Liver Pathology Flashcards
Response to Liver Injury

Atrophy
What is the stain used and what does it stain?

Reticulin Stain
Reticulin fibers
Response to liver injury

Regeneration
Response to liver injury? What is the possible cause?

Fibrosis
Parasitic migration
Response to liver injury? What is the common name for this disease?

Fibrosis
“Milk Spotted Liver”
Condition

Cirrhosis
Response to liver injury

Biliary hyperplasia
Condition?

Capsular Fibrosis - Incidental Finding
Condition?

Tension Lipidosis - Incidental Finding
Condition?

Hepatic Rupture - Incidental Finding
Condition?

Healing of capsular rupture - Incidental Finding
Condition?

Liver Autolysis - Post Mortem Change
Condition?

Bile Inhibition - Post Mortem Change
Condition?

Multifocal Liver Necrosis
Pattern of hepatocellular degeneration and necrosis?

Centrilobular Necrosis
Pattern of hepatocellular degeneration and necrosis?

Midzonal Necrosis
Pattern of hepatocellular degeneration and necrosis?

Periportal Necrosis
Condition?

Massive Hepatic Necrosis
Common Cause?

Hepatosis Dietetica of Swine
(Massive Hepatic Necrosis)
Condition?

Congenital Biliary Cysts
Condition?

Congenital Polycystic Liver Disease
Condition?
Common Name?

Hepatic Chronic Passive Congestion
“Nutmeg Liver”
Condition?

Hepatic Vein Thrombosis
Condition?

Telangiectasis
Condition?

Amyloidosis
Multifocal hepatic necrosis is indicative of what specific type of hepatitis?

Viral Hepatitis
Multifocal necrotizing hepatitis is indicative of what specific type of hepatits

Bacterial Hepatitis
Condition?
Etiology?

Bacillary Hemoglobinuria
Clostridium haemolyticum
Condition?
Etiology?

Tyzzer’s Disease
Clostridium piliforme
Condition?

Liver Abcesses
Condition?

Granulomatous Hepatitis
Specific type of hepatitis?

Mycotic Hepatitis
Condition?
Etiology?

Parasitic Hepatitis
Ascaris suum
Condition?
Etiology?
Parasitic Hepatitis
Flukes
Condition caused by Fasicola hepatica

Chronic Fibrosing Cholangitis
Condition?
Etiology?
Parasitic Hepatitis - Hydatidosis
Cestodes
Condition?
Etiology?

Protozoal Hepatitis - “Black Head”
Histomonas meleagridis
Condition?

Pyrrolizidine Alkaloid Toxicity
Condition

Cholelithiasis
Condition?
Cause?

Hepatocutaneous Syndrome - Superficial Necrolytic Dermatitis
Manifestation of Liver Dysfunction and Failure
Condition
Cause

