Essentials: Liver Pathology (Summary Slides) Flashcards
Microvesicular steatosis (definition)
Accumulation of numerous small lipid droplets in hepatocytes (liver cells).
Pathogenesis: Microvesicular steatosis is associated with 3 conditions/etiologies
- Acute fatty liver of pregnancy (AFLP)
- Reye’s syndrome
- Drugs (aspirin)
How dangerous is microvesicular steatosis?
Acute liver failure is common with this condition! This is a life-threatening condition (emergency)!
Macrovesicular steatosis (definition)
Accumulation of large fat vacuoles in hepatocytes (liver cells)
Pathogenesis: Macrovesicular steatosis is associated with 4 main etiologies
- Alcohol abuse
- Obesity
- Drug abuse
- Type II diabetes & hyperlipidemia
Alson seen in hepatitis C
Macrovesicular steatosis can progress to…
steatohepatitis (if inflammation and liver injury develop)
Steatohepatitis (definition)
fat buildup in the liver that leads to inflammation of the liver.
3 types of steatohepatitis
Alcohol
ASH: Acoholic steatohepatitis
Metabolic syndromes:
NASH: Non-alcoholic steatohepatitis
Alcoholic and non-alcoholic steatohepatitis: macroscopic appearance
Pale, greasy & enlarged liver
Alcoholic and non-alcoholic steatohepatitis: key histologic features (3)
- Injured hepatocytes (balloon cells)
- Mallory-Denk bodies
- Chicken wire fibrosis
- Inflammation! (lymphocytes, neutrophils)
Non-alcoholic fatty liver disease (NAFLD) (definition)
NAFLD is a spectrum of liver disease (metabolic syndrome) that includes NASH (non-alcoholic steatohepatitis)
Autoimmune Hepatitis (definition)
Chronic liver disease characterized by immune-mediated hepatocyte damage.
3 key histologic features of autoimmune hepatitis
- Interface hepatitis (inflammation at the junction of the portal tracts and hepatic lobules)
- Plasma cell infiltration
- Rosetting of liver cells (hepatocytes form flower-like pattern)
How do we treat autoimmune hepatitis?
Autoimmune hepatitis responds very well to STEROIDS.
Autoimmune hepatitis is more common in…
more common in (Caucasian) women than men
3 auto-antibodies present in autoimmune hepatitis
ANA
SMA
Anti-LKM1
Primary biliary cholangitis (PBC) (definition)
Autoimmune attack on intra-hepatic bile ducts causing inflammation.
Key histological feature of primary biliary cholangitis (PBC)
Florid duct lesions with granulomas (around the intra-hepatic bile ducts)
Antibody that is a hallmark of primary biliary cholangitis (PBC)
AMA
(presence of AMA is highly specific for PBC)
Primary biliary cholangitis is most commonly seen in…
middle-aged females (50s)
3 main symptoms of primary biliary cholangitis
- Fatigue
- Pruritus (itching)
- Jaundice
Key histological feature of primary sclerosing cholangitis (PSC)
Onion skin fibrosis
Primary sclerosing cholangitis (definition)
Chronic liver disease that causes inflammation and scarring of the bile ducts
Which type of cholangitis affects both intra and extra hepatic ducts
Primary sclerosing cholangitis