestoabnormalstimulithatunderliealldiseases.Systemicpathologyexaminesthespecificresponsesofspecializedorgansandtissuestomoreorlesswelldefinedstimuli.MajorpointsDefinitionCausesPathogenesisLesionsEffectsChineseproverbIhear,Iforget;Isee,Iremember;Ido,Iunderstand.ChapterTwo
CellandTissueInjury
CELLINJURYANDNECROSISGeneralmechanisms:Maintenanceoftheintegrityofcellmembranes.AerobicrespirationandproductionofATP.Synthesisofenzymesandstructureproteins.Preservationoftheintegrityofthegeneticapparatus.CELLSREACTTOADVERSEINFLUENCESADAPTINGSUSTAININGREVERSIBLEINJURYSUFFERINGIRREVERSIBLEINJURYANDDYINGSectionA:CellularAdaptation
SectionB:Degeneration
(reversibleinjury)
SectionC:CellDeath
SectionD:CellularAging
SectionA
Cellularadaptation:AtrophyHypertrophyHyperplasia
MetaplasiaCELLULARADAPTATIONExcessivephysiologicstresses.Somepathologicstimuli.Anew,butalteredstatepreservingtheviabilityofthecell.ATROPHYDecreaseinmassofthecellHYPERTROPHY
IncreaseinmassofthecellAtrophyPhysiologicalPathological
Fig2-5PATHOLICALATROPHY
Decreasedworkload(廢用性).Lossofinnervation(神經(jīng)性).Diminishedbloodsupply(貧血性).Pressure(壓迫性).Inadequatenutrition(營養(yǎng)不良性).Lossofendocrinestimulation(內(nèi)分泌性).Aging(老年性).MorphologyofatrophyBrownatrophyReductioninthenumberofcellorganelles.Increaseinthenumberofautophagicvacuoles.Lipofuscingranules(Brownatrophy)AtrophyEffects:ReversibleDecreaseinfunctionalcapacityHYPERTROPHYPhysiologicalPathological
Fig2-6HYPERTROPHYIncreasedfunctionaldemand.Specifichormonalstimulation.HYPERTROPHYPathologic:工作性代償性替代性內(nèi)分泌性HYPERPLASIAThemythofPrometheus.
Fig2-1HYPERPLASIA
Physiologichyperplasia:HormonalhyperplasiaCompensatoryhyperplasiaPathologichyperplasia:Excessivehormonalstimulation.EffectsoflocallyproducedGFsontargetcells.PARTIALHEPATECTOMYPrimingProliferationGroeth
lnhibitionGROWTHFACTORSANDCYTOKINESHGFTGF-EGFTNF-IL-6OthersADJUVANTSNorepinephrineInsulinGlucagonThyroidhormoneGROWTHINHIBITORSTGF-
OthersGrowthfactorsAdjuvanisMatrixdegradationProliferated
endometriumComplexhyperplasiaMetaplasiaOneadultcelltypeisreplacedbyanother.Geneticreprogrammingofstemcells.Epithelialandmesenchymal
metaplasia.Squamous
metaplasia
BronchialepitheliaEpitheliainbileductCervicalepitheliaIntestinalmetaplasiaofgastricepitheliaBonemetaplasia.慢性萎縮性胃炎,AB/PAS
染色:胃腺上皮--腸上皮化生chronicgastritis胃粘膜腸化Degeneration:Definition1.ACUTECELLULARSWELLINGSectionBEtiologyIschemicInfectiousToxic
心肌空泡變CELLULARSWELLINGEM:線粒體腫脹內(nèi)質(zhì)網(wǎng)擴張核糖體脫失糖原顆粒減少CELLULARSWELLINGEffects:Reversible,mildDecreaseinfunctionalcapacity
IntracellularaccumulationAnormalcellularconstituentaccumulatedinexcess,(e.g.Water,lipid,protein,carbohydrates,pigment)Anabnormalsubstance:exogenousendogenousIntracellularaccumulationAnormalendogenoussubstance,buttherateofmetabolismisinadequatetoremoveGeneticoracquireddefectsinmetabolism,packaging,transportorsecretion--storagedisease.Anabnormalexogenoussubstanceisdepositedduetothecellunabletodegradeortransportittoothersites2.FATTYCHANGEEtiologyIschemicInfectiousToxic
Starvation,corticosteroidtherapyHepatitistypeCAlcoholExcessiveentryoffreefattyacidsintotheliver(starvation,corticosteroidtherapy).Enhancedfattyacidsynthesis.Decreasedfattyacidoxidation.
