Lec 23 LIver Path Flashcards
What are the 2 blood supplies to the liver?
portal vein = 70%
hepatic artery = 40%
Of periportal hepatocytes, midzonal hepatocytes, centrilobular hepatocytes:
- where is most oxygen/nutrients?
- where is most metabolism?
- where is most susceptible to ischemia
periportal = rich in ox and nutrients
midzonal = middle
centrilobular = poorest ox/nutrients; highly susceptible to ischemia; major zone of drug metabolism
What do you see histologically with acute hepatitis?
- panlobular liver cell balooning and acdiophil body formation
- lymphocytes
- DON’T SEE NEUTROPHILS
What is cause of fulminant hepatitis?
2/3 due to viral hepatitis
1/3 due to drugs or chemicals
What defines chronic hepatitis pathologically?
dense lymphoplasmacytic infiltrate in portal tracts
- may or may not be associated with hepatocyte necrosis and scarring
What do you see grossly in fulminant hepatitis?
liver is shrunken and soft
capsule is wrinkled
What do you see grossly in acute hepatitis?
liver swollen and red
capsule edematous
focal depression due to subcapsular necrosis
color bright yellow or green
What is the reserve progenitor cell compartment of the liver?
canal of hering
What histo findings mark regeneration?
- mitoses
- thickening of hepatocyte cords
- disorganization of structure
What do you see on histology with hep A infection?
prominent plasma cells [w/ hoff body]
- cholestatic hepatitis
What do you see in acute hep B infection histologically?
- apoptotic bodies
- macrophages
- inflammation
What do you see in chronic hep B infection histologically?
- ground glass hepatocytes = finely granular eosinophilic cytoplasm containing HBsAg
- nucleus pushed to the side
What is the cause of liver cell injury in chronic hep C?
attributed to cytotoxic T cells
What do you see on pathology with chronic Hep C?
- lymphoid aggregates or lymphoid follicles
- steatosis
What do you see on histology with autoimmune hepatitis?
- hepatocyte necrosis
- prominent plasma cells
- interface hepatitis
- necrosis
= similar to chronic viral hepatitis