48,454
edits
Difference between revisions of "Talk:Medical liver disease"
Jump to navigation
Jump to search
Talk:Medical liver disease (view source)
Revision as of 17:39, 2 December 2013
, 17:39, 2 December 2013→Minimal activity - hepatitis C
m (→Comment) |
|||
| (3 intermediate revisions by the same user not shown) | |||
| Line 49: | Line 49: | ||
====Comment==== | ====Comment==== | ||
The bile ducts have focal non-specific abnormalities without cholestasis that are not sufficient to diagnose primary sclerosing cholangitis (PSC). It is possible that this represents PSC, which is often patchy, and may have not been sampled in the relatively small number of portal tracts present in this biopsy. The histomorphologic findings are not compatible with autoimmune hepatitis. | The bile ducts have focal non-specific abnormalities without cholestasis that are not sufficient to diagnose primary sclerosing cholangitis (PSC). It is possible that this represents PSC, which is often patchy, and may have not been sampled in the relatively small number of portal tracts present in this biopsy. The histomorphologic findings are not compatible with autoimmune hepatitis. | ||
==Steatohepatitis & viral hepatitis== | |||
===Microscopic=== | |||
<pre> | |||
Size of biopsy: Adequate | |||
Fragmentation: Absent | |||
Fibrosis: Stage 2-3/4, mostly stage 2 | |||
Fibrous septa: Present | |||
Septa with curved contours: Present – focally only | |||
Large droplet steatosis (% of hepatocytes): Present, moderate 60% | |||
Ballooning of hepatocytes: Present, rare | |||
Mallory-Denk bodies: Present, rare | |||
Portal inflammation: Present | |||
Interface activity: Minimal (0-1/4) | |||
Lobular necroinflammation: Minimal | |||
Ducts: Present in normal numbers | |||
Duct injury: Absent | |||
Ductular reaction: Absent | |||
Cholestasis: Absent | |||
Terminal hepatic venules: Present | |||
Iron stain: Absent | |||
Ground glass cells with routine stains: Absent | |||
PASD for alpha-1 antitrypsin droplets: Negative | |||
</pre> | |||
===Final diagnosis=== | |||
<pre> | |||
Liver (random) medical core biopsies: | |||
- Liver with minimal chronic hepatitis (grade 0-1/4), with moderate fibrosis (stage 2-3/4). | |||
- Minimal steatohepatitis. | |||
- Moderate steatosis. | |||
</pre> | |||
== Possible drug-induced hepatitis == | |||
===Final diagnosis=== | |||
Liver (random) medical core biopsies: <br> | |||
- Liver with mild steatosis. <br> | |||
- Marked fibrosis (stage 3 of 4). <br> | |||
- Negative for steatohepatitis. <br> | |||
- Scattered eosinophils in the portal tracts, see comment. <br> | |||
====Comment==== | |||
The findings are consistent with a resolving steatoheptitis. | |||
The eosinophils in the portal tracts raise the possibility of a drug-induced or herbal-induced hepatitis. The use of ibuprofen is noted in the clinical history; however, this is not typically associated with steatosis. | |||
==Minimal activity - hepatitis C== | |||
<pre> | |||
LIVER, CORE BIOPSIES: | |||
- LIVER WITH MINIMAL CHRONIC HEPATITIS (GRADE 0-1/4), WITH | |||
MILD FIBROSIS (STAGE 1-2/4). | |||
- MINIMAL STEATOSIS. | |||
</pre> | |||