Difference between revisions of "Steatohepatitis"

Jump to navigation Jump to search

Steatohepatitis (view source)

Revision as of 18:52, 2 September 2016

965 bytes added ,  18:52, 2 September 2016
→‎Images: Replaced a non-large image case with a large image case
(→‎Images: Replaced a non-large image case with a large image case)
Line 172: Line 172:


====Images====
====Images====
{|
[[File:1 Nash 8 680x512px.tif| Steatohepatitis. Brunt necroinflammatory grade 1. Brunt fibrosis stage 1.]]
[[File:2 Nash 8 680x512px.tif| Steatohepatitis. Brunt necroinflammatory grade 1. Brunt fibrosis stage 1.]]
<br>
[[File:3 Nash 8 680x512px.tif| Steatohepatitis. Brunt necroinflammatory grade 1. Brunt fibrosis stage 1.]]
[[File:4 Nash 8 680x512px.tif| Steatohepatitis. Brunt necroinflammatory grade 1. Brunt fibrosis stage 1.]]
<br>
[[File:5 Nash 8 680x512px.tif| Steatohepatitis. Brunt necroinflammatory grade 1. Brunt fibrosis stage 1.]]
[[File:6 Nash 8 680x512px.tif| Steatohepatitis. Brunt necroinflammatory grade 1. Brunt fibrosis stage 1.]]
|}
Steatohepatitis. Brunt necroinflammatory grade 1. Brunt fibrosis stage 1. Steatosis afflicts about 30% of hepatocytes; note the absence of visible triads (Row 1 Left 20X). Cytoplasmic tufts of ballooning degeneration [violet arrows] were commonly found; a lymphohistiocytic aggregate [blue arrow], important for NAFLD, but not for Brunt, is seen (Row 1 Right 400X). A triad shows a vein [green arrow], an artery [red arrow], an interlobular duct [blue arrow], and proliferating bile ductules [cyan arrows]; only a few lymphocytes are seen (Row 2 Left 400X). Central vein shows only a few endothelial cells, with somewhat packed hepatocytes surrounding it  (Row 2 Right 400X). Trichrome shows mostly space of Disse fibrosis [black arrows], sometimes adjoining hepatocytes [green arrows] show this is a stage 1 fibrosis (Row 3 Left 400X). Trichrome shows a central vein with a minimum of sclerosis; an interhepatocyte fibrous extension [arrow] displays the very beginning of fibrosis (Row 3 Right 400X).
{|
{|
[[File:1 Steatohep 4 680x512px.tif|Panacinar steatosis with unremarkable, small triads (40X).]]
[[File:1 Steatohep 4 680x512px.tif|Panacinar steatosis with unremarkable, small triads (40X).]]
Line 179: Line 191:
[[File:4 Steatohep 4 680x512px.tif|Triad with mild chronic inflammation without interface hepatitis (400X).]]
[[File:4 Steatohep 4 680x512px.tif|Triad with mild chronic inflammation without interface hepatitis (400X).]]
|}
|}
Steatohepatitis Brunt necroinflammatory grade 3, Brunt fibrosis stage 1 (not shown). Panacinar steatosis with unremarkable, small triads (UL 40X). Ballooning degeneration, with cytoplasmic tufts (arrows) (UR 400X). Lipogranuloma (LL 400X). Triad with mild chronic inflammation without interface hepatitis (LR 400X).
Steatohepatitis Brunt necroinflammatory grade 3, Brunt fibrosis stage 1 (not shown). Panacinar steatosis with unremarkable, small triads (Row 1 Left 40X). Ballooning degeneration, with cytoplasmic tufts [arrows] (Row 1 Right 400X). Lipogranuloma (Row 2 Left 400X). Triad with mild chronic inflammation without interface hepatitis (Row 2 Right 400X).
{|
{|
[[File:1 Steatohep 5 680x512px.tif|Steatosis afflicts almost all hepatocytes (pan-acinar) (Row 1 Left 40X).]]
[[File:1 Steatohep 5 680x512px.tif|Steatosis afflicts almost all hepatocytes (pan-acinar) (Row 1 Left 40X).]]
Line 190: Line 202:
[[File:6 Steatohep 5 680x512px.tif|Trichrome shows a bridge (arrows) (Row 3 Right 200X).]]
[[File:6 Steatohep 5 680x512px.tif|Trichrome shows a bridge (arrows) (Row 3 Right 200X).]]
|}
|}
Steatohepatitis. Brunt necroinflammatory grade 3, Brunt fibrosis stage 3. Steatosis afflicts almost all hepatocytes (pan-acinar) (Row 1 Left 40X). An isolated septal duct with concentric fibrosis (arrow) should not result in a diagnosis of primary sclerosing cholangitis. The woman who underwent the biopsy had a normal bilirubin level, a normal alkaline phosphatase level, and only slightly elevated transaminase levels. (Row 1 Right 200X). Cytoplasmic tufts (arrows) prove  ballooning degeneration (Row 2 Left 400X). PAS with diastase shows PAS-D Kupffer cells (arrows) (Row 2 Right 400X). Reticulin shows thick black lines (red arrows) of collapse, without portal central bridging. The apparent loss of reticulin due to steatosis (double head cyan arrow) should not be considered regeneration or hepatoma (Row 3 Left 200X). Trichrome shows a bridge (arrows) (Row 3 Right 200X).
Steatohepatitis. Brunt necroinflammatory grade 3, Brunt fibrosis stage 3. Steatosis afflicts almost all hepatocytes (pan-acinar) (Row 1 Left 40X). An isolated septal duct with concentric fibrosis [arrow] should not result in a diagnosis of primary sclerosing cholangitis. The woman who underwent the biopsy had a normal bilirubin level, a normal alkaline phosphatase level, and only slightly elevated transaminase levels. (Row 1 Right 200X). Cytoplasmic tufts [arrows] prove  ballooning degeneration (Row 2 Left 400X). PAS with diastase shows PAS-D Kupffer cells (arrows) (Row 2 Right 400X). Reticulin shows thick black lines [red arrows] of collapse, without portal central bridging. The apparent loss of reticulin due to steatosis [double head cyan arrow] should not be considered regeneration or hepatoma (Row 3 Left 200X). Trichrome shows a bridge [arrow] (Row 3 Right 200X).


