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Difference between revisions of "Liver pathology"
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→Stains: more, reformat
(→Biopsy: tweak, divide) |
(→Stains: more, reformat) |
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=Stains= | =Stains= | ||
*The stains ordered (initially) are dependent on the clinical history. | *The stains ordered (initially) are dependent on the clinical history. | ||
*#Anything with "tumour", "mass", or "query metastasis": 3 H&E | *#Anything with "tumour", "mass", or "query metastasis" in the clinical history is "tumour". | ||
*#*Stains: | |||
*#**3 H&E. | |||
*#Everything else is assumed to be "medical". | *#Everything else is assumed to be "medical". | ||
*#*Stains: | |||
*#**PAS-D - to detect mucin. | |||
* | *#**PAS - marks glycogen and mucin; useful for microvesicular steatosis | ||
** | *#**Trichrome - to detect fibrosis/cirrhosis. | ||
* | *#***Mallory trichrome: red = hepatocytes, blue/black = nuclei, green = fibrosis. | ||
** | *#**Reticulin - demonstrates architecture. | ||
*** | *#**Iron stain. | ||
*Iron stain. | *#***Grading (0-4): 0 = none, 1: only at high power, 2: at medium power, 3: at lowest power, 4: seen without microscope. | ||
**Grading (0-4): 0 = none, 1: only at high power, 2: at medium power, 3: at lowest power, 4: seen without microscope. | *#****One should comment on location, i.e. macrophage (Kupffer cell) vs. periportal hepatocytes vs. centrilobular hepatocytes vs. bile ducts vs. endothelial cells. | ||
** | |||
===Additional stains/IHC=== | ===Additional stains/IHC=== | ||
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*[[Oil red O]]. | *[[Oil red O]]. | ||
**Useful for steatosis, not commonly done. | **Useful for steatosis, not commonly done. | ||
*[[HPS]]. | |||
**Similar to trichrome. | |||
Common IHC:<ref name=ap27may09/> | Common IHC:<ref name=ap27may09>AP. 27 May 2009.</ref> | ||
*CK7 - bile ducts, and bile ductules +ve. | *CK7 - bile ducts, and bile ductules +ve. | ||
*CD34 - should be -ve in normal liver. | *CD34 - should be -ve in normal liver. | ||