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Pathology > 7. Pathology Of The Liver, Gallbladder, And Pancreas - BP > Flashcards

7. Pathology Of The Liver, Gallbladder, And Pancreas - BP Flashcards

1
Q

With what viral hepatitis do we see cholestatic hepatitis as an outcome?

A

Hep A

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2
Q

What is the microscopic morphology of acute viral hepatitis?

A
  1. Ballooning degeneration, hepatocyte necrosis (acidophil bodies), and lobular disarray (loss of architecture).
  2. Portal tract inflammation - mononuclear infiltrate with or without spillover into the surrounding parenchyma.
  3. Spotty of bridging necrosis.
  4. Possible cholestasis.
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3
Q

With what morphology is hep B associated?

A

Ground-glass hepatocytes.

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4
Q

With what morphology is hep C associated?

A

With mild fatty change (macrovesicular steatosis in sublobular region, lymphoid aggregates, and reactive bile duct epithelium.

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5
Q

What is the microscopic morphology of chronic viral hepatitis?

A
  1. Evidence of hepatocyte injury (ballooning degeneration), necrosis, and regeneration.
  2. Portal tract inflammation with or without spillover.
  3. Fibrosis –> portal, periportal, or bridging.
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6
Q

What is referred as interface hepatitis?

A

Portal tract inflammation with spillover.

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7
Q

Mention some drugs that affect the liver.

A
  1. Acetaminophen –> centrilobular necrosis
  2. Vinyl chloride, thorotrast –> angiosarcoma
  3. Oral contraceptives –> hepatic adenomas
  4. Chlorpromazine –> cholestasis
  5. Halothane –> fulminant hepatitis
  6. Phenytoin, isoniazid –> acute/chronic hepatitis
  7. Methotrexate, Amiodarone –> fibrosis and cirrhosis
  8. Sulfonamides –> granulomas
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8
Q

What is the MC neoplasm affecting the liver?

A

A metastasis

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9
Q

What are in, decreasing order of occurence, the common sources of liver metastases?

A
  1. Lung
  2. Colon
  3. Pancreas
  4. Breast
  5. Stomach
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10
Q

What is the target group of hepatocellular carcinoma?

A

> 60, but depends upon risk factors.

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11
Q

Mention some major risk factors for development of HCC.

A
  1. 85-90% a background of cirrhosis –> HBV, HCV, Wilson, hemochromatosis, chronic alcoholism are risk factors.
  2. Aspergillus flavus (Produces aflatoxin).
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12
Q

What is special about HCC?

A

Its propensity for blood vessel invasion.

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13
Q

What is the gross morphology of HCC?

A

Tumor may be unifocal, multifocal, or diffuse.

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14
Q

What is the microscopic morphology of HCC?

A

The more well-differentiated forms look like hepatocytes and can produce bile as well as manifest accumulations of fat (steatosis) and Mallory hyaline.

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15
Q

What are the symptoms of HCC?

A
  1. Abdominal pain
  2. Abdominal mass
  3. Weight loss
  4. Deterioration of liver function
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16
Q

What are the signs of HCC?

A

Incr. α-fetoprotein –> over 400ng/mL.

17
Q

What are the risk factors of cholangiocarcinoma?

A
  1. Primary sclerosing cholangitis
  2. Opisthorchis sinensis infection
  3. Thorotrast
18
Q

What are the forms in which cholangiocarcinoma and HCC can occur in combination?

A
  1. Two seperate tumors
  2. A collision tumor
  3. A mixed tumor
19
Q

What is the focal nodular hyperplasia?

A

Benign tumor - has histologic features similar to cirrhosis.

20
Q

What is the epidemiology of focal nodular hyperplasia?

A

Young to middle-aged females.

21
Q

What is the gross morphology of focal nodular hypeplasia?

A

Nodule with a central scar.

22
Q

What is the microscopic morphology of focal nodular hyperplasia?

A

Nodules of hepatocytes, divided by fibrous septae with bile ductular proliferation within the fibrous septae.

23
Q

What is the epidemiology of hepatic adenoma?

A

Young women using oral contraceptives.

24
Q

What are the complications of hepatic adenoma?

A

Can rupture and can harbor HCC.

25
Q

What is the microscopic morphology of hepatic adenoma?

A
  1. Nodules of hepatocytes with fibrous septae.

2. No bile duct proliferation within fibrous septae.

26
Q

What is important to remember for hepatic hemangioma?

A
  1. It is common.

2. Could rupture, causing hemoperitoneum.

27
Q

What type of hemangioma is usually the hepatic one?

A

Cavernous

28
Q

What is the target group of hepatoblastoma?

A

Children

29
Q

What is the genetic abnormality of hepatoblastoma?

A

Activation of Wnt/β-catenin signaling pathway by mutation of β-catenin gene in 80% of tumors.

30
Q

What are the two types of hepatoblastoma?

A

Epithelial and mixed epithelial and mesenchymal types.

31
Q

What is the microscopic morphology of epithelial hepatoblastoma?

A

Composed of small cells resembling fetal and embryonal cells.

32
Q

What is the microscopic morphology of mixed epithelial and mesenchymal hepatoblastoma?

A

Epithelial cells and mesenchymal stroma (bone, cartilage, muscle).

Pathology (16 decks)

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