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Cardio > Histopathology Liver disease > Flashcards

Histopathology Liver disease Flashcards

1
Q

Benign types

A

Haemangioma
Liver cell adenoma
Blie duct malformations
Focal nodular hyperplasia

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2
Q

Malignant

A 
HCC
Cholangiocarcinoma
Angioarcoma heptaoblastoma
Lymphoma
Metastasis
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3
Q

Haemangioma description

A

Most common benign vascular tumour

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4
Q

Haemangioma detection

A

Incidental pick up and rarely rupture

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5
Q

Bile duct malformation epi

A 
Common
Incidental finding at surgery
Often misinterpreted as metastasis
Benign
Along with bile duct adenoma
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6
Q

Liver cell adenoma more common in

A

Women

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7
Q

Liver cell adenoma associated with

A

Contraceptive use (this subtype is the least likely to turn malignant)

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8
Q

FNH Similar features to

A

Cirrhosis

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9
Q

FNH presentation

A

Tumour like malformation
Central scar
Can become very large
More common in women

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10
Q

HCC epi

A
  • Most common primary malignant tumour
  • More common in men
  • 5th most common malignancy in men worldwide
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11
Q

HCC causes

A
  • Cirrhosis
  • Hep B/C
  • ASH/NASH
  • Autoimmune hepatitis, chronic biliary disease
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12
Q

HCC least common causes

A
  • Haemochromatosis
  • A1AT-defiency
  • Wilson’s disease
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13
Q

Diagnostic test

A

Alpha-feto protein (large increase) (seen in more than 50% of HCC or testicular)

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14
Q

Fibrolamellar HCC

A

Occurs in younger people
No background cirrhosis
Better Prognosis

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15
Q

Hepatoblastoma occurs in

A

Children under 5 years

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16
Q

Hepatoblastoma epi

A

Most frequent liver tumour in children

Most are male

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17
Q

Hepatoblastoma Diagnosis

A

AFP often raised

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18
Q

Hepatoblastoma Appearance

A

Lobulated

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19
Q

Hepatoblastoma Prognosis

A

Good

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20
Q

Hepatoblastoma Histological

A

Different histological variants

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21
Q

Angiosarcoma epi

A

Rare but most common sarcoma of liver

Most common in men

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22
Q

Angiosarcoma causes

A

Thorotrast
Arsenic
Anabolic steroids
Vinyl chloride

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23
Q

Angiosarcoma prognosis

A

Poor

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24
Q

Cholangiocarcinoma prognosis

A

Often aggressive with poor prognosis

25
Q

Cholangiocarcinoma associated with

A

Chronic inflammation of bile ducts (PSC, parasites, pyogenic cholangitis)

26
Q

Metastasis: epi

A

Most common malignant tumour in the liver

Common primary sites: colon, upper GI,lung, heart

27
Q

Medical

Types

A
  1. Viral hepatitis
  2. Alcoholic/non-alcoholic fatty liver disease
  3. Autoimmune hepatitis
  4. Chronic biliary disease (PSC/PBC)
  5. Drug induced liver injury
  6. Inherited disorders (Wilson’s. haemochromatosis, A1At-defiency)
28
Q

Hep A

A
  • No carrier state
  • Faeco-oral transmission
  • Course can be mild, cholestatic or lead to liver failure
  • Just acute
  • Vaccine available
29
Q

Hep B

A
  • Transmission via bodily fluids
  • Acute and chronic disease
  • High prevalence worldwide
  • Can lead to cirrhosis and HCC
30
Q

Hep C

A
  • Usually associated with chronic state
  • Blood transmission
  • Often leads to cirrhosis and can lead to HCC
31
Q

Delta virues

A
  • Super/co-infection in pre-existing hepatitis B

* Can lead to fulminant hepatitis

32
Q

Hep E

A

Hep E

33
Q

(Non-) alcoholic fatty liver disease → causes

A 
Alcohol excess
Obesity
Diabetes
Drugs
Many more
34
Q

(Non-) alcoholic fatty liver disease → can lead to

A

Fibrosis/cirrhosis

35
Q

(Non-) alcoholic fatty liver disease → can lead to epi

A

Very common in the western world

High burden on health services

36
Q

Autoimmune hepatitis →blood tests

A

High ALT
High IgG
ANA +

37
Q

Autoimmune hepatitis → presentation

A

Acutely but usually chronic disease

38
Q

Autoimmune hepatitis → can lead to

A

Cirrhosis

39
Q

Autoimmune hepatitis →treated with

A

Steroids or immunosupression

40
Q

Primary sclerosing cholangitis

Epi

A

Often present in young/middle aged males

41
Q

Primary sclerosing cholangitis

Common in

A

Patients with UC

42
Q

Primary sclerosing cholangitis

Appearance

A

Typical appearance in biliary tree imaging

43
Q

Primary sclerosing cholangitis

Path

A

Progressive inflammation and fibrosis of large intra and extra hepatic bile ducts

44
Q

Primary sclerosing cholangitis

Can lead to and increased risk of

A

Secondary biliary cirrhosis and increased risk of CC

45
Q

Primary sclerosing cholangitis

Tests

A

AMA negative
Well recognised in children
p-ANCA+

46
Q

Primary biliary cirrhosis:

Epi

A

Middle aged females

47
Q

Primary biliary cirrhosis:

Tests

A

AMA +
IgM+
Alk phos raised

48
Q

Primary biliary cirrhosis:

Can lead to

A

Cirrhosis

49
Q

Drug induced liver injury:

Note

A

• Any histological picture can b caused by drugs, some are dose dependent some are not.
Hugely variable

50
Q

Wilson’s disease

Definition

A

Autosomal recessive mutation on chromosome 13

Abberant storage of copper in many organs including the liver

51
Q

Wilson’s disease

Leads to

A

Liver failure amongst other symptoms

52
Q

Wilson’s disease

Presents in

A

Often presents in childhood

53
Q

Haemochromatosis:

Definition

A

Autosomal recessive mutation of HFE gene on chromosome 6

54
Q

Haemochromatosis:

Leads to

A

Increased iron absorption and storage in the liver

55
Q

Haemochromatosis:

Increased risk of

A

HCC

56
Q

Alpha – 1 – antitrypsin defiency: mutation

A

In the A1AT gene on chromosome 14

57
Q

Alpha – 1 – antitrypsin defiency:

Path

A

Abnormal protein leads to accumulation in the liver

58
Q

Alpha – 1 – antitrypsin defiency:

Increased risk of

A

HCC

59
Q

Cirrhosis:

A

irreversible destruction of the liver architecture associated with fibrosis and nodule formation which may follow necrosis

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