{| class="wikitable sortable"  
{| class="wikitable sortable"  
Line 199: Line 211:
| [[Image:Steatohepatitis Cases 03.tif |thumb| Fibrosis stage 1 Brunt necroinflammatory grade 2 (WC)]]
| [[Image:Steatohepatitis Cases 03.tif |thumb| Fibrosis stage 1 Brunt necroinflammatory grade 2 (WC)]]
| Necroinflammatory grades Brunt 2, NAH 6. Fibrosis stage 1. About half the hepatocytes show macrovesicular steatosis (UL), with sparing of part of the acinus (UL, Black arrowhead), Lipogranulomas, acomar inflammatory collections, mostly macrophages, about steatosis/ballooning degeneration afflicted hepatocytes or adjacent to them (UR, green arrowheads) are present.Tufts/flocks of ballooning degeneration are readily found (LL, magenta arrowheads). Mild to moderate mononuclear inflammation of portal triads does not exclude steatohepatitis (LL, yellow arrowheads).  Trichrome displays the blue thin lines that separate hepatocytes in stage 1 fibrosis (LR blue arrowheads). Original oculars UL 4X, UR 40X (higher pixel photograph), LL 40X , LR 10X
| Necroinflammatory grades Brunt 2, NAH 6. Fibrosis stage 1. About half the hepatocytes show macrovesicular steatosis (UL), with sparing of part of the acinus (UL, Black arrowhead), Lipogranulomas, acomar inflammatory collections, mostly macrophages, about steatosis/ballooning degeneration afflicted hepatocytes or adjacent to them (UR, green arrowheads) are present.Tufts/flocks of ballooning degeneration are readily found (LL, magenta arrowheads). Mild to moderate mononuclear inflammation of portal triads does not exclude steatohepatitis (LL, yellow arrowheads).  Trichrome displays the blue thin lines that separate hepatocytes in stage 1 fibrosis (LR blue arrowheads). Original oculars UL 4X, UR 40X (higher pixel photograph), LL 40X , LR 10X
|-
| [[Image:Steatohepatitis Cases 02.tif |thumb| Fibrosis stage 2 Brunt necroinflammatory grade 1 (WC)]]
| Necroinflammatory grades Brunt 1, NAH 3. Fibrosis stage 2.  Overall, about a third of the biopsy shows mostly macrovesicular steatosis (UL).  Rare inflammatory aggregates and ballooned hepatocytes were seen, but occasional linear/ropy Mallory hyalin was seen (UR blue arrowhead). Although trichrome can highlight Mallory hyalin (LL red arrowhead), the remainder of the image shows other cytoplasmic collections will also stain blue/blue-grey.  The trichrome stain also showed peri-portal fibrosis (LR, yellow arrowheads).  Original oculars UL 4X, UR 40X (higher pixel photograph), LL  40X (higher pixel photograph), LR 20X
|-
|-
|[[Image:Steatohepatitis Cases 05.tif |thumb| Fibrosis stage 4 Brunt necroinflammatory grade 3 (WC)]]
|[[Image:Steatohepatitis Cases 05.tif |thumb| Fibrosis stage 4 Brunt necroinflammatory grade 3 (WC)]]
Mitchell
Account-creators
179

edits

Retrieved from "https://librepathology.org/wiki/Special:MobileDiff/45815"

Navigation menu