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Organ Systems Pathology > Liver Pathology > Flashcards

Liver Pathology Flashcards

1
Q

What cell type is responsible for defending the liver against bacterial and viral agents?

A

Kupffer cells

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2
Q

What antibody in enterohepatic circulation is responsible for protecting against pathogens?

A

IgA

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3
Q

What part of hepatocytes are responsible for defense against pathogens?

A

Phase I in the SER and phase II in the cytosol

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4
Q

What change do injured hepatocytes often undergo?

A

Hydropic vacuolar change (lipidosis if mild)

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5
Q

Chronic, mild injury to hepatocytes causes what change?

A

Atrophy

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6
Q

What does apoptosis in the liver look like histologically?

A

Intensely eosinophilic bodies with well defined borders and a pericellular halo

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7
Q

This pattern of injury consists of foci of varying sizes scattered through lobes

A

Random

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8
Q

Random pattern injury is usually caused by ___

A

Infectious agents arriving via the bloodstream

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9
Q

This pattern of injury is seen as all hepatocytes in defined areas of all lobules being affected to approximately the same extent

A

Zonal

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10
Q

What pattern is associated with a “reticulated” liver?

A

Zonal

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11
Q

With acute ___ injury, the liver overall will be swollen and friable, with rounded lobular edges

A

Zonal

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12
Q

The subset of the zonal pattern of injury is the most common, with the least oxygenated hepatocytes around the central vein (zone 3) being affected

A

Centrilobular

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13
Q

Hypoxia due to right sided cardiac insufficiency, anemia, or shock is a common cause of this pattern

A

Centrilobular

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14
Q

Bioactivation of xenobiotics from the gut causes free radical damage in this pattern

A

Centrilobular

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15
Q

This pattern (a subset of zonal) occurs when only part of zone 3 is affected; it generally precedes centrilobular pattern and has the same etiologies

A

Paracentral

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16
Q

This is the rarest of the patterns (still a subset of zonal) and is most often seen in horses, pigs, and cats; it is mainly due to toxic insult (such as aflatoxin, hexachloraphene, and steroid hepatopathy)

A

Midzonal (zone 2)

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17
Q

This is an uncommon pattern (subset of zonal) that reflects direct hepatocyte damage by an agent entering from the bloodstream; usually involves a “direct-acting” toxicant that does not require bioactivation

A

Periportal (zone 1)

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18
Q

This subset of the zonal pattern reflects severe and extensive damage such that zones of damage begin to coalesce

A

Bridging

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19
Q

This subset of the zonal pattern occurs when the entire lobule is affected; the liver acutely becomes a sac of dilated, engorged sinusoids and then the parenchyma collapses and fibrosis occurs

A

Massive

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20
Q

Viruses are the least likely to induce this response and fibrosis, while bacteria and parasites are the most likely to induce this response and fibrosis

A

Inflammatory

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21
Q

This condition is generally associated with an infectious agent and is random in distribution

A

Acute hepatitis

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22
Q

Viral inducers of acute hepatitis cause ___ and ___ exudate

A

Necrosis

Light suppurative

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23
Q

Bacterial inducers of acute hepatitis cause ___ and ___ exudate

A

Necrosis

Heavy suppurative

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24
Q

Coliform bacterial inducers of acute hepatitis cause ___ or ___ exudate

A

Pyogranulomatous

Granulomatous

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25
Q

Any persistent infectious agent will cause this, in which the agent is surrounded by fibrosis

A

Chronic hepatitis

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26
Q

This liver condition consists of necrosis and/or apoptosis in midzonal and periportal areas; if not stopped, it can become end stage liver

A

Chronic active hepatitis

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27
Q

This liver condition is often unnoticed until necropsy of an animal with a systemic infection; neutrophils and lymphocytes are sometimes seen in the portal triads as evidence the liver was dealing with an insult

A

Reactive hepatitis

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28
Q

This inflammation is centered around and in cholangioles of the portal triad; N0 may be present, but it is more common for lymphocytes, macrophages, and fibrosis to be seen

A

Cholangitis

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29
Q

This type of hepatitis centers around cholangioles but spreads to periportal hepatocytes; it occurs when agents such as flukes travel up the biliary tree

A

Cholaniohepatitis

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30
Q

In large scale hepatocyte loss, these stem cells create replacements for the ones lost

A

Oval cells

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31
Q

Regeneration without scarring occurs rapidly under what two conditions?

