At higher magnification, vasculitis with arterial wall necrosis is seen. Note the fragmented remains of neutrophilic nuclei (karyorrhexis). Acute inflammation is a non-selective process that can lead to tissue destruction. Thus, it is best if the response is fast and localized, so that tissue destruction is minimal, and this is what happens most of the time. Clinically apparent inflammatory disease processes are characterized by more extensive, ongoing inflammation.
When necrosis of cells occurs, there is release of cytoplasmic contents, some of which may find their way into circulation. Some cytoplasmic contents, such as enzymes, may be more specific for some tissues than others, and measuring them in the peripheral blood gives an indication of where the inflammation and necrosis may be. Thus, creatine kinase (CK) elevations suggest damage to striated muscle, while elevation of serum lipase is more specific for pancreas, and an elevated alanine aminotransferase (ALT) suggests hepatocyte injury. Some enzymes, such as lactate dehydrogenase (LDH) can come from many tissue sources.