Dncreased
esterificationoffattyacid---triglycerides(alcohol).Decreasedapoproteinsynthesis(CCl4).Impairedlipoproteinsecretionfromtheliver(alcohol).FATTYCHANGEMorphologyoffattychangeSudanIII,OilredO,OsmicacidLiverHeartKidney脂肪肝嚴(yán)重的肝細(xì)胞脂肪變性,并出現(xiàn)一系列臨床異?!螀^(qū)脹滿、痛、厭油食轉(zhuǎn)氨酶高等心肌脂肪變LipidsSteatosis(fattychanges)
clearvacuolesinliver,heartCholesterolandcholesterolestersAtherosclerosis
XanthomasInflammationandnecrosis
CholesterolosisIntracellularhyalinechangesHyalinedegenerationofarteriolesHyalinedegenerationofconnectivetissue3.Hyalinechanges(degeneration)
Absorptionofproteincausinghyalinedropletsinproximalepithelialcellsinthekidney.
Russelbodiesinplasmacells.Viralinclusionsinthecytoplasmorthenucleus.Massesofalteredintermediatefilaments(Mallorybodies).IntracellularhyalinechangesProteinreabsorptiondropletsintherenaltubularepithelium.膠元纖維玻璃樣變Aheterogeneousgroupofpathogenicfibrillarproteinsaccumulatingintissuesandorgans.ExcesssynthesisResistancetocatabolism4.AMYLOIDOSISChemicalnatureofamyloidfibrilsTwomajorforms:AL(amyloidlightchainprotein)AA(amyloid-associatedprotein):
DerivedfromserumAA(12kd)synthesizedinliverandelevatedininflammatorystates.Minorformsofamyloidfibrils:Transthyretin(TTR):Amutantformofaserumproteininfamilialamyloid
polyneuropathy.AvariantofTTRinaging.Beta-2-microglobulin(thecomponentofclassIMHCmolecules)inlong-term
hemidialysis.
primary(B-celldyscrasia,AL)Secondaryorreactive(AA):Collagendiseases,bronchiectasis,chronic
osteomyelitis.
Hemodialysis-related:Beta-2-microglobulindeposition.Hereditary(AA)ClinicalformsofamyloidosisSystemicamyloidosis:
Nodular(tumor-formingdeposits,B-celldyscrasia,AL)Endocrineamyloidosis(procalcitonin)
Amyloidosisofaging:Heart,lung,pancreas,spleen,brain.LocalizedamyloidosisAmyloidosisoftheliverischaracterizedbyhomogeneouseosinophilicmaterialinthesinusoids5.GlycogenExcessiveintracellulardepositsofglycogenareseeninpatientswithanabnormalityineitherglucoseorglycogenmetabolismClearvacuolesinthecytoplasmDMGlycogenstoragedisease肝糖元,卡紅
Exogenous:
CarbonTattooingEndogenous:
LipofuscinMelanin
Hemosiderin
Bilirubin6.Pigmentation文身之皮膚痣,黑色素肺GPC,含鐵血黃素,F(xiàn)e肝血色病Idiopathichemochromatosis
膽汁與膽色素DystrophiccalcificationMetastaticcalcification7.Pathologiccalcification
Necrotictissues
AtheromaDamagedheartvalves
DystrophiccalcificationFig2-13冠狀動脈鈣化
IncreasedsecretionofparathyroidhormoneDestructionofbonetissueVitaminD-relateddisorders:
SarcoidosisRenalfailureMetastaticcalcificationHypercalcimiaMetastaticcalcificationAffectingInterstitialtissueofgastricmucosaKidneysLungsPulmonaryveinsSystemicarteries肺轉(zhuǎn)移性鈣化肺轉(zhuǎn)移性鈣化SectionCCELLDEATH一、NECROSISDefinitionCausesLesionTypesFatesNECROSISThesumofthemorphologicchangesthatfollowcelldeathinlivingtissueandorgan:Denaturationofproteins.Enzymaticdigestionoforganellesandcytosol.Swelling,denaturationandcoagulationofproteinsBreakdownofcellularorganellesCellrupture
Commontypeofnecrosisafterexogenousstimuli.Enzymaticdigestionbylysosomalenzymesofthedeadcellsthemselves.AUTOLYSISHETEROLYSISDigestionbylysosomalenzymesofimmigrantleukocytes.ThreepatternofnuclearchangesKaryolysis(DNaseactivity)Pyknosis(DNAcondensation)Karyorrhexis(fragmentationofpyknoticnucleus)MorphologicappearanceofnecrosisIncreasedeosinophilia:LossofRNAinthecytoplasmIncreasedbindingofeosintodenatured
cytoplasmic
proteinMoreglassyhomogeneousappearanceLossofglycogenparticlesVacuolatedandmoth-eatencytoplasmCalcificationofnecroticcellsTYPESOFCELLDEATH
necrosis
Coagulationnecrosis
Caseousnecrosis
Gangrene
Liquefactionnecrosis(fatnecrosis)
