XVI - The Liver, Gallbladder and Biliary Tree Flashcards
Marked cell enlargement with irregularly clumped cytoplasm showing large, clear space
Ballooning degeneration (TOPNOTCH) Robbins Basic Pathology, 8th ed,. 633
Multiple tiny fat droplets that do not displace the nucleus which appear in such conditions as alcoholic liver disease, Reye syndrome, and acute fatty liver of pregnancy.
Microvesicular steatosis Robbins Basic Pathology, 8th ed, p. 633
A single large fat droplet that displaces the nucleus seen in alcoholic liver disease or in the livers of obese or diabetic individuals.
Macrovesicular steatosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 633
Diffuse, foamy, swollen appearance to the hepatocyte caused by retained biliary material.
Feathery degeneration(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 633
Poorly stained mummified hepatocytes
Coagulative necrosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 633
Isolated hepatocytes become shrunken, pyknotic, and intensely eosinophilic.
Apoptosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 633
Hepatocyte necrosis is distributed immediately around the central vein, extending into the midzonal area in the setting of ischemia and several drug and toxic reactions.
Centrilobular necrosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 633
A pattern of nonrhythmic, rapid extension-flexion movements of the head and extremities, best seen when the arms are held in extension with dorsiflexed wrists, seen in patients with hepatic encephalopathy.
Asterixis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 635
A diffuse process characterized by bridging fibrous septa, in the form of delicate bands or broad scars around multiple adjacent lobes, and the conversion of normal liver architecture into structurally abnormal nodules, encircled by fibrotic bands. Liver architecture is disrupted.
Liver Cirrhosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 635
Presence of ground-glass hepatocytes, a finely granular, eosinophilic cytoplasm and sanded nuclei, shown by electron microscopy
Hepatitis B infection(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 645
Necrotic cells appear to have dropped out with collapse of the sinusoidal collagen reticulin framework where the cells have disappeared; scavenger macrophage aggregates mark sites of dropout.
Hepatocyte cytolysis (in viral hepatitis)(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 647
Hepatocytes shrink, become intensely eosinophilic, and have fragmented nuclei; effector T cells may be present in the immediate vicinity.
Hepatocyte apoptosis (in viral hepatitis)(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 647
The hallmark of serious liver damage
Fibrosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 647
May occur as solitary or multiple lesions, ranging from millimeters to massive lesions, many centimeters in diameter. They are generally produced by gram-negative bacteria such as Escherichia coli and Klebsiella sp.
Pyogenic (bacterial) hepatic abscesses (TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 648
Liver is enlarged, soft, yellow and greasy. Lipid accumulates to the point of creating large clear macrovesicular globules, compressing and displacing the nucleus to the periphery of the hepatocyte.
Hepatic Steatosis (Fatty Liver)(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 649
Eosinophilic, cytoplasmic inclusions characteristic of alcoholic hepatitis.
Mallory bodies(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 650
Almost always accompanied by a brisk sinusoidal and perivenular fibrosis; occasionally periportal fibrosis may predominate.
Alcoholic hepatitis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 650
Liver is yellow-tan, fatty, and enlarged, usually weighing over 2 kg. Over the span of years it is transformed into a brown, shrunken, nonfatty organ, sometimes weighing less than 1 kg.
Alcoholic Cirrhosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 650
Pattern of cirrhosis in viral hepatitis.
Macronodular(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 650
Pattern of cirrhosis in alcoholic hepatitis.
Micronodular(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 650
The liver may shrink to 500 to 700 gm and become transformed into a limp, red organ covered by a wrinkled, overly large capsule. Necrotic areas have a muddy red, mushy appearance with blotchy bile staining. Complete destruction of hepatocytes in contiguous lobules leaves only a collapsed reticulin framework and preserved portal tracts.
Massive hepatic necrosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 653
Golden-yellow granules in the cytoplasm of periportal hepatocytes, which stain blue with the Prussian blue stain.
Hemosiderin(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 655
Green to brown deposits of copper in Descemet membrane in the limbus of the cornea.
Kayser-Fleischer rings (TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 656
Excessive copper deposition in the liver causing hepatic changes ranging from mild fatty change to massive liver necrosis. In the brain, injury affects the basal ganglia, demonstrating atrophy and cavitation. Kayser-Fleischer rings are characteristic.
Wilson disease(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 655