Difference between revisions of "Medical liver disease"

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Medical liver disease (view source)

Revision as of 20:33, 1 September 2016

1,774 bytes added ,  20:33, 1 September 2016
Replaced etoh & hcv small image cases
(→‎Images: Replaced a non-large image case with a large image case)
(Replaced etoh & hcv small image cases)
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====Images====
====Images====
{| class="wikitable sortable"
{|
| [[File:HCV C1 2016 06 22.tif|thumb|Hepatitis C case for Libre Pathology]]
[[File:1 HCV 9 680x512px.tif| Hepatitis C virus. Metavir Activity Index 1 (PMN 0 LN 1).]]
| Metavir activity index 1 (Piecemeal necrosis 0-1, Lobular necrosis 1), Metavir fibrosis stage 2. Hepatitis C genotype 1a. Expanded, dark triads (UL blue arrowhead). Focus of spotty necrosis (UR green arrowhead). Reticulin shows occasional, equivocal foci of piecemeal necrosis, with a thin black line possibly encircling a hepatocytes (LL yellow arrowhead); the activity index is unaffected by the difference in piecemeal necrosis score. Trichrome shows portal fibrosis with extension outside area of blood vessels (LR purple arrowhead) Original oculars UL 2X, UR 20X, LL 40X, LR 40X
[[File:2 HCV 9 680x512px.tif| Hepatitis C virus. Metavir Activity Index 1 (PMN 0 LN 1).]]
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[[File:3 HCV 9 680x512px.tif| Hepatitis C virus. Metavir Activity Index 1 (PMN 0 LN 1).]]
[[File:4 HCV 9 680x512px.tif| Hepatitis C virus. Metavir Activity Index 1 (PMN 0 LN 1).]]
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[[File:5 HCV 9 680x512px.tif| Hepatitis C virus. Metavir Activity Index 1 (PMN 0 LN 1).]]
[[File:6 HCV 9 680x512px.tif| Hepatitis C virus. Metavir Activity Index 1 (PMN 0 LN 1).]]
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|}
Hepatitis C virus. Metavir Activity Index 1 (PMN 0 LN 1).
Preserved architecture shows small, inflamed triads [red arrows] and foci of spotty necrosis [blue arrows] (Row 1 Left 40X). Trichrome shows periportal fibrosis [blue arrow] and central venous sclerosis [green arrow] (Row 1 Right 100X). A higher power view of an inflamed triad with interface hepatitis, but a smooth outline, suggesting no piecemeal necrosis (Row 2 Left 200X). A focus of spotty necrosis near an unafflicted triad below it  (Row 2 Right 200X). Reticulin shows collapse [arrows] extending from/near portal triad without piecemeal necrosis (Row 3 Left 200X).  Reticulin shows collapse [arrows] extending from/near central vein  (Row 4 Left 200X).
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{|
[[File:1 hcv 6 680x512px.tif|Inflamed bands cross hepatocytes with steatosis (Row 1 Left 40X).]]
[[File:1 hcv 6 680x512px.tif|Inflamed bands cross hepatocytes with steatosis (Row 1 Left 40X).]]
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====Images====
====Images====
{| class="wikitable sortable"
{|
| [[File:Alcoholic Liver Disease c1 2016 06 23.tif|thumb|Cirrhosis in a patient with a history of alcohol abuse]]
[[File:1 etoh 3 680x512px.tif| Alcoholic hepatitis with Metavir stage IV fibrosis (advanced fibrosis/cirrhosis).]]
| Cirrhosis in a person with alcohol abuse.  At low power bands separate hepatocyte regions (UL). Higher power at left shows isles of hepatocytes, some ballooned; at right, hepatocytes with many lumens, at lower power perhaps suggesting steatosis, here evidencing regeneration (UL). Focus of spotty necrosis (UR). PAS-D stain showing extensive benign bile duct proliferation, overall localized, with red rimd (LL). Trichrome shows fibrosis about nodules (LR).
[[File:2 etoh 3 680x512px.tif| Alcoholic hepatitis with Metavir stage IV fibrosis (advanced fibrosis/cirrhosis).]]
Original oculars UL 4X, UR 20X, LL 40X, LR 10X
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[[File:3 etoh 3 680x512px.tif| Alcoholic hepatitis with Metavir stage IV fibrosis (advanced fibrosis/cirrhosis).]]
[[File:4 etoh 3 680x512px.tif| Alcoholic hepatitis with Metavir stage IV fibrosis (advanced fibrosis/cirrhosis).]]
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[[File:5 etoh 3 680x512px.tif| Alcoholic hepatitis with Metavir stage IV fibrosis (advanced fibrosis/cirrhosis).]]
[[File:6 etoh 3 680x512px.tif| Alcoholic hepatitis with Metavir stage IV fibrosis (advanced fibrosis/cirrhosis).]]
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Alcoholic hepatitis with Metavir stage IV fibrosis (advanced fibrosis/cirrhosis).
Trichrome shows relatively non-inflamed fibrous bands, as well as [between green dots] nodules. The lack of regeneration throughout might have precluded a diagnosis of cirrhosis, but stage IV fibrosis under the Metavir system is justified (Row 1 Left 20X). Reticulin shows regenerative nodules [left] with mostly two or more nuclei between black lines juxtaposed to non-regenerative hepatocytes on the right, without piecemeal necrosis. (Row 1 Right 100X). Regenerative nodules show occasional neutrophils [red arrow] and cytoplasmic tufts of ballooned cells, sometimes possibly Mallory hyalin [green arrows] (Row 2 Left 200X). Triads (note vein [green arrow], artery [yellow arrow], and interlobular bile duct [blue arrow]) generally showed little or no interface hepatitis, even when expanded by fibrosis and inflamed (Row 2 Right 200X). Occasional foci of spotty necrosis were seen (Row 3 Left 200X).  This edge of an inflamed triads shows neutrophils about proliferated bile ducts [red arrows], as well as Mallory-Denk bodies [blue arrows]  (Row 4 Left 400X).
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{|
[[File:1 ALC 2 680x512px.tif|Expanded, inflamed triads with increased bile duct/vascular openings. Mild steatosis (40X).]]
[[File:1 ALC 2 680x512px.tif|Expanded, inflamed triads with increased bile duct/vascular openings. Mild steatosis (40X).]]
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