Liver Pathology maybe.....the histopathology curriculum is very vague, just go in with an open mind Flashcards
Types of biopsy
Core - deep organ lesions Punch - superficial organ lesions Incisional (wedge) Excisional Organectomy
Stages of histopathology
Biopsy
Fixation
Processing
Minimum 7 days
Cytology techniques
FNAC
Exfoliative cytology
Benign disorders or liver
Haemangioma
Liver cell adenoma
Bile duct malformation
Focal nodularhyperplasia
Malignant disorders of liver
Hepatocellular carcinoma (HCC)
Angiosarcoma
Cholangiocarcinoma
Causes of HCC
Cirrhosis
Hep B/C
Autoimmune hepatitis
Chronic biliary disease
Fibrolammelar HCC
Histology: blue fibrotic tissue
Younger pts
HCC on histology
Bile within duct
Causes of liver angiosarcoma
Arsenic
Thorotrast
Steroids
Vinyl chloride
Cholangiocarcinoma
Cancer of bile duct epithelial cells
Viral hepatitis
Hep A B C D E
You should have seen the ridiculous flashcard you had for all of these
Hssssssss
Hep A transmission
Faeco oral
Hep A Sx
Mild or lead to liver failure
Hep B transmission
Body fluid
Hep B Sx
Leads to cirrhosis and HCC
Hep C transmission
Blood
Hep C Sx
Leads to cirrhosis and HCC
Hep D transmission
Co infection with Hep B
Hep D Sx
Leads to fulminant hepatitis (acute liver failure and encephalopathy)
Hep E transmission
Food/water
Hep E Sx
Acute / fulminant
Pts in whom Hep E is more severe
Pregnant
Children
Causes of Non Alcoholic Fatty Liver Disease
Alcohol
Obesity
Diabetes
Drugs
Autoimmune hepatitis consequences
Cirrhosis
HCC
Ix for Autoimmune hepatitis
High ALT
High IgG
ANA positive
Mx of Autoimmune hepatitis
Steroids
Immunosuppression
Primary Sclerosing Cholangitis
Autoimmune
Large bile ducts affected
Ix for Primary Sclerosing Cholangitis
AMA negative
?pANCA positive
Primary Biliary Cirrhosis
Autoimmune
Small bile ducts
Ix for primary biliary cirrhosis
AMA negative
IgM positive
High ALP
Wilson’s disease
Abnormal storage of copper in liver, iris, etc
Sx of Wilson’s disease
Liver failure
Genetics of Wilson’s disease
Chromosome 13
Autosomal recessive
Haemochromatosis
Increased iron absorption/storage in liver
Sx of Haemochromatosis
Cirrhosis
HCC
Genetics of Haemochromatosis
Chromosome 6, HFE gene
Autosomal recessive
Alpha 1 antitrypsin deficiency
Abnormal protein accumulation in liver
Sx of Alpha 1 antitrypsin deficiency
Fibrosis
Cirrhosis
HCC
Genetics of Alpha 1 antitrypsin deficiency
Chromosome 14