3.2 Pathology of liver disease Flashcards
define centrilobular
The hepatocytes in the vicinity of the terminal hepatic veain
Define periportal
The hepatocytes near the portal tract
What is the portal tract?
Sinusoids between the liver plates that contains the main blood vessels running into the liver as well as the bile duct
What is steatosis
Accumulation of neutral fat and triglycerides in hepatocytes - occurs in defects in lipid metabolism, lipoprotein synthesis or excess in diet/adiposity (fatty liver)
What is the usual pattern of steatosis in alcoholic fatty liver disease>
A mixture of small and large fat droplets which are most prominent around the central vein extending out towards the portal tracts
What is the pattern of injury in shock?
Perivenular first to die
what is the pattern of injury with toxins?
Necrosis around the portal tract as they are the first exposed to toxins
What pathology changes will you see in the liver from cholestasis?
dark bile accumulation in the caniculi and hepatocytes
What will you see in alcoholic hepatitis?
Central zone swelling
Spotty single necrosis
Mallory bodies
Neutrophil infiltration
What will you see in alcoholic liver disease?
Central/perivenular sclerosis
Progressive injury and cirrhosis (central zone injury which will progress across acinus with collagen deposition to portal tracts, cirrhotic nodule formation)
Cirrhosis (dose related)
What will you see with liver cirrhosis?
Nodules of regenerating hepatocytes separated by scars with distortion of blood flow
What are the types of cirrhosis
Micronodular (regular): uniform nodules and scars formed from fragments of single liver lobules (uniform confluent necrosis)
Macronodular (irregular): nodules and scars of various sizes formed from multiple adjacent lobules (non uniform) END STAGE
What will you see in portal hypertension?
Expansile nodules and scar contraction with central zone fibrosis ad venous outflow obstruction
What are the complications of cirrhosis
Portal hypertension
Obstruction of bile excretion
Hepatocyte dysfunction
Loss of normal proliferation - HCC
What mutation causes haemochromatosis
90% due to C282Y
The most common is H63D but less likely to develop
