liver by hadi Flashcards
Diffuse, foamy, swollen appearance to the hepatocyte caused by retained biliary material
Feathery degeneration
These appear in cirrhotic livers, are larger than surrounding cirrhotic nodules but do not display atypical features. Contains more than one portal tract, have an intact reticulin framework, and do not seem to be precursors of malignant lesions
Macroregenerative nodules
Poorly stained mummified hepatocytes
Coagulative necrosis
Isolated hepatocytes become shrunken, pyknotic, and intensely eosinophilic
Apoptosis
Presence of “ground-glass” hepatocytes, a finely granular, eosinophilic cytoplasm and “sanded” nuclei, shown by electron microscopy
hep B
Necrotic cells appear to have “dropped out,” with collapse of the sinusoidal collagen reticulin framework where the cells have disappeared; scavenger macrophage aggregates mark sites of dropout
Hepatocyte cytolysis in viral
The hallmark of serious liver damage
Fibrosis
Almost always accompanied by a brisk sinusoidal and perivenular fibrosis; occasionally periportal fibrosis may predominate
Alcoholic hepatiti
Pattern of cirrhosis in viral hepatitis
Macronodular
Pattern of cirrhosis in alcoholic hepatitis
Micronodular
Golden-yellow granules in the cytoplasm of periportal hepatocytes, which stain blue with the Prussian blue stain:
Hemosiderin
Green to brown deposits of copper in Descemet membrane in the limbus of the cornea
Kayser-Fleischer rings
Excessive copper deposition in the liver causing hepatic changes ranging from mild fatty change to massive liver necrosis. In the brain, injury affects the basal ganglia, demonstrating atrophy and cavitation. Kayser-Fleischer rings are characteristic
wilson
Hepatocytes with round to oval cytoplasmic globular inclusions which are strongly positive in a periodic acid-Schiff stain. By electron microscopy they lie within smooth, and sometimes rough, endoplasmic reticulum
Alpha-1 antitrypsin Deficiency
A rare disease characterized by microvesicular fatty change in the liver and encephalopathy. Microscopy of hepatocellular mitochondria reveals pleomorphic enlargement and electron lucency of the matrices, with disruption of cristae and loss of dense bodies
reye syndrome
A chronic, progressive, and often fatal cholestatic liver disease, characterized by a nonsuppurative destruction of small and medium-sized intrahepatic bile ducts (“florid duct lesion”). On cut surface, the liver is hard, with a finely granular appearance, with extraordinary yellow-green pigmentation
Primary biliary cirrhosis
A chronic cholestatic disorder, characterized by progressive fibrosis and destruction of extrahepatic and large intrahepatic bile ducts. Affected portal tracts show concentric periductal “onion-skin” fibrosis and a modest lymphocytic infiltrate. Progressive atrophy of the bile duct epithelium leads to obliteration of the lumen, leaving behind a solid, cordlike fibrous scar
Primary sclerosing cholangitis
Liver is slightly enlarged, tense, and cyanotic, with rounded edges. Microscopically, there is congestion of centrilobular sinusoids. With time, centrilobular hepatocytes become atrophic, resulting in markedly attenuated liver cell cords. Liver fibrosis mostly “centrilobular”
assive congestion of the liver secondary to right-sided heart failure
Characterized by deposition of hemosiderin in the following organs: liver, pancreas, myocardium, pituitary, adrenal, thyroid and parathyroid glands, joints, and skin; cirrhosis; and pancreatic fibrosis:
Hereditary hemochromatosis
Results from the thrombosis of two or more major hepatic veins and is characterized by hepatomegaly, weight gain, ascites, and abdominal pain. The liver is swollen, is red-purple, and has a tense capsule. The affected hepatic parenchyma reveals severe centrilobular congestion and necrosis:
budd chiari
Caused by toxic injury to sinusoidal endothelium. Damaged endothelial cells slough off and create emboli that block blood flow. Accompanied by passage of red blood cell into the space of Disse, proliferation of stellate cells, and fibrosis of terminal branches of the hepatic vein
Sinusoidal Obstruction Syndrome
These are lesions larger than 1 mm in diameter that appear in cirrhotic livers. Considered to be precursors of hepatocelluar cancers, are often monoclonal, and may contain chromosome aberrations similar to those present in liver cancers
Dysplastic nodules
A distinctive variant of HCC, which occurs in young male and female adults (20-40 years of age) of equal incidence, no association with cirrhosis or other risk factors. usually consists of a single large, hard “scirrhous” tumor with fibrous bands coursing through it. Composed of well-differentiated polygonal cells growing in nests or cords and separated by parallel lamellae of dense collagen
bundles.
Fibrolamellar carcinoma(A distinctive variant of hepatocellular carcinoma that occurs in young adults and has no association with HBV or cirrhosis risk factors.)
Condition wherein the exudate contained in the gallbladder is composed virtually of pure pus.
Empyema of the gallbladder
Steril stones black and brown are
infected w bacteria
This pattern of GB carcinoma grows into the lumen as an irregular, cauliflower mass, but at the same time it invades the underlying wall
Exophytic pattern of gallbladder carcinoma
Characterized by fibrosing cholangitis of bile ducts
lymphocytic infiltrate, and progressive atrophy of the bile duct epithelium, and obliteration of the lumen
Concentric periductal fibrosis or Onion-Skin fibrosis with solid, cordlike fibrous scar. “Beading” of barium column in radiographs of the intrahepatic and extrahepatic biliary tree
Primary sclerotic cholangitis
tumors arising from the part of the common bile duct between the cystic duct junction and the confluence of the right and left hepatic ducts at the liver hilus
Klatskin tumors
macrovesicular steatosis, involving most regions of the hepatic lobule. The intracytoplasmic fat is seen as clear vacuoles.
