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Difference between revisions of "Medical liver disease"
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→Vanishing bile duct syndrome: added gvhd
(→Other: Added a casepf PSS) |
(→Vanishing bile duct syndrome: added gvhd) |
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*[[CK7]] -ve. | *[[CK7]] -ve. | ||
**Marks bile ducts. | **Marks bile ducts. | ||
==Hepatic Graft versus Host Disease (L-GVHD)== | |||
[[File:3 579232643 sl 1.png| Hepatic graft versus host disease (L-GVHD)]] | |||
[[File:3 579232643 sl 2.png| Hepatic graft versus host disease (L-GVHD)]] | |||
[[File:3 579232643 sl 3.png| Hepatic graft versus host disease (L-GVHD)]] | |||
[[File:3 579232643 sl 4.png| Hepatic graft versus host disease (L-GVHD)]] | |||
[[File:3 579232643 sl 5.png| Hepatic graft versus host disease (L-GVHD)]] | |||
[[File:3 579232643 sl 6.png| Hepatic graft versus host disease (L-GVHD)]] | |||
[[File:3 579232643 sl 7.png| Hepatic graft versus host disease (L-GVHD)]] | |||
<br> | |||
Hepatic graft versus host disease (L-GVHD) in a 22 yo man who underwent bone marrow transplantation after developing ALL. A. Low power view shows brownish discoloration in triad, but is otherwise of little interest. B. Arterioles in triads were accompanied by bile ducts in only 30% of cases; this image shows an arteriole without a bile duct. Note the pigment and the accompanying macrophage/lymphocyte inflammation, not extreme. The added chronic inflammation is a feature of chronic L-GVHD. C. Bile ducts, when shown, showed extensive damage, here seen as loss of cytoplasm, and nuclear pleomorphism and hyperchromasia (other degenerative changes, not seen here, include nuclear dropout or necrosis, cytoplasmic eosinophilia, loss of duct lumen). Lymphocytosis into the ducts was not seen. D. Ballooned hepatocytes and dilated canaliculi were seen. E. Pigment was present, but mostly in Kupffer cells, not hepatocytes or as bile plugs. F. Up to two foci of spotty necrosis were seen in a 100X field (field shown is 200X); not shown are rare apoptotic hepatocytes. G. An iron stain showed the pigment represented extemsive iron deposition, with emphasis on Kupffