Liver Pathology II Cholestatic and Neoplastic

Question 1

2 etiologies of Zone 3 fibrosis

Answer 1

budd-chiari (hepatic vein blockage) and right side heart failure

Question 2

3 complications of cirrhosis

Answer 2

1. decreased synthetic/clearing function (bleeding, encephalopathy)
2. portal hypertension from fibrosis
3. increase hcc risk

Question 3

Histologic findings of cholestasis

Answer 3

bile plugs, feathery degeneration –> fibrosis

Question 4

How does pancreatic cancer lead to jaundice?

Answer 4

stricture formation due to adenocarcinoma (duct cells) in the pancreatic head causing desmoplastic response

Question 5

How can a choledochal cyst cause jaundice?

Answer 5

torsion of the bile duct or precipitation of bile stones in cyst or local injury/neoplastic transformation

Question 6

Porcelain gallbladder

Answer 6

calcium in gallbladder wall –> increases risk for dysplasia and cancer

Question 7

Klatskin tumor

Answer 7

cholangiocarcinoma at the bifurcation of the R/L hepatic ducts leading to jaundice

Question 8

Is there an association between cholangiocarcinoma and underlying liver disease?

Answer 8

no –> does not arise from chronically damaged/cirrhotic liver

Question 9

What conditions increase risk of cholangiocarcinoma?

Answer 9

1. liver flukes

2. PSC

Question 10

Does intrahepatic cholangiocarcinoma tend to present with jaundice?

Answer 10

no –> too many ducts to block

Question 11

Does cholecystitis tend to present with jaundice?

Answer 11

no –> blocking gallbladder doesn’t obstruct biliary tree

Question 12

Does cholangitis tend to present with jaundice?

Answer 12

sure –> inflammation of main ducts can cause obstruction

Question 13

What is AMA in PBC?

Answer 13

abnormal expression of mitochondrial pyruvate dehydrogenase component E2 expressed on apical membrane of cell causes antibody formation –> cell attack –> biliary epithelial death

Question 14

ERCP finding in PSC

Answer 14

beads on a string

Question 15

Histologic finding PSC

Answer 15

onion skin bile ducts

Question 16

Why do some people with PSC present with cholestasis and jaundice?

Answer 16

precipitations of biliary sludge forms in bile ducts

Question 17

Most common tumor in non-cirrhotic liver

Answer 17

metastatic –> GI > Lung >other

Question 18

T/F Benign liver tumors are rare

Answer 18

T –> usually malignant

Question 19

Are hepatocellular adenomas precursors for hepatocellular carcinoma?

Answer 19

No

Question 20

Is bile duct adenoma a precursor for cholangiocarcinoma?

Answer 20

No

Question 21

Is hemangioma a precursor for angiosarcoma?

Answer 21

No