Alcoholic liver
Morphology: liver biopsy shows steatosis, multifocal parenchymal inflammation, Mallory hyaline, hepatocyte death, and sinusoidal
fibrosisSteatohepatitis or Nonalcoholic Steatohepatitis
portal tract expansion with inflammatory cells and fibrous tissue and interface hepatitis with spillover of inflammation into the adjacent parenchyma Lymphoid aggregates can also be seen
Chronic hepatiis c
Marked cell enlargement with irregularly clumped cytoplasm showing large, clear spaces.
Ballooning degeneratio
Multiple tiny fat droplets that do not displace the nucleus which appear in such conditions as alcoholic liver disease, Reye syndrome, and acute fatty liver of pregnancy.
Microvesicular steatosis
a single large fat droplet that displaces the nucleus seen in alcoholic liver disease or in the livers of obese or diabetic individuals
Macrovesicular steatosis
Poorly stained mummified hepatocytes
coagulative necrosis
Hepatocyte necrosis is distributed immediately around the central vein, extending into the midzonal area in the setting of ischemia and several drug and toxic reactions
Centrilobular necrosis
a diffuse process characterized by bridging fibrous septa, in the form of delicate bands or broad scars around multiple adjacent lobes, and the conversion of normal liver architecture into structurally abnormal nodules, encircled by fibrotic bands Liver architecture is disrupted
Cirrhosis
The hallmark of serious liver damage.
Fibrosis
Mallory in alcholic
(not only)
Well-demarcated but poorly encapsulated lesion, consisting of hyperplastic hepatocyte nodules with a central fibrous scar. Appears in noncirrhotic livers and may reach up to many centimeters in diameter. It occurs in response to local vascular injury
Focal nodular hyperplasia
Gallbladder is usually enlarged (twofold to threefold) and tense, and it assumes a bright red or blotchy, violaceous to green-black discoloration, imparted by subserosal hemorrhages. The gallbladder lumen is filled with a cloudy or turbid bile that may contain fibrin, blood, and frank pus
Acute cholecystitis
The gallbladder may be contracted, of normal size, or enlarged. Presence of stones in the absence of inflammation is diagnostic.
Chronic cholecystitis
Appears as a poorly defined area of diffuse thickening and induration of the gallbladder wall that may cover several square centimeters or involve the entire gallbladder, scirrhous and very firm in consistency
Infiltrating pattern of gallbladder carcinoma
Appear typically with an abundant fibrous stroma (desmoplasia) explaining their firm, gritty consistency Most exhibit clearly defined glandular and tubular structures lined by somewhat anaplastic cuboidal to low columnar epithelial cells. Bile pigment and hyaline inclusions are not found within the cells
Cholangiocarcinomas
“Beading” of barium column in radiographs of the intrahepatic and extrahepatic biliary tree Concentric periductal fibrosis or Onion-Skin fibrosis with solid, cordlike fibrous scar
Primary Sclerosing Cholangitis
What type of viral hepatitis frequently show lymphoid aggregates within portal tracts?
Hepatitis C
A characteristic feature of this type of viral hepatitis is the high mortality rate among pregnant women, approaching 20%
Hepatitis E
A distinctive variant of hepatocellular carcinoma that occurs in young adults and has no association with HBV or cirrhosis risk factors
Fibrolamellar Carcinoma
What is the most common liver tumor of young childhood
Hepatoblastoma
What are the most common benign neoplasm in the liver
Hemangiomas
These benign neoplasms tend to occur in young women who have used oral contraceptives and regress on discontinuance of their use.
Liver cell Adenoma
Rokitansky- Aschoff sinuses are structures seen in what organ?
Gallbladder
What is the most common congenital anomaly of the gallbladder?
Presence of Phrygian Cap
AKA Strawberry Gallbladder
Cholesterolosis
These are tumors arising from the part of the common bile duct between the cystic duct junction and the confluence of the right and left hepatic ducts at the liver
hilusKlatskin tumors
What does unrelieved cholestasis lead to?
Portal tract fibrosis
- Gross morphology: GB is shrunken, nodular, and chronically inflamed with foci of necrosis and hemorrhage
Xanthogranulomatous cholecystitis
Gross morphology: the mucosal surface of the gallbladder is studded with minute yellow flecks
Strawberry Gallbladder Cholesterolosis
Type of liver transplant rejection: infiltration of a mixed population of inflammatory cells into portal tracts, bile ducts, and hepatocyte injury and endothelitis
Acute cellular rejections
Type of liver transplant rejection severe obliterative arteritis of small and larger arterial vessels results in ischemic changes in the liver parenchyma
Chronic Rejection
The combination of hypoperfusion and retrograde congestion acts synergistically to generate what type of necrosis in the liver?
Centrolobular hemorrhagic necrosis
Morphology: characterized by the presence of round to oval cytoplasmic globular inclusions in hepatocytes, which in routine H and E stains are acidophilic and indistinctly demarcated from the surrounding cytoplasm
A1 antitrypsin deficienc
What zone of the liver if particularly vulnerable of ischemic injury and number of drug and toxic reactions?
Centrilobular zone
What zone of the liver is particularly affected in eclampsia?
Periportal zone
