Hereditary hemochromatosis: Difference between revisions

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www:

*[http://path.upmc.edu/cases/case77/path.html Hemochromatosis (upmc.edu)].

{|

[[File:1 Iron 1 680x512px.tif|Trichrome shows thin fibrous bands (20X).]]

[[File:2 Iron 1 680x512px.tif|Iron stain shows dense iron deposition (40X).]]

|-

[[File:3 Iron 1 680x512px.tif|At high power, a modest inflammatory infiltrate accompanies proliferating bile ductules; no piecemeal necrosis (400X)]]

[[File:4 Iron 1 1360x1024px.tif|Reticulin stain with regenerative findings, cords with two nuclei thickness, hepatic acini (400X, higher pixel photo)]]

|}

Hemochromatosis with bridging fibrosis.

Trichrome shows thin fibrous bands (Row 1 Left 20X). Iron stain shows dense iron deposition (Row 1 Right 40X). At high power, a modest inflammatory infiltrate accompanies proliferating bile ductules; no piecemeal necrosis (Row 2 Left 400X). Reticulin stain with regenerative findings, cords with two nuclei thickness, hepatic acini (Row 2 right 400X, higher pixel photo).

{|

[[File:1 Iron 2 680x512px.tif|Fibrous bands dissect hepatocyte nodules (Row 1 Left 20X).]]

[[File:2 Iron 2 680x512px.tif|Iron stain shows 4+ iron, identifiable at the lowest magnification, as well by naked eye (Row 1 Right 20X)]]

<br>

[[File:3 Iron 2 680x512px.tif|This nodule has occasionally enlarged nuclei, which should not be considered dysplasia in and of itself. Note associated relatively inflammation free band with proliferated bile ductules. (Row 2 Left 400X).]]

[[File:4 Iron 2 680x512px.tif|Reticulin stain shows two cell thick regenerative cords with sinusoidal black lines lacking orientation (Row 2 Right 400X).]]

|}

Hemochromatosis with cirrhosis..

Fibrous bands dissect hepatocyte nodules (Row 1 Left 20X). Iron stain shows 4+ iron, identifiable at the lowest magnification, as well by naked eye (Row 1 Right 20X) This nodule has occasionally enlarged nuclei, which should not be considered dysplasia in and of itself. Note associated relatively inflammation free band with proliferated bile ductules. (Row 2 Left 400X). Reticulin stain shows two cell thick regenerative cords with sinusoidal black lines lacking orientation (Row 2 Right 400X).

==Stains==

Iron stain +ve -- '''important'''.

Line 47:

Line 66:

**Must be separated from ''siderosis'' -- iron in Kupffer cells.

Grading ~~(0-4)~~:

===Grading===

The quantity of iron is scored as follows:

*0 = none.

*1: only at high power.

@@ Line 42: / Line 42: @@
 www:
 *[http://path.upmc.edu/cases/case77/path.html Hemochromatosis (upmc.edu)].
+{|
+[[File:1 Iron 1 680x512px.tif|Trichrome shows thin fibrous bands (20X).]]
+[[File:2 Iron 1 680x512px.tif|Iron stain shows dense iron deposition (40X).]]
+|-
+[[File:3 Iron 1 680x512px.tif|At high power, a modest inflammatory infiltrate accompanies proliferating bile ductules; no piecemeal necrosis (400X)]]
+[[File:4 Iron 1 1360x1024px.tif|Reticulin stain with regenerative findings, cords with two nuclei thickness, hepatic acini (400X, higher pixel photo)]]
+|}
+Hemochromatosis with bridging fibrosis.
+Trichrome shows thin fibrous bands (Row 1 Left 20X). Iron stain shows dense iron deposition (Row 1 Right 40X). At high power, a modest inflammatory infiltrate accompanies proliferating bile ductules; no piecemeal necrosis (Row 2 Left 400X). Reticulin stain with regenerative findings, cords with two nuclei thickness, hepatic acini (Row 2 right 400X, higher pixel photo).
+{|
+[[File:1 Iron 2 680x512px.tif|Fibrous bands dissect hepatocyte nodules (Row 1 Left 20X).]]
+[[File:2 Iron 2 680x512px.tif|Iron stain shows 4+ iron, identifiable at the lowest magnification, as well by naked eye (Row 1 Right 20X)]]
+<br>
+[[File:3 Iron 2 680x512px.tif|This nodule has occasionally enlarged nuclei, which should not be considered dysplasia in and of itself. Note associated relatively inflammation free band with proliferated bile ductules. (Row 2 Left 400X).]]
+[[File:4 Iron 2 680x512px.tif|Reticulin stain shows two cell thick regenerative cords with sinusoidal black lines lacking orientation (Row 2 Right 400X).]]
+|}
+Hemochromatosis with cirrhosis..
+Fibrous bands dissect hepatocyte nodules (Row 1 Left 20X). Iron stain shows 4+ iron, identifiable at the lowest magnification, as well by naked eye (Row 1 Right 20X) This nodule has occasionally enlarged nuclei, which should not be considered dysplasia in and of itself. Note associated relatively inflammation free band with proliferated bile ductules. (Row 2 Left 400X). Reticulin stain shows two cell thick regenerative cords with sinusoidal black lines lacking orientation (Row 2 Right 400X).
 ==Stains==
 Iron stain +ve -- '''important'''.
@@ Line 47: / Line 66: @@
 **Must be separated from ''siderosis'' -- iron in Kupffer cells.
-Grading (0-4):
+===Grading===
+The quantity of iron is scored as follows:
 *0 = none.
 *1: only at high power.

Hereditary hemochromatosis: Difference between revisions

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