A

Stroma is present and severe collapse has not occured
Inflammation is minimal or nonexistent
(this is often the case in toxicant injury)

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32
Q

Cholangioles respond to any outflow impairment via this method; it is usually associated with longstanding liver damage

A

Biliary hyperplasia

33
Q

The supporting stroma of the triads in the liver is a combination of what three types of collagen?

A

I, III, IV

34
Q

After chronic and/or repetitive injury, what cells (that normally store triglycerides) redifferentiate into myofibroblastic cells?

A

Stellate (Ito) cells

35
Q

What do redifferentiated Ito cells deposit? (2)

A

Coarse collagen I

Ground substance

36
Q

This is a diffuse process characterized by fibrosis and the conversion of the normal architecture into structurally abnormal lobules

A

End stage liver (cirrhosis)

37
Q

As part of end stage fibrosis, shunts develop between what vessels?

A

hepatic arterioles and central veins

38
Q

Regeneration of “normal” hepatocytes in end stage liver can cause what gross lesions? (2)

A

Macronodular

Micronodular

39
Q

What species are more prone to macronodular cirrhosis? (3)

A

Dogs
Cats
Humans

40
Q

What species are more prone to micronodular cirrhosis?

A

Horses, sheep, goats, cattle

41
Q

What type of fibrosis lends to a poor prognosis?

A

Bridging

42
Q

Approximately how much liver parenchyma needs to be lost before clinical signs manifest?

A

3/4

43
Q

Acute liver failure happens in cases of ___

A

Massive fibrosis

44
Q

Chronic liver failure happens as ___ develops

A

End stage liver

45
Q

What is the mechanism behind hepatic encephalopathy?

A

Liver failure -> loss of urea cycle -> ammonia cannot be converted to urea -> ammonia buildup in blood -> ammonia gets into PNS and CNS and damages astrocytes

46
Q

All clotting factors except ___ are synthesized in the liver; this is why bleeding often occurs in cases of liver failure

A

VIII

47
Q

Why does ascites occur with liver failure? (2)

A

Albumin not produced; cannot maintain oncotic pressure

Shunting causes hypertension, leading to leakage

48
Q

What is a cutaneous change seen in dogs and cats with liver failure?

A

Epidermal necrosis and ulceration with parakeratosis

49
Q

What is a cutaneous change seen in herbivores with liver failure?

A

Secondary photosensitization (dt buildup of phylloerythrin)

50
Q

These are normally incidental, can get quite large, reflect abnormal development of the biliary tress, and occur in dogs, cats, and pigs

A

Biliary cysts

51
Q

This mainly occurs in large animals when a ligamentous attachment causes hypoxia in an organ

A

Tension lipidosis

52
Q

This horse disease’s etiology is debated (Parasites? Residual adhesions between the diaphragm and hepatic capsule? Aliens?) but the lesions associated with it are tags and plaques

A

Capsular fibrosis (fibrous tags)

53
Q

A condition of unknown etiology in which hepatocytes drop out and sinusoids dilate to fill the space, becoming irregular and blood filled; common in cattle and old cats

A

Telangiectasia

54
Q

This circulatory disorder is almost always a consequence of right sided cardiac insufficiency, with sinusoids engorging from centrilobular to entire lobule. When acute, the liver is swollen, red, spongy, and oozes blood. When chronic, the liver is large, pale, and firm.

