liver histopathology

Question 1

what type of cells are hepatocytes

Answer 1

epithelial

Question 2

reticular fibres which stain

Answer 2

silver

Question 3

what is in portal triad

Answer 3

venule, arteriole, bile duct

Question 4

what/where are Kupffer cells

Answer 4

specialised macrophages in liver sinusoids

Question 5

which stain Keupffer cells, what colour

Answer 5

PAS - magenta

Question 6

what/where are stellate cells

Answer 6

in space of Disse, modified fibroblasts

Question 7

what is 1/6 wedge of liver lobe called

Answer 7

acinus

Question 8

other name for stellate cell

Answer 8

Ito cell

Question 9

primary vs 2ary liver disease

Answer 9

Question 10

describe the morphology of 4 liver injuries

Answer 10

Question 11

causes of steatosis 4

Answer 11

Alcoholic liver disease
Non-Alcoholic fatty liver disease (Obesity, Diabetes – type 2)
Drugs
Viral hepatitis (Hep C)

Question 12

Answer 12

balloon degeneration f hepatocytes ->apoptosis, irreversible

Question 13

steatosis vs balloning

Answer 13

steatosis has regular outline

Question 14

what is this, what is it a feature of

Answer 14

spotty necrosis, acute/active hepatitis

Question 15

why are these lymphocytes here

Answer 15

necrosis of hepatocyte

Question 16

where do liver progenitor cells live

Answer 16

Canals of Hering

Question 17

what are cholangiocytes

Answer 17

epithelial cells liveing in the bile ducts

Question 18

Question 19

Question 20

Answer 20

liver fibrosis

Question 21

what causes stellate cells to differentiate into myofibroblasts and produce fibrin

Answer 21

Kupffer cells and hepatocytes releasing chemokines during inflammation. toxins actuing directly on the stellate cells

Question 22

3 features of cirrhosis

Answer 22

Bridging fibrous septa
Parenchymal nodules
Disruption of the liver architecture

Question 23

canals of Hering =

Answer 23

terminal bile ductules

Question 24

Answer 24

Bilirubin retention

Accumulation (retention) of bile pigment within the hepatic parenchyma.

Elongated green-brown plugs are visible in the bile canaliculi.

= canalicular cholestasis = jaundice

Question 25

how can you tell this is benign

Answer 25

well-circumscribed, no necrosis or haemorrhage – homogenous surface, background liver usually normal

Question 26

how can you tell the carcinoma is malignant

Answer 26

poorly circumscribed, necrosis, heterogenous surface, background liver may have abnormalities (e.g. Cirrhosis)
Called carcinoma – Hepatocellular carcinoma

Question 27

Answer 27

Irregular nodules
Hepatocytes look like normal and grow in thick trabeculae (well differentiated)
Hyperchromatic nuclei, pleomorphic, irregular
Dilated bile canaliculi

Hepatocellular carcinoma HCC

Question 28

Answer 28

Atypical epithelial cells with various degrees of glandular differentiation and invasion (cribriform, papillary)
Hyperchromatic nuclei
Extensive necrosis

Metastatic adenocarcinoma

Question 29

gene mutations 3 in cholangiocarcinoma

Answer 29

KRAS mutations in both intrahepatic and extra hepatic. but extrahepatic biliary adenocarcinomas are most likely to have mutations in TP53 and SMAD4

Question 30

Answer 30

metastatic adenocarcinoma

Question 31

Answer 31

macroscopic metastatic adenocarcinoma - multiple nodules

Question 32

what is cholangiocarcinoma

Answer 32

cancer in the bile ducts

Question 33

Answer 33

cholangiocarcinoma

Histology shows an adenocarcinoma in fibrotic stroma
Well to moderately differentiated with clearly defined glandular structures lined by malignant epithelial cells

Question 34

what do cholangiocarcinomas often secrete

Answer 34

mucin