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AP/CP Boards > Hepatobilliary > Flashcards

Hepatobilliary Flashcards

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16
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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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AP/CP Boards (29 decks)

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