A

Passive congestion - a disease of outflow

55
Q

This disease is often associated with plant or fungal toxicosis and is characterized by fibrosis around the centrilobular veins, leading to congestion

A

Veno-occlusive disease

56
Q

Severe acute ___ will lead to profound centrilobular hypoxia with degeneration and necrosis

A

Anemia - a disease of inflow

57
Q

Slowly developing ___ will lead to atrophy of centrilobular hepatocytes

A

Anemia

58
Q

Anemia and passive congestion both result in a ___ pattern

A

Reticular

59
Q

These may be intra or extra hepatic but usually involve one large caliber between the portal vein and vena cava; intrahepatic more common in large dogs, extrahepatic more common in small dogs

A

Congenital porto-systemic shunts

60
Q

Due to abnormal blood supply, this causes the liver to be small with poorly defined lobules, small hepatocytes, indistinct veins, and abundant arterioles

A

Congenital porto-systemic shunt

61
Q

Developing secondarily to bridging fibrosis, veno-occlusive disease, abnormally large regenerative nodules, or amyloidosis, this disease impairs flow within the portal venous system leading to pressure buildup and ascites

A

Portal hypertension

62
Q

This condition appears grossly as a large, soft, friable, pale yellow liver with a reticulated pattern and greasy texture; it can arise from metabolic disturbances as well as toxic injury

A

Lipidosis

63
Q

This condition is pathologic and occurs mainly in dogs with hyperadrenocorticism; the liver will be enlarged and slightly pale with a reticular pattern and normal texture

A

Glycogen accumulation

64
Q

Typically occurs in large animals with chronic infections and tends to be peri-sinusoidal; the liver appears smaller, pale brown, and slightly firmer than normal with a waxy texture

A

Amyloidosis

65
Q

This condition leads to acute necrosis and inflammation via free radicals, ending in end stage liver in certain sheep and dogs

A

Copper accumulation

66
Q

This accumulates in Kupffer cells due to hemoglobin breakdown and may give the liver a blackish color

A

Hemosiderin

67
Q

Wear and tear pigment

A

Lipofuscin

68
Q

Melanin in the liver of a mammal is reflective of ___

A

Congenital melanosis (pigment where it shouldn’t be)

69
Q

Melanin in the liver of a bird, reptile, or amphibian is indicative of ___

A

Chronic inflammatory disease

70
Q

This virus in dogs targets hepatocytes and endothelial cells lining sinusoids and appears as an enlarged, friable liver with necrosis and a reticular pattern of small, white foci; there are blue, smudgy inclusion bodies in affected nuclei; edema of the gall bladder wall is almost diagnostic

A

Canine Adenovirus

71
Q

This virus induces random foci of necrosis and little inflammation in the liver; it is seen histologically as acidophilic intranuclear inclusion bodies

A

Herpes

72
Q

This can be either fibronous/fibrinopurulent and cover the capsular surface or granulomatous/pyogranulomatous and expand out from the triads. Meow.

A

FIP wet form and dry form

73
Q

Bacteria causing abscesses can reach the liver via these three routes

A

Portal system
Umbilicus (neonates)
Lung -> pulmonary veins -> L heart -> hepatic arteries

74
Q

Aerobic or facultative anaerobic bacteria tend to cause a ___ abscess while anaerobic bacteria tend to cause a ___ abscess

A

Purely suppurative

Necrotic, foul-smelling, cavitating

75
Q

Which bacteria are most responsible for abscesses in horses? (2)

A

Actinobacillus equuli

Listeria monocytogenes

76
Q

Which bacteria are most responsible for abscesses in cattle? (3)

A

Arcanobacter pyogenes
Fusobacterium necrophorum
Pasteurella multocida

77
Q

Which bacteria are most responsible for abscesses in sheep? (3)

A

Corynebacterium ovis
Haemophilus agni
Pasteurella haemolytica

78
Q

Which bacteria is most responsible for abscesses in dogs and cats?

A

Yersinia tularensis

79
Q

Which bacteria are most responsible for abscesses in rabbits? (4)

A

Pasteurella multocida
Yersinia tularensis
Listeria monocytogenes
Streptococcus

Organ Systems Pathology (2 decks)

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