Coagulative necrosis is most commonly associated with which tissue injury?

• A. Fatty infiltration
• B. Autolysis after death
• C. Liquefactive necrosis
• D. Ischemic/hypoxic injury in solid organs

Answer: (D)

Coagulative necrosis occurs when solid organs experience ischemic or hypoxic injury. In this situation, proteins denature and proteolysis is inhibited, so the tissue preserves its architecture for a while even though the cells are dead, giving a firm, infarct-like appearance. This pattern is typical in organs such as the heart, kidney, and spleen. Other options reflect different processes: fatty infiltration is lipid accumulation, autolysis after death is postmortem self-digestion, and liquefactive necrosis arises from enzymatic digestion (as in the brain or abscesses). Thus, the injury most commonly linked to coagulative necrosis is ischemic/hypoxic injury in solid organs.