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Difference between revisions of "Steatohepatitis"
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Steatohepatitis Brunt necroinflammatory grade 3, Brunt fibrosis stage 1 (not shown). Panacinar steatosis with unremarkable, small triads (UL 40X). Ballooning degeneration, with cytoplasmic tufts (arrows) (UR 400X). Lipogranuloma (LL 400X). Triad with mild chronic inflammation without interface hepatitis (LR 400X). | Steatohepatitis Brunt necroinflammatory grade 3, Brunt fibrosis stage 1 (not shown). Panacinar steatosis with unremarkable, small triads (UL 40X). Ballooning degeneration, with cytoplasmic tufts (arrows) (UR 400X). Lipogranuloma (LL 400X). Triad with mild chronic inflammation without interface hepatitis (LR 400X). | ||
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[[File:1 Steatohep 5 680x512px.tif|Steatosis afflicts almost all hepatocytes (pan-acinar) (Row 1 Left 40X).]] | |||
[[File:2 Steatohep 5 680x512px.tif|An isolated septal duct with concentric fibrosis (arrow) should not result in a diagnosis of primary sclerosing cholangitis. The patient had a normal bilirubin. (Row 1 Right 200X).]] | |||
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[[File:3 Steatohep 5 680x512px.tif|Cytoplasmic tufts (arrows) prove ballooning degeneration (Row 2 Left 400X).]] | |||
[[File:4 Steatohep 5 680x512px.tif|PAS with diastase shows PAS-D Kupffer cells (arrows) (Row 2 Right 400X).]] | |||
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[[File:5 Steatohep 5 680x512px.tif|Reticulin shows thick black lines (red arrows) of collapse, without portal central bridging. The apparent loss of reticulin due to steatosis (double head cyan arrow) should not be considered regeneration or hepatoma (Row 3 Left 200X).]] | |||
[[File:6 Steatohep 5 680x512px.tif|Trichrome shows a bridge (arrows) (Row 3 Right 200X).]] | |||
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Steatohepatitis. Brunt necroinflammatory grade 3, Brunt fibrosis stage 3. Steatosis afflicts almost all hepatocytes (pan-acinar) (Row 1 Left 40X). An isolated septal duct with concentric fibrosis (arrow) should not result in a diagnosis of primary sclerosing cholangitis. The patient had a normal bilirubin. (Row 1 Right 200X). Cytoplasmic tufts (arrows) prove ballooning degeneration (Row 2 Left 400X). PAS with diastase shows PAS-D Kupffer cells (arrows) (Row 2 Right 400X). Reticulin shows thick black lines (red arrows) of collapse, without portal central bridging. The apparent loss of reticulin due to steatosis (double head cyan arrow) should not be considered regeneration or hepatoma (Row 3 Left 200X). Trichrome shows a bridge (arrows) (Row 3 Right 200X). | |||
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| [[Image:Steatohepatitis Cases 02.tif |thumb| Fibrosis stage 2 Brunt necroinflammatory grade 1 (WC)]] | | [[Image:Steatohepatitis Cases 02.tif |thumb| Fibrosis stage 2 Brunt necroinflammatory grade 1 (WC)]] | ||
| Necroinflammatory grades Brunt 1, NAH 3. Fibrosis stage 2. Overall, about a third of the biopsy shows mostly macrovesicular steatosis (UL). Rare inflammatory aggregates and ballooned hepatocytes were seen, but occasional linear/ropy Mallory hyalin was seen (UR blue arrowhead). Although trichrome can highlight Mallory hyalin (LL red arrowhead), the remainder of the image shows other cytoplasmic collections will also stain blue/blue-grey. The trichrome stain also showed peri-portal fibrosis (LR, yellow arrowheads). Original oculars UL 4X, UR 40X (higher pixel photograph), LL 40X (higher pixel photograph), LR 20X | | Necroinflammatory grades Brunt 1, NAH 3. Fibrosis stage 2. Overall, about a third of the biopsy shows mostly macrovesicular steatosis (UL). Rare inflammatory aggregates and ballooned hepatocytes were seen, but occasional linear/ropy Mallory hyalin was seen (UR blue arrowhead). Although trichrome can highlight Mallory hyalin (LL red arrowhead), the remainder of the image shows other cytoplasmic collections will also stain blue/blue-grey. The trichrome stain also showed peri-portal fibrosis (LR, yellow arrowheads). Original oculars UL 4X, UR 40X (higher pixel photograph), LL 40X (higher pixel photograph), LR 20X | ||
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|[[Image:Steatohepatitis Cases 05.tif |thumb| Fibrosis stage 4 Brunt necroinflammatory grade 3 (WC)]] | |[[Image:Steatohepatitis Cases 05.tif |thumb| Fibrosis stage 4 Brunt necroinflammatory grade 3 (WC)]] | ||