Hepatobilliary Flashcards
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Liver: Structural Change Stains
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Reticulin/silver stain: detect minor abnormalities
- Lobular damage
- perivenular reticulin = venous congestion
Trichrome/collagen stain:
- pericellular fibrosis = steatohepatitis
- blocked veins: necrotic areas, alcoholic liver dz, venous outflow obstruction and epithelioid haemangioendothelioma
Elastin stain: recent collapse vs. fibrosis
- elastic fibers outside portal tracts = chronic dz
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Liver: ‘Ground-glass’ Stains
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Liver: Hepatocellular damage - ‘Ground-glass’
- Chronic hepatitis B - IHC
- Medication (e.g. barbiturate)
- Cyanamide alcohol aversion tx - PAS-D
- Lafora’s dz(myoclonus epilepsy) - PAS
- Type IV glycogenosis - PAS
- Transplant recipients - PAS
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Liver: Structural Changes - Portal
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Enlarged portal tracts +/- bridging fibrous septa
- Mild chronic viral hepatitis
- Predominantly portal changes
- biliary tract disease
- haemochromatosis
- congenital hepatic fibrosis
- schistosomiasis
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Liver: Structural Changes - Lobular
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Distorted reticulin framework of parenchyma
- Lobular damage
- Acute and chronic hepatitis
- Portal + lobular = primary biliary cirrhosis (PBC)
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Liver: Hepatocyte Swelling
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Liver: Hepatocyte Swelling
- Adaptive hyperplasia of smooth ER
- Drugs
- Cholestasis (rare)
- Allograft biopsies soon after liver transplant
- 2/2 preservation injury of the donor liver
- Perivenular hepatocyte swelling
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Liver: Hepatocyte Ballooning
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Liver: Hepatocyte Ballooning
- Rounding of the cell outlines is a feature of cell damage
- Canalicular cholestasis
- Hepatitis: viral, drug, autoimmune hepatitis
- Steatohepatitis: clear, wisp-like strands of rarefied cytoplasm, +/- Mallory–Denk bodies
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Liver: Feathery Degeneration
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Liver: Feathery Degeneration
- Large bile-duct obstruction
- Intracellular cholestasis with retention of bile and bile salts
- Mild hepatocyte enlargement
- Pale, rarefied and reticular, often vacuolated cytoplasm
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