Difference between revisions of "Liver pathology"

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Liver pathology (view source)

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Image:Von_Meyenburg_complex_low_mag.jpg | Von Meyenburg complex - bile duct hamartoma (WC)
Image:Von_Meyenburg_complex_low_mag.jpg | Von Meyenburg complex - bile duct hamartoma (WC)
Image:Bile_duct_hamartoma_intermed_mag.jpg | Bile duct hamartoma - intermed. mag. (WC)
Image:Bile_duct_hamartoma_intermed_mag.jpg | Bile duct hamartoma - intermed. mag. (WC)
Image:Von_Meyenburg_complex_liver.jpg | Von Meyenburg complex / bile duct hamartoma (WC)
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===Cirrhosis===
===Cirrhosis===
*Cirrhosis ''is'' stage 4 (Laennec).
{{Main|Cirrhosis}}
**The formal Robbins definitions is:<ref name=Ref_PCPBoD8_439>{{Ref PCPBoD8|439}}</ref> (1) bridging fibrosis, (2) nodule formation, and (3) disruption of the hepatic architecture.
*The etiology of late stage fibrosis (cirrhosis), may be impossible to determine.
*Perisinusoidal fibrosis may suggest congestive hepatopathy.<ref>OA. September 15, 2009.</ref>
*In NAFLD portal-to-portal fibrosis (septal/bridging fibrosis) tends to be more common than perivenular fibrosis.<ref name=pmid14991537>Pathologic features associated with fibrosis in nonalcoholic fatty liver disease. Gramlich T, Kleiner DE, McCullough AJ, Matteoni CA, Boparai N, Younossi ZM. Hum Pathol. 2004 Feb;35(2):196-9. PMID 14991537.</ref>
*The classic teaching is that cirrhosis is irreversible; however, there is increasing evidence that it regresses.<ref name=pmid11079009>{{Cite journal  | last1 = Wanless | first1 = IR. | last2 = Nakashima | first2 = E. | last3 = Sherman | first3 = M. | title = Regression of human cirrhosis. Morphologic features and the genesis of incomplete septal cirrhosis. | journal = Arch Pathol Lab Med | volume = 124 | issue = 11 | pages = 1599-607 | month = Nov | year = 2000 | doi = 10.1043/0003-9985(2000)1241599:ROHC2.0.CO;2 | PMID = 11079009 }}</ref><ref name=pmid21286337>{{Cite journal  | last1 = Kim | first1 = SU. | last2 = Park | first2 = JY. | last3 = Kim | first3 = do Y. | last4 = Ahn | first4 = SH. | last5 = Choi | first5 = EH. | last6 = Seok | first6 = JY. | last7 = Lee | first7 = JM. | last8 = Park | first8 = YN. | last9 = Chon | first9 = CY. | title = Non-invasive assessment of changes in liver fibrosis via liver stiffness measurement in patients with chronic hepatitis B: impact of antiviral treatment on fibrosis regression. | journal = Hepatol Int | volume = 4 | issue = 4 | pages = 673-80 | month =  | year = 2010 | doi = 10.1007/s12072-010-9201-7 | PMID = 21286337 }}</ref><ref name=pmid24304452>{{Cite journal  | last1 = Casado | first1 = JL. | last2 = Quereda | first2 = C. | last3 = Moreno | first3 = A. | last4 = Pérez-Elías | first4 = MJ. | last5 = Martí-Belda | first5 = P. | last6 = Moreno | first6 = S. | title = Regression of liver fibrosis is progressive after sustained virological response to HCV therapy in patients with hepatitis C and HIV coinfection. | journal = J Viral Hepat | volume = 20 | issue = 12 | pages = 829-37 | month = Dec | year = 2013 | doi = 10.1111/jvh.12108 | PMID = 24304452 }}</ref>
 
Special types:
*Garland cirrhosis ([[AKA]] holly leaf cirrhosis) - see ''[[primary biliary cirrhosis]]''.
====Gross====
Cirrhosis can be divided (in gross pathology) into:
*Micronodular cirrhosis - classically due to [[alcohol]].
**Uniform, diffuse.
*Macronodular cirrhosis - classically due to viral hepatitis.
**Irregular.
 
Images:
*[http://www.meddean.luc.edu/lumen/MedEd/orfpath/cirhosis.htm Cirrhosis - macronodular & micronodular (meddean.luc.edu)].
<gallery>
Image:Cirrhosis_high_mag.jpg | Cirrhotic liver - trichrome stain. (WC/Nephron)
</gallery>


===Steatosis===
===Steatosis===
Mark
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