Amorphous densities in mitochondria are the most pathognomonic sign of irreversible cell injury. This indicates severe damage to the mitochondria, which are responsible for producing energy in the cell. The presence of amorphous densities suggests a disruption in the normal functioning of the mitochondria, leading to irreversible cell injury. This can occur due to various factors such as toxins, lack of oxygen, or severe cellular stress. The other options mentioned, such as swelling of the cell membrane, ribosomes detached from endoplasmic reticulum, and clumping of nuclear chromatin, may also indicate cell injury but are not as specific or characteristic as the presence of amorphous densities in mitochondria.