FibrinoidnecrosisApoptosis1.CoagulationnecrosisDenaturesofbothstructuralandenzymaticproteinsbyinjuryorthesubsequentincreasingintracellularacidosis.HerpessimplexhepatitiswithscatteredfociofcoagulativenecrosisCaseousnecrosisAsubtypeofcoagulationnecrosisWhiteandcheesyTuberculosisCompletelyobliteratedtissuearchitectureTB,干酪樣壞死GangreneAsubtypeofcoagulationnecrosisDrygangreneWetgangreneGasgangrene2.LiquefactivenecrosisBacterialorfungalinfectionsCentralnervoussystemAmebiasis肺膿腫腸阿米巴,液化性壞死腸阿米巴,液化性壞死腦軟化FatnecrosisTraumaticActivatedpancreaticlipasesAcutepancreatitis:fatnecrosisandinflammatorycellsindamagedpancreaticparenchyma3.FibrinoidnecrosisThecombinationofcelldeathanddepositionoffibrin-likematerialFibrinImmunoglobulinOtherplasmaproteinsFibrinoidnecrosis
DeeplyeosinophilicCollagendiseasesNecroticvasculitisMalignanthypertension纖維素樣壞死AbsorptionDischarge:ErosionUlcerSinusFistulaCavitationOrganizationEncapsulationCalcificationFatesofnecrosis二、APOPTOSIS(Programmedcelldeath)
Programmeddestructionofcellsduringembryogenesis.Hormonedependentinvolutionoftissuesintheadult.Celldeletioninproliferatingcellpopula-
tions(intestinalcryptepithelium),tumors,andlymphoidorgans.
Pathologicatrophyinparenchymal
organsafterductobstruction.CelldeathbycytotoxicTcells.Cellinjuryincertainviraldiseases.Celldeathproducedbyavarietyofinjuriousstimuligiveninlowdoses(dthermalinjury).MORPHOLOGICALFEATURESOFAPOPTOSISCellshrinkageChromatincondensationandfragmentation.Formationofcytoplasmicblebsandapoptoticbodies.Phagocytosisofapoptoticbodiesbyadjacenthealthycellsormacrophages.Lackofinflammation.
Necrosis
ApoptosisStimuliHypoxiaPhysicalToxinsPathologicalHistology
CellswellingSinglecellCoagulationNChromatinDisruptionofcondensationorganellesApoptoticbodiesDNA
RandomInternucleosomalbreakdown
Diffuse
Necrosis
ApoptosisMechanismATPdepletionGeneactivationMembraneEndonucleaseinjuryFreeradicalsTissue
InflammationNoinflammation
reaction
PhagocytosisofapoptoticbodiesFig1-18Biochemicalfeaturesofapoptosis1.PROTEINCLEAVAGE:
Caspases(cysteineprotease)Nuclearscaffold
Cytoskeletalprotein2.PROTEINCROSS-LINKING:
Transglutaminase
Cytoplasmicproteinshrunkenshalls
apoptoticbodiesBiochemicalfeaturesofapoptosis3.DNAbreakdown:50-300kbpiecesCa2+,Mg2+dependentendonucleasesDNAoligonucleosomesDNAladders(alsoseeninnecrosis)4.PHAGOCYTICRECOGNITION
Receptorsonmacrophagesforthesurfacecomponents(phosphatidylserine,thrombospondin)onapoptoticbodies.Fig1-19Apoptosis-associatedgenesbcl-2,c-myc,p53Fig1-20SectionD:CellularAging
AnumberofcellfunctiondeclineOxidativephosphorylationisreducedAdecreasedcapacityforuptakeofnutrientsandforrepairofDNAdamageAccumulationoflipofuscinAgeneticallydeterminedclockEffectsofcontinuousexposuretoexogeneousinfluenceSectionA:RegenerationSectionB:FibrousRepairSectionC:WoundhealingSectionD:FractureRepairChapterThree:RepairLabilecellsStablecellsPermanentcellsRegenerationcapacitySectionA:
Regeneration1.Completelyregeneration2.FibrousrepairLabilecells
Normallydividedactivelytoreplacecellsthatarebeingcontinuouslostfromthebody.
Thechancesofrestorationbyregenerationareexcellent.
Includingepithelialstemcellsinbasallayer,hematopoieticstemcellinbonemarrow.TheregenerativecapacitytypesofcellsStablecells
Alonglifespanandarecharacterizedbyalowrateofdivision,retainthecapacitytoenterthemitoticcellcycleiftheneedarises.Chancesofregenerationremain.Includingparenchymalcellofsolidglandularorgan(liver,pancreas)andmesenchymalcells.TheregenerativecapacitytypesofcellsPermanentcells
Nocapacityformitoticdivisioninpostnatallife.
Neurons,striatedandcar
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