Difference between revisions of "Medical liver disease"

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| [[File:HCV C1 2016 06 22.tif|thumb|Hepatitis C case for Libre Pathology]]

| Metavir activity index 1 (Piecemeal necrosis 0-1, Lobular necrosis 1), Metavir fibrosis stage 2. Hepatitis C genotype 1a. Expanded, dark triads (UL blue arrowhead). Focus of spotty necrosis (UR green arrowhead). Reticulin shows occasional, equivocal foci of piecemeal necrosis, with a thin black line possibly encircling a hepatocytes (LL yellow arrowhead); the activity index is unaffected by the difference in piecemeal necrosis score. Trichrome shows portal fibrosis with extension outside area of blood vessels (LR purple arrowhead) Original oculars UL 2X, UR 20X, LL 40X, LR 40X

|-

~~| [[File:HCV C2 2016 06 22.tif|thumb|Hepatits C case for Libre Pathology]]~~

| Metavir activity index 2 (Piecemeal necrosis 2, Lobular necrosis 1). Hepatitis C genotype 3a. Steatosis, not pan-acinar and dark, expanded triads(UL) with the inset showing a Councilman body. Reticulin collapse, not portal-central (UR green arrowhead). Reticulin with more than focal piecemeal necrosis in some triads/tracts (LL magenta arrowheads) Trichrome stain of a tract (the entire structure may be a large bridge) with thinner bridges (LR cyan arrowheads).

~~Original oculars. UL 4X (inset 40X with higher magnification), UR 20X, LL 40X, LR 10X~~

|}

{|

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Hepatitis C with metavir stage IV fibrosis (advanced fibrosis/cirrhosis) and confluent piecemeal necrosis.

Inflamed bands cross hepatocytes with steatosis (Row 1 Left 40X). Trichrome shows extensive bridges (Row 1 Right 40X). Trichrome also documents early nodule formation (Row 2 Left 40X). Reticulin shows regeneration (two nuclei per cord) in a nodule, but not throughout (Row 2 Right 200X). Hematoxylin and eosin shows piecemeal necrosis as inflammatory cells surrounding hepatocytes (Row 3 Left 400X). Reticulin shows black lines about hepatocytes, indicating confluent piecemeal necrosis (Row 3 Right 400X).

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[[File:1 HCV 7 680x512px.tif|Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3]]

[[File:2 HCV 7 680x512px.tif|Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3]]

<br>

[[File:3 HCV 7 680x512px.tif|Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3]]

[[File:4 HCV 7 680x512px.tif|Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3]]

<br>

[[File:5 HCV 7 680x512px.tif|Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3]]

[[File:6 HCV 7 680x512px.tif|Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3]]

|}

Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3.

Expanded dark triads, indicating interface hepatitis [red arrows], foci of steatosis [green arros], potential bridge [blue arrow] (Row 1 Left 20X). Extending from triad are stretches of apparent necrosis [green arrows], inflammatory cells bound hepatocytes afflicted by piecemeal necrosis [yellow arrows], ballooning degeneration denoted by cytoplasmic tufts [blue arrows] (Row 1 Right 400X). Reticulin shows collapse (necrosis) with thick bands [red arrows], as well as rosettes [green arrows] indicating dilated cholangioles (Row 2 Left 200X). Reticulin here shows continuous piecemeal necrosis with black bounded hepatocyte islets [arrows] (Row 2 Right 200X). Reticulin here shows a bridge with regeneration, wherein two or more nuclei lie between reticulin lines [arrows] (Row 3 Left 200X). Trichrome demarcates one of the bridges (Row 3 Right 200X).

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Difference between revisions of "Medical liver disease"

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@@ Line 178: / Line 178: @@
 | [[File:HCV C1 2016 06 22.tif|thumb|Hepatitis C case for Libre Pathology]]
 | Metavir activity index 1 (Piecemeal necrosis 0-1, Lobular necrosis 1), Metavir fibrosis stage 2.  Hepatitis C genotype 1a.  Expanded, dark triads (UL blue arrowhead). Focus of spotty necrosis (UR green arrowhead). Reticulin shows occasional, equivocal foci of piecemeal necrosis, with a thin black line possibly encircling a hepatocytes (LL yellow arrowhead); the activity index is unaffected by the difference in piecemeal necrosis score. Trichrome shows portal fibrosis with extension outside area of blood vessels (LR purple arrowhead)  Original oculars UL 2X, UR 20X, LL 40X, LR 40X
-|-
-| [[File:HCV C2 2016 06 22.tif|thumb|Hepatits C case for Libre Pathology]]
-| Metavir activity index 2 (Piecemeal necrosis 2, Lobular necrosis 1). Hepatitis C genotype 3a.    Steatosis, not pan-acinar and dark, expanded triads(UL) with the inset showing a Councilman body. Reticulin collapse, not portal-central (UR green arrowhead). Reticulin with more than focal piecemeal necrosis in some triads/tracts (LL magenta arrowheads) Trichrome stain of a  tract (the entire structure may be a large bridge) with thinner bridges (LR cyan arrowheads).
-Original oculars. UL 4X (inset 40X with higher magnification), UR 20X, LL 40X, LR 10X
 |}
 {|
@@ Line 195: / Line 191: @@
 Hepatitis C with metavir stage IV fibrosis (advanced fibrosis/cirrhosis) and confluent piecemeal necrosis.
 Inflamed bands cross hepatocytes with steatosis (Row 1 Left 40X). Trichrome shows extensive bridges  (Row 1 Right 40X). Trichrome also documents early nodule formation (Row 2 Left 40X). Reticulin shows regeneration (two nuclei per cord) in a nodule, but not throughout (Row 2 Right 200X). Hematoxylin and eosin shows piecemeal necrosis as inflammatory cells surrounding hepatocytes (Row 3 Left 400X). Reticulin shows black lines about hepatocytes, indicating confluent piecemeal necrosis (Row 3 Right 400X).
+{|
+[[File:1 HCV 7 680x512px.tif|Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3]]
+[[File:2 HCV 7 680x512px.tif|Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3]]
+<br>
+[[File:3 HCV 7 680x512px.tif|Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3]]
+[[File:4 HCV 7 680x512px.tif|Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3]]
+<br>
+[[File:5 HCV 7 680x512px.tif|Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3]]
+[[File:6 HCV 7 680x512px.tif|Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3]]
+|}
+Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3.
+Expanded dark triads, indicating interface hepatitis [red arrows], foci of steatosis [green arros], potential bridge [blue arrow] (Row 1 Left 20X). Extending from triad are stretches of apparent necrosis [green arrows], inflammatory cells bound hepatocytes afflicted by piecemeal necrosis [yellow arrows], ballooning degeneration denoted by cytoplasmic tufts [blue arrows] (Row 1 Right 400X). Reticulin shows collapse (necrosis) with thick bands [red arrows], as well as rosettes [green arrows] indicating dilated cholangioles (Row 2 Left 200X). Reticulin here shows continuous piecemeal necrosis with black bounded hepatocyte islets [arrows] (Row 2 Right 200X). Reticulin here shows a bridge with regeneration, wherein two or more nuclei lie between reticulin lines [arrows] (Row 3 Left 200X). Trichrome demarcates one of the bridges (Row 3 Right 200X).
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