Photosensitization
Manifestation of liver dysfunction or failure
Condition

Hepatic Nodular Hyperplasia
Condition

Hepatocellular Adenoma
Condition

Hepatocellular Carcinoma
Condition

Cholangiocellular Carcinoma
What is the largest visceral organ?
Liver
The liver receives what percent of cardiac output?
25%
What are the components of the liver structural unit?
Central Vein
Portal Triad
Limiting Plate
What are the components of the portal triad
Bile Ductules
Branches of the portal vein
Hepatic Artery, Nerves, and Lymphatics
Which zone of the liver is the most oxygenated?
Zone 1 - Centroacinar
What cell type makes up 80% of the liver mass?
Hepatocytes
Kupfer Cells
Regional macrophage, participate in immune and regenerative response
Stellate Cells
Produce and maintain entracellular matrix and store vitamin A
Clinical signs of hepatic injury become evident after what percent of parenchyma is injured?
75%
Liver enzymes used as biomarkers of liver injury
AST
ALT
LDH
Alkaline Phosphatase
Gamma-Glutamyl Transpeptidase
Responses of the liver to injury
Atrophy
Hypertrophy and hyperplasia
Regeneration
Fibrosis
Biliary Hyperplasia
Liver atrophy can cause
Increased catabolism
Decreased blood flow
Decreased bile flow
Pressure
Percentage of liver parenchyma that can regenerate in one week
60%
Oval cells
Differentiate into hepatocytes or bile duct epithelium
Requirements for hepatic regeneration
Intact framework
Good blood supply
Patent bile ducts
What cell type proliferates in hepatic injury leading to replacement by fibrosis
Stellate Cells
Cirrhosis
Hepatocellular nodular proliferation, fibrosis, causing impaired blood and bile flow - End Stage Liver
Biliary Hyperplasia
Bile duct proliferation - multiple bile ducts
Capsular Fibrosis - “Perihepatitis Filamentosa”
Incidental liver lesion found in horses that is caused by resolution of peritionitis or parasitic migration
Tension Lipidosis
Incidental liver finding of cattle and horses
Focal areas of pale discoloration adjacent to mesenteric attachment
Hepatic Rupture
Incidental finding of the liver - scars of healed traumatic injury, spider web appearance with hemorrhage
Common post mortem changes of the liver
Pale, irrecular foci
Green/black discoloration
Emphysema
Autolysis
Bile inhibition
Possible eitiologies for Multifocal LIver Necrosis
Bacterial
Viral
Parasitic
Zonal Necrosis
Defined areas within hepatic lobule or acini are affected
Common cause of Centrilobular Necrosis
Hypoxia
Periportal Necrosis
Bridging from one portal area to another
Common etiology of Periportal Necrosis
Toxin
Hepatosis Dietetica of swine causes what heptic lesions
Massive Hepatic Necrosis
Cause of Hepatosis Dietetica of Swine
Associated with generation of free radicals and deficiency of vitamin E/selenium
Biliary Cysts
Incidental finding - abnormal development of bile ductules
Polycystic Liver Disease
Multiple cysts located in the liver and kidney
Polycystic Liver Disease needs to be differentiated from
Parasitic Cyts
Acute Hepatic Congestion
Slight enlargement, prominent reticular pattern
Hepatic Chronic Passive Congesion
“Nutmeg Liver”
Reticulated pattern due to zonal congestion - blood concentrated around central vein
Right sided Congestive Heart Failure causes what type of hepatic lesion?
Hepatic Chronic Passive Congestion
Hepatic Vein Thrombosis - “Budd Chiari Syndrome” causes
Hepatomegaly
Ascites
Abdominal Pain
Causes of Hepatic Vein Thrombosis
Conditions producing thrombotic tendencies or sluggish flow
Congenital Portosystemic Shunts
Blood within the portal venous system bypasses the liver and drain into the posterior vena cava or azygous vein
Histologic appearance of Congenital Portosystemic Shunts
Small hepatocytes
Portel veins in small triads
Prominent hepatic arterioles
Telangiectasis
Presence of focal areas in which sinusoids are dilated and filled with blood
Gross appearance of telangiectasis
Irregular, circumscribed, dark-red foci of cavernous ectasia of sinusoids
The liver can accumulate:
Fat
Glycogen
Amyloid
Copper
Pathogenesis of Hepatic Lipidosis
Free Fatty Acids > Fatty Acids > Triglycerides > Lipoproteins > Lipid Accumulation
Mechanisms of Hepatic Lipidosis
Excessive entry of fatty acids
Decreased oxidation
Increased esterification of fatty acids
Decreased apoprotein synthesis
Impaired secretion of lipoprotein
Gross appearance of Hepatic Lipidosis
Enlarged, heavy, uniform light yellow or orange liver that cuts with ease and is greasy, edges are rounded and surface is smooth - tissue floats
Histologic appearance of Hepatic Lipidosis
Marked Hepatocellular Vacuolation
Stains used to detect hepatic lipidosis
Oil Red O
Osmium tetroxide
Physiological Fatty Liver
Bottleneck movement of lipid through hepatocytes and triglyceride accumulates
Bovine Fatty Liver Syndrome
Obese animals within few days after parturition, precipiatated by event that causes cow to go off feed.
Influx of fatty acids to the liver and decreased export of lipoprotein from liver
Endocrine disorders that can lead to hepatic lipidosis
Diabetes mellitus
Hypothyroidism
Glycogne accumulation in the liver can cause
Diabetes Mellitus
Hyperadrenocorticism
Glycogen Storage Diseases
Amyloid accumulation in the liver is a consequence of
Prolonged antigenic stimulation
Familial predisposition
Histologic appearance of hepatic amyloidosis
Amyloid accumulation in space of Disse - atrophy of hepatic cords
Special stain used to detect amyloid
Congo Red