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Difference between revisions of "Talk:Liver pathology"
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→Fulimant liver failure: new section
(Created page with "==Waffle on PSC== ===Microscopic=== The specimen has an adequate length but contains only six complete portal tracts. There is mild periductal fibrosis (with a suggestion of an ...") |
(→Fulimant liver failure: new section) |
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====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. | ||
== Fulimant liver failure == | |||
===Microscopic description=== | |||
A. | |||
Liver: The sections show a parenchymal lymphocytic infiltrate with massive hepatocyte necrosis and a vigorous histocytic response, as demonstrated by CD68 immunostaining. The rare surviving hepatocytes show degenerative changes or swelling. There is no definite steatosis. There are no histomorphologically normal hepatocytes. | |||
There is focal perservation of the portal tracts. The remaining central veins show fibrinoid necrosis. There is a relative preservation of the bile ducts and bile ductular proliferation, as demonstrated by pan-keratin immunostainging. There is moderate cholestasis. The parencyhma has moderate thin strands of fibrotic tissue without an apparent zonality. | |||
Gallbladder: The section shows a normal gallbladder wall. There is no inflammation or necrosis. | |||
===Final diagnosis=== | |||
A.<br> | |||
i) Native liver, liver transplantation - diffuse massive hepatic necrosis, see comment.<br> | |||
ii) Native gallbladder, liver transplantation - no pathologic diagnosis. | |||
====Comment==== | |||
The findings of massive parenchymal collapse and abundant lymphocytes, with a moderate non-zonal reactive fibrosis and a reactive bile ductular proliferation, are consistent with a viral hepatitis. | |||