Difference between revisions of "Alpha-1 antitrypsin deficiency"

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→‎Images: Added a case with non-specific staining
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Alpha 1 Antitrypsin deficiency with cirrhosis. Dark inflamed bands bound hepatocyte nodules (Row 1 Left 40X). Steatosis afflicts some hepatocyte areas, within inflamed band lie proliferated bile ductules (Row 1 Right 100X). Reticulin shows regenerative (more than 2 nuclei per cord) nodules (black lines without definite directionality) amid bands (Row 2 Left 100X). Trichrome shows scar (Row 2 Right 100X). Hepatocytes show steatosis, foamy degeneration, and intranuclear inclusions (Row 3 Left 400X). PAS-D shows A1AT cytoplasmic granules; in non-A1AT cirrhosis, these granules would neither be in so many hepatocytes nor, in general, as large    (Row 3 Right 400X).  
Alpha 1 Antitrypsin deficiency with cirrhosis. Dark inflamed bands bound hepatocyte nodules (Row 1 Left 40X). Steatosis afflicts some hepatocyte areas, within inflamed band lie proliferated bile ductules (Row 1 Right 100X). Reticulin shows regenerative (more than 2 nuclei per cord) nodules (black lines without definite directionality) amid bands (Row 2 Left 100X). Trichrome shows scar (Row 2 Right 100X). Hepatocytes show steatosis, foamy degeneration, and intranuclear inclusions (Row 3 Left 400X). PAS-D shows A1AT cytoplasmic granules; in non-A1AT cirrhosis, these granules would neither be in so many hepatocytes nor, in general, as large    (Row 3 Right 400X).  
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[[File:1 A1AT 2 680x512px.tif| Alpha 1 anti-trypsin (A1AT) granules in cirrhosis, not due to A1AT deficiency; A1AT level was normal.]]
[[File:2 A1AT 2 680x512px.tif| Alpha 1 anti-trypsin (A1AT) granules in cirrhosis, not due to A1AT deficiency; A1AT level was normal.]]
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[[File:3 A1AT 2 680x512px.tif| Alpha 1 anti-trypsin (A1AT) granules in cirrhosis, not due to A1AT deficiency; A1AT level was normal.]]
[[File:4 A1AT 2 680x512px.tif| Alpha 1 anti-trypsin (A1AT) granules in cirrhosis, not due to A1AT deficiency; A1AT level was normal.]]
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[[File:5 A1AT 2 680x512px.tif| Alpha 1 anti-trypsin (A1AT) granules in cirrhosis, not due to A1AT deficiency; A1AT level was normal.]]
[[File:6 A1AT 2 680x512px.tif| Alpha 1 anti-trypsin (A1AT) granules in cirrhosis, not due to A1AT deficiency; A1AT level was normal.]]
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Alpha 1 anti-trypsin (A1AT) granules in cirrhosis, not due to A1AT deficiency; A1AT level was normal. A. Low power shows an inflamed foci, bands, and hepatocyte regions [2x]. B. Trichrome confirms blue fibrosis about hepatocyte isles [4X]. C. Proliferated bile ductules (black arrows) border hepatocytes with glycogenated nuclei (green arrows), consistent with the history of diabetes [200X]. D. Reticulin shows two-cell thick regenerated cords (green arrows) and circles for rosettes (black arrows) [200X]. E. PAS with diastase stain shows occasional small red granules (arrows) and red dust in cytoplasm of hepatocytes near edge of regenerative nodule [400X]. E. A1AT immunostain shows occasional small brown granules (arrows) in cytoplasm of hepatocytes near edge of regenerative nodule [400X].


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