Liver Pathology II Cholestatic and Neoplastic Flashcards
2 etiologies of Zone 3 fibrosis
budd-chiari (hepatic vein blockage) and right side heart failure
3 complications of cirrhosis
- decreased synthetic/clearing function (bleeding, encephalopathy)
- portal hypertension from fibrosis
- increase hcc risk
Histologic findings of cholestasis
bile plugs, feathery degeneration –> fibrosis
How does pancreatic cancer lead to jaundice?
stricture formation due to adenocarcinoma (duct cells) in the pancreatic head causing desmoplastic response
How can a choledochal cyst cause jaundice?
torsion of the bile duct or precipitation of bile stones in cyst or local injury/neoplastic transformation
Porcelain gallbladder
calcium in gallbladder wall –> increases risk for dysplasia and cancer
Klatskin tumor
cholangiocarcinoma at the bifurcation of the R/L hepatic ducts leading to jaundice
Is there an association between cholangiocarcinoma and underlying liver disease?
no –> does not arise from chronically damaged/cirrhotic liver
What conditions increase risk of cholangiocarcinoma?
- liver flukes
2. PSC
Does intrahepatic cholangiocarcinoma tend to present with jaundice?
no –> too many ducts to block
Does cholecystitis tend to present with jaundice?
no –> blocking gallbladder doesn’t obstruct biliary tree
Does cholangitis tend to present with jaundice?
sure –> inflammation of main ducts can cause obstruction
What is AMA in PBC?
abnormal expression of mitochondrial pyruvate dehydrogenase component E2 expressed on apical membrane of cell causes antibody formation –> cell attack –> biliary epithelial death
ERCP finding in PSC
beads on a string
Histologic finding PSC
onion skin bile ducts
Why do some people with PSC present with cholestasis and jaundice?
precipitations of biliary sludge forms in bile ducts
Most common tumor in non-cirrhotic liver
metastatic –> GI > Lung >other
T/F Benign liver tumors are rare
T –> usually malignant
Are hepatocellular adenomas precursors for hepatocellular carcinoma?
No
Is bile duct adenoma a precursor for cholangiocarcinoma?
No
Is hemangioma a precursor for angiosarcoma?
No
