Apoptosis also occurs when a cell is damaged beyond repair, or infected with a virus. The "decision" for apoptosis can come from the cell itself, or from a call that is part of the immune system. If the apoptosis program of a cell itself is damaged (by mutation), or if the initiation is blocked (by a virus), a damaged cell can start growing without restrictions, developing into cancer.
Programmed cell death is an integral part of vertebrate? tissue development, and it does not elicit the inflammatory reponse which is characteristic of necrosis?. In other words, apoptosis does not resemble the sort of reaction that comes as a result of tissue damage due to accident or pathogenic infection. Instead of swelling and bursting --and, hence, spilling their internal contens into extracellular space--, apoptotic cells and their nucleus shrink, and often fragment. In this way, they can be efficiently phagocytose?d (and, as a consequence of this, their components reused) by macrophage?s or by neighgoring cells.