Feb23 M2-Liver Pathology Flashcards
3 path charact of cirrhosis
- Diffuse liver involvement
- Fibrous septation
- Nodular regeneration
microvesicular steatosis: important association
acute liver failure (potentially life-threatening)
steatohepatitis: specific charact important to remember
ballooned cells, Mallory-Denk bodies (and have fibrosis, etc.)
important autoimmune hepatitis (AIH) charact on histology
plasma cells
diagnostic test for primary biliary cholangitis + def of this disease
AMA (positive). (anti-mt Ab). PBC=autoimmune attack on intrahepatic bile ducts
disease linked with primary sclerosing cholangitis + def of PSC
UC (ulcerative colitis). PSC = fibrosis and inflamm of bile ducts intra and extra hepatic
PBC and PSC increased risk for what
cholangiocarcinoma (very bad cancer)
microvesicular steatosis pathogenesis + features
patho: pregnancy, reye syndrome (child taking too much ASA), drugs
features: uncommon, fulminant failure
steatohepatitis patho and features
patho: macrovesicular steatosis, ballooned cells, Mallory Denk bodies
features: ETOH or NASH (metab syndrome)
autoimmune hepatitis patho and features
patho: plasma cells
features: ANA and SMA +, more in females, rx=steroids
most common autoimmune hepatitis and its charact
type 1. high ANA and SMA, give steroids, more in women
PBC (primary biliary cholangitis) patho and features (including rx)
patho: florid duct lesion (granuloma) on intrahepatic ducts
features: AMA +, more in females, pruritus (itchiness), osteporosis, rx = urso
primary sclerosing cholangitis patho and features (including how to dx)
patho: onion-skin fibrosis (periductal fibrosis) (intra and extra hep ducts)
features: more in males, assoc with UC, dx by ERCP, risk of cholangioCA, pruritus and osteoporosis
2 things in common in PSC and PBC
pruritus (itchiness) and osteoporosis
NASH vs simple steatosis
simple steatosis = no inflamm and no balloon cells. macrovesicular steatosis alone
PSC important charact on patho to diff from PBC
PSC has no granulomas
hereditary hemochromatosis def + most common gene in adults
recessive disorders of excessive Fe abso.
HFE gene most common in adults
HFE gene hemochromatosis: specific mutation
C282Y (cysteine to tyrosine)
HFE gene hemochromatosis symptoms (4), specific sentence to remember it
bronzed diabetic with cirrhosis and CMP
hereditary hemochromatosis = increased risk of what
200x higher risk of HCC (hepatocellular CA)
Wilson’s disease pathophgy
recessive mutation in a gene for copper excretion in bile. copper excess in body: liver toxicity (+ brain, etc.)
Budd-Chiari syndrome def + main association
thrombosis of major hepatic veins (outflow obstruction)
**risk factor is a myeloproliferative disease, especially PRV (polycythemia rubra vera)
number 1 cause of fulminant hepatic failure + def of that
acetaminophen overdose. means liver failure within 2 wks of onset of symptoms
hereditary hemochromatosis pathogenesis + features (including treatment)
patho: Fe in hepatocytes, C282Y mutation
features: bronzed diabetic cirrhosis CMP, HCC risk, phlebotomize (drain blood)
AAT (alpha 1 antitrypsin) patho and features
patho: PAS-D droplets in zone 1
features: PiZZ mutation. emphysema. in adults or children.
Wilson’s disease: patho and features
patho: copper in zone 1
features: Kayser-Fleischer rings (cornea), Parkinson-like brain damage, hemolytic anemia, renal injury
Budd Chiari syndrome patho and features
patho: hepatic vein thrombosis
features: more in females. associated with myeloproliferative syndromes like PRV (polycythemia rubra vera)
fulminant hepatic failure patho (with no1 cause) and features (diff associations and causes)
patho: no 1 cause is acetaminophens (massive hepatic necrosis)
features: drugs, HAV, HBC, autoimmune hepatitis, Wilson’s, ischemia, Budd-Chiari syndrome, microvesicular steatosis, malignancy
1 most common tumor of the liver (neoplasm)
hemangioma (is benign neoplasm)
no1 malignancy (malignant tumor) in the liver (no1 tumor is hemangioma)
liver metastases (lung, colon, breast)
HCC associated with what most importantly
hepatitis B
3 things associated with portal htn
ascites, splenomegaly, esophageal varices
2 things associated with hepatic encephalopathy
elevated ammonia, asterixis,
patho features seen on liver with alcohol consumption
steatosis, mallory-denk bodies, balloon cells
autoimmune hepatitis patho feature + dx test
plasma cells. dx = ANA + (antinuclear ab)
PBC patho and dx test
patho: granulomatous florid duct lesions
dx test = AMA +
PSC patho and assoc disease
onion skin fibrosis
associated with ulcerative colitis
hereditary hemochromatosis cause
excessive iron in the body (excessive Fe abso)
Wilson’s disease: disease of what mineral
copper
hepatocellular adenoma type of cancer + assoc with what
benign neoplasm. associated with OCP (oral contraceptive pill)
hepatocellular carcinoma: stains for what on patho
alpha fetoprotein
HCC associated with what
- hereditary hemochromatosis
- hepatitis B
hep C vs hep A associations
HAV: fulminant hepatic failure, travelling,
HCV: cirrhosis
