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Year 5 path SW > Histopathology 8: Liver pathology > Flashcards

Histopathology 8: Liver pathology Flashcards

1
Q

Aspergillus produces …………. which causes hepatocellular carcinoma

A

Aflatoxin

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2
Q

Which tumour marker indicates hepatocellular carcinoma ?

A

AFP

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3
Q

List 4 causes of hepatocellular carcinoma ?

A
  • Hepatitis B or C
  • Alcoholic cirrhosis
  • Haemochromatosis
  • Aflatoxin
  • NAFLD
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4
Q

Which cancer is caused by liver flukes ?

A

Cholangiocarcinoma

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5
Q

Which syndrome is associated with cholangiocarcinoma ?

A

Lynch syndrome type II

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6
Q

What are the macrophages in the liver called ?

A

Kupffer cells

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7
Q

Where do stellate cells reside in the liver ?

A

Space of disse

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8
Q

Is alcoholic cirrhosis micronodular or macronodular ?

A

Micronodular

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9
Q

Is cirrhosis due to viral hepatitis micronodular or macronodular ?

A

Macronodular

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10
Q

List 3 histological features of alcoholic liver disease ?

A
  • Ballooning
  • Mallory denk bodies
  • Fibrosis
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11
Q

What causes NAFLD ?

A

Insulin resistance e.g due to diabetes or obesity

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12
Q

What is the characteristic histological features of PBC ?

A

Granulomatous destruction of bile ducts secondary to chronic inflammation

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13
Q

Which auto antibody is associated with PBC ?

A

anti-mitochondrial antibodies

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14
Q

Describe the characteristic histological features of PSC ?

A
  • Periductal bile duct cirrhosis leading to bile duct loss

- “Onion skinning”

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15
Q

Which disease is associated with PSC ?

A

Ulcerative colitis

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16
Q

Is cirrhosis due to biliary tract disease micronodular or macronodular ?

A

Micronodular

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17
Q

List 5 genetic causes of liver cirrhosis ?

A 
haemochromatosis 
wilson's disease
alpha 1 antitrypsin deficiency 
galactosaemia 
glycogen storage disease
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18
Q

What is the most common benign liver tumour ?

A

Haemangioma

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19
Q

Which zone in liver lobules is the first to be affected by alcoholic liver disease ?

A

Zone 3

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20
Q

Which HLA is associated with autoimmune hepatitis ?

A

HLA-DR3

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21
Q

List 3 auto antibodies seen in autoimmune hepatitis ?

A

ANA
Anti-SMA
Anti-LKM

22
Q

ERPC shows beading of bile ducts.

Most likely diagnosis ?

A

PSC

23
Q

What is Budd-Chiari syndrome ?

A

Compression/ Occlusion of the hepatic vein

24
Q

Which stain is used to identify copper in Wilson’s disease “

A

Rhodanine stain

25
Q

What happens to Caeruloplasmin levels in Wilson’s disease ?

A

They are reduced

26
Q

Which genetic disease causes both Emphysema and liver cirrhosis ?

A

Alpha 1 antitrypsin deficiency

27
Q

Which auto-immune disease is associated with PBC ?

A

Sjogrens

28
Q

What is the triad for PBC ?

A

Jaundice
xanthelasma
pruritus

29
Q

Give 2 causes of haemosiderosis ?

A

alcohol

blood transfusions

30
Q

describe the dual blood supply of the liver

A

hepatic portal vein

hepatic artery

31
Q

what are stellate cells

A

store vitamin A
when activated - become myofibroblasts and lay down collagen
responsible for most of the scarring in liver disease

32
Q

which liver zone has the most metabolically active enzymes

A

3 (closest to central vein)

33
Q

describe the process of stellate activation

A

normal hepatocytes have microvilli
endothelial cells have no BM and have spaces between
stellate cells sit in the space between endothelial cells (space of disse)
blood gets through the endothelial cells

liver injury - kupffer cells activate 
endothelial cells stick together 
blood struggles to get through 
hepatocytes lose their microvilli 
stellate cells secrete BM type collagen into space of disse
34
Q

what is cirrhosis

A

whole liver involvement
fibrosis
intra- and extra-hepatic shunting of blood
intrahepatic shunting = blood comes through liver but not in contact with hepatocytes
extrahepatic = blood backlogs into porto-systemic anastamoses

35
Q

2 complications of cirrhosis

A

portal hypertension
hepatic encephalopathy
liver cell cancer

36
Q

features of acute hepatitis

A

hep A and E
drugs

spotty necrosis

37
Q

features of chronic hepatitis

A

viral hepatitis
drugs
AI

38
Q

features of alcoholic liver disease

A

fatty liver
alcoholic hepatitis
cirrhosis

39
Q

list histological features of alcoholic hepatitis

A 
ballooning 
Mallory denk bodies (pink deposits)
apoptosis
pericellular fibrosis
mainly in zone 3
40
Q

features of NASH

A

hepatitis resulting from NAFLD
caused by insulin resistance associated with raised BMI and diabetes
one of commonest causes of liver disease ww

41
Q

features of PBC

A

F>M
bile duct loss associated with chronic inflammation (with granulomas)
diagnostic test = AMA
bile ducts surrounded by epithelioid macrophages

42
Q

features of PSC

A 
M>F
periductal bile duct fibrosis leading to loss 
associated with UC 
increased risk of cholangiocarcinoma 
diagnostic = bile duct imaging
43
Q

features of haemochromatosis

A

genetically determined increased gut iron ab
HFe gene on chr 6
iron deposition in parenchymal cells
‘bronzed diabetes’ - skin and pancreas

44
Q

what is haemosiderosis

A

iron overload
accumulation of iron in macrophages
result of blood transfusions

45
Q

what is wilsons disease

A

accumulation of copper due to failure of excretion of copper by hepatocytes into bile
chr 13
accumulates in liver and CNS and iris (KF rings)

46
Q

antibodies in AI hepatitis

A

anti-smooth muscle antibodies (ASMA)

responds to steroids

47
Q

what is alpha-1 antitrypsin deficiency

A

failure to secrete alpha- 1 antitrypsin
deficiency in the blood, excess in hepatocytes
chronic hepatitis
emphysema

48
Q

causes of hepatic granulomas

A

specific - PBC, drugs

general - TB, sarcoidosis

49
Q

list benign liver tumours

A

liver cell adenoma
bile duct adenoma
haemangioma

50
Q

list malignant liver tumorus

A 
secondary (most common)
hepatocellular carcinoma 
hepatoblastoma 
cholangiocarcinoma (associated with PSC, worm infections, cirrhosis)
hemangiosarcoma

Year 5 path SW (106 decks)

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