Liver pathology Flashcards
Causes (all) of liver cirrhosis
Alcohol
Metabolic dysfunction associated liver disease (fatty liver disease)
Chronic viral hepatitis
Autoimmune hepatitis
Primary biliary cholangitis/cirrhosis (PBC)
Primary sclerosing cholangitis (PSC)
Iron overload – haemochromatosis
Copper overload – Wilson disease
Alpha 1 antitrypsin deficiency
Budd-Chiari syndrome
Drug-induced liver disease
Chronic right sided heart failure
Complications of cirrhosis
- Portal hypertension (porto-caval anatomoses)
Oesophageal varices
Caput medusa
Haemorrhoids - Ascites
- Liver failure
Complications of alcoholic liver disease
Cirrhosis
Portal hypertension – varices/ascites
Malnutrition
Hepatocellular carcinoma
Negative impact on psychosocial wellbeing
crhonic hepatitis B+ C associated with …
portal inflammation of the liver
extension of that inflammation from portal tract into hepatocyte parenchyma with destruction of limiting plate hepatocytes
outline the 3 main groups of autoimmune disease of Liver/Bile ducts
Autoimmune hepatitis
PBC: Primary biliary cholangitis/cirrhosis (PBC)
PSC: Primary sclerosing cholangitis
hallmark of autoimmune condition in autoimmune hepatitis
**Plasma cell rich inflammation in portal tracts
**
Emperipolesis: infiltration of lymphocytes into and through a hepatocyte
Hepatocyte rosettes
cholestasis means
loss of bile ducts
name the 3 main liver storage diseases
Haemochromatosis
Wilson’s disease
Alpha-1 antitrypsin deficiency
haemochromatosis is
xs iron within the liver
primary = genetic condition, inherited autosomal recessive , causes increased absorpiont of iron
secondary = iron overload from diet + blood transfusions
wilsons
xs copper associate protein deposition (in liver + basal ganglia-brain)
chronic heaptitis + neurological deterioration
a-1 antitrypsin deficiency (AAT)
AAT is a protein made in the liver and protects the lungs from being damaged by XS enzyme activity during inflammation/infection
inherited autosomal recessive (misfolded protein)
causes cirrhosis + emphysema/COPD
tumours of the liver
Primary (rare):
Hepatocellular adenoma
Hepatocellular carcinoma (hepatoma)
Secondary (more common):
Metastases i.e. colon, pancreas, stomach, breast, lung
hepatocellualr adenoma is not associated wiht cirrhosis
true or false
true
PSC
autoimmune disease of the liver/bile duct
Primary Sclerosing Cholangitis (PSC)
Chronic inflammation affecting intra- and extra-hepatic bile ducts
Leads to periductal fibrosis, destruction of ducts
Associated with ulcerative colitis
Increased risk of bile duct/colonic carcinomas
onion skinning” fibrosis around a bile duct (periductal)
FIBROSIS
PBC
autoimmune disease of the liver/bile duct
Primary Biliary Cholangitis/Cirrhosis (PBC)
unknown cause
affects only the small intrahepatic bile ducts
granulomatous inflammation which destroys small bile ducts
Dense lymphocytic inflammation in portal tracts (can mimic hepatitis)
cholestasis
+/- fibrosis +/- cirrhosis
AUTOIMMUNE HEPATITIS
