liver histopathology Flashcards
what type of cells are hepatocytes
epithelial
reticular fibres which stain
silver
what is in portal triad
venule, arteriole, bile duct
what/where are Kupffer cells
specialised macrophages in liver sinusoids
which stain Keupffer cells, what colour
PAS - magenta
what/where are stellate cells
in space of Disse, modified fibroblasts
what is 1/6 wedge of liver lobe called
acinus
other name for stellate cell
Ito cell
primary vs 2ary liver disease
describe the morphology of 4 liver injuries
causes of steatosis 4
Alcoholic liver disease
Non-Alcoholic fatty liver disease (Obesity, Diabetes – type 2)
Drugs
Viral hepatitis (Hep C)
balloon degeneration f hepatocytes ->apoptosis, irreversible
steatosis vs balloning
steatosis has regular outline
what is this, what is it a feature of
spotty necrosis, acute/active hepatitis
why are these lymphocytes here
necrosis of hepatocyte
where do liver progenitor cells live
Canals of Hering
what are cholangiocytes
epithelial cells liveing in the bile ducts
liver fibrosis
what causes stellate cells to differentiate into myofibroblasts and produce fibrin
Kupffer cells and hepatocytes releasing chemokines during inflammation. toxins actuing directly on the stellate cells
3 features of cirrhosis
Bridging fibrous septa
Parenchymal nodules
Disruption of the liver architecture
canals of Hering =
terminal bile ductules
Bilirubin retention
Accumulation (retention) of bile pigment within the hepatic parenchyma.
Elongated green-brown plugs are visible in the bile canaliculi.
= canalicular cholestasis = jaundice
how can you tell this is benign
well-circumscribed, no necrosis or haemorrhage – homogenous surface, background liver usually normal
how can you tell the carcinoma is malignant
poorly circumscribed, necrosis, heterogenous surface, background liver may have abnormalities (e.g. Cirrhosis)
Called carcinoma – Hepatocellular carcinoma
Irregular nodules
Hepatocytes look like normal and grow in thick trabeculae (well differentiated)
Hyperchromatic nuclei, pleomorphic, irregular
Dilated bile canaliculi
Hepatocellular carcinoma HCC
Atypical epithelial cells with various degrees of glandular differentiation and invasion (cribriform, papillary)
Hyperchromatic nuclei
Extensive necrosis
Metastatic adenocarcinoma
gene mutations 3 in cholangiocarcinoma
KRAS mutations in both intrahepatic and extra hepatic. but extrahepatic biliary adenocarcinomas are most likely to have mutations in TP53 and SMAD4
metastatic adenocarcinoma
macroscopic metastatic adenocarcinoma - multiple nodules
what is cholangiocarcinoma
cancer in the bile ducts
cholangiocarcinoma
Histology shows an adenocarcinoma in fibrotic stroma
Well to moderately differentiated with clearly defined glandular structures lined by malignant epithelial cells
what do cholangiocarcinomas often secrete
mucin
