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Difference between revisions of "Medical liver disease"
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→Autoimmune hepatitis-primary biliary cirrhosis overlap syndrome: Added an important overlap. A very difficult diagnostic problem is illustrated with features of both AIH & obstruction
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(→Autoimmune hepatitis-primary biliary cirrhosis overlap syndrome: Added an important overlap. A very difficult diagnostic problem is illustrated with features of both AIH & obstruction) |
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*Abbreviated PBC. | *Abbreviated PBC. | ||
{{Main|Primary biliary cirrhosis}} | {{Main|Primary biliary cirrhosis}} | ||
==Autoimmune hepatitis with obstruction - combined changes== | |||
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[[File:1 AIH OBS 1.tif|Low power shows inflammation; portal triads, lobules, central veins cannot be distinguished (40X).]] | |||
[[File:2 AIH OBS 1.tif|Trichrome shows central venous sclerosis (red arrowhead), periportal fibrosis (green arrowhead), & space of Disse collagenization (yellow arrowhead); juxtaposition of central vein & portal tract indicates collapse, no definite bridging was seen (100X)]] | |||
[[File:3 AIH OBS 1.tif|Central vein is inflamed with a rare plasma cell (cyan arrowhead) (400X).]] | |||
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[[File:4 AIH OBS 1.tif|Interface hepatitis with plasma cells (yellow arrows) and ballooned hepatocytes (red arrows). Lobule is disorganized (400X).]] | |||
[[File:5 AIH OBS 1.tif|Proliferating bile ductules (blue arrows) with occasional neutrophils (fucsia arrows), indicative of obstruction, but not acute cholangitis, which requires inflamed bile duct itself, best diagnosed with associated blood vessel (400X).]] | |||
[[File:6 AIH OBS 1.tif|Rare distorted rosettes with greenish brown strands of bile (left arrow) or bile plugs (right arrow) (400X).]] | |||
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Patient with SLE and obstructive jaundice that resolved with apparent passage of stone. Low power shows inflammation; portal triads, lobules, central veins cannot be distinguished (UL 40X). Trichrome shows central venous sclerosis (red arrowhead), periportal fibrosis (green arrowhead), & space of Disse collagenization (yellow arrowhead); juxtaposition of central vein & portal tract indicates collapse, no definite bridging was seen (UM 100X). Central vein is inflamed with a rare plasma cell (cyan arrowhead) (UR 400X). Interface hepatitis with plasma cells (yellow arrows) and ballooned hepatocytes (red arrows). Lobule is disorganized (LL 400X). Proliferating bile ductules (blue arrows) with occasional neutrophils (fucsia arrows), indicative of obstruction, but not acute cholangitis, which requires inflamed bile duct itself, best diagnosed with associated blood vessel (LM 400X). Rare distorted rosettes with greenish brown strands of bile (left arrow) or bile plugs (right arrow) (LR 400X). | |||
==Autoimmune hepatitis-primary biliary cirrhosis overlap syndrome== | ==Autoimmune hepatitis-primary biliary cirrhosis overlap syndrome== | ||