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FA: GI > Histo features > Flashcards

Histo features Flashcards

1
Q

gross of acute viral hepatitis

A

enlarged, reddened liver;

green if cholestatic

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2
Q

What are the 5 types of parenchymal damage associated w/ viral hepatitis?

A 
hepatocyte injury;
hepatocyte necrosis;
regenerative changes (hepatocyte proliferation);
sinusoidal cell reactive changes;
portal tracts
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3
Q

What is indicative of hepatocyte injury? cholestasis? HCV?

A

injury: swelling=>ballooning degeneration
cholestasis: canalicular bile plugs;

HCV: mild fatty change of hepatocytes

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4
Q

What are features of hepatocyte necrosis?

A

cytolysis (rupture) or apoptosis (shrink);
bridging necrosis if severe;
lobular disarray w/ loss of architecture

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5
Q

Describe sinusoidal cell reactive changes in acute viral hep

A

accumulation of phagocytosed cellular debris in Kupffer cells;
influx of mononuclear cells into sinusoids

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6
Q

Descirbe how the portal tracts appear on histo in acute viral hep

A

inflammation=> mononuclear;

inflamm spillover into adjacent parenchyma w/ hepatocyte necrosis

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7
Q

What changes are overlapped in chronic and acute hep?

A

hepatocyte injury, necrosis, apoptosis, regeneration;

sinusoidal cell reactive changes

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8
Q

Describe how the portal tracts appear on histo in chronic viral hep

A

inflammation confined to portal tracts or spillover into adjacent parenchyma w/ hepatocyte necrosis;

bridging inflammation and necrosis

fibrosis w/ portal deposition or portal and periportal deposition or formation of bridging fibrous septa

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9
Q

How does HBV present on histo?

A

ground-glass hepatocytes => accumulation of HBsAg

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10
Q

How does HCV present on histo?

A

bile duct epithelial cell proliferation, lymphoid aggregate formation

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11
Q

moderate intake of alcohol does what to liver?

A

hepatic steatosis => small microvesicular

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12
Q

chronic intake of alcohol does what to liver?

A

macrovesicular globules w/ lipid accumulation

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13
Q

where does hepatic steatosis typically take place?

A

centrilobular

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14
Q

how does a chronic alcoholic liver look grossly?

A

large, soft, yellow, greasy

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15
Q

presence of what characterizes alcoholic hepatitis?

A

hepatocyte swelling and necrosis;
mallory bodies;
neutrophil infiltration;
fibrosis (sinusoidal & perivenular & periportal)

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16
Q

where might mallory bodies be seen?

A 
alcoholic hepatitis;
primary biliary cirrhosis;
Wilson's; 
chronic cholestatic syndromes;
hepatocellular tumors
17
Q

At the end of cirrhosis, how does the liver look grossly?

A

shrunken, brown, nonfatty w/ micronodular cirrhosis

18
Q

morphologic finding associated w/ cholestasis

A

bland hepatocellular cholestasis w/o inflammation

19
Q

morphologic finding associated w/ cholestatic hepatitis

A

cholestasis w/ lobular necroinflammatory activity;

may show bile duct destruction

20
Q

morphologic finding associated w/ hepatocellular necrosis

A

spotty hepatocyte necrosis;
submassive necrosis, zone 3;
massive necrosis

21
Q

morphologic finding associated w/ steatosis

A

macrovesicular

22
Q

morphologic finding associated w/ steatohepatitis

A

microvesicular, Mallory bodies

23
Q

morphologic finding associated w/ fibrosis and cirrhosis

A

periportal and pericellular fibrosis

24
Q

morphologic finding associated w/ granulomas

A

noncaseating epitheliod granulomas

25
Q

morphologic finding associated w/ vascular lesion

A

sinusoida obstruction syndrome (obliteration of central veins);
Budd-Chiari syndrome;
Sinusoidal dilatation;
Peliosis hepatis (blood filled cavities not lined by epithelial cells)

26
Q

morphologic finding associated w/ neoplasms

A

hepatic adenoma;
HCC;
cholangiocarcinoma;
angiosarcoma

27
Q

Associated agents that may cause cholestasis

A

contraceptive and anabolic steroids;

estrogen replacement therapy

28
Q

Associated agents that may cause cholestatic hepatitis

A

many ABx;

phenothiazines

29
Q

Associated agents that may cause hepatocellular necrosis and related morphologic damages

A

spotty hepatocyte necrosis: methyldoya, phenytoin
zone 3 submassive: acetaminophen, halothane;
massive necrosis: isoniazid, phenytoin

30
Q

Associated agents that may cause macrovesicular steatosis

A

EtOH;

methotrexate, corticosteroids, total parenteral nutrition

31
Q

Associated agents that may cause steatohepatitis w/ microvesicular and mallory bodies

A

amiodarone, ethanol

FA: GI (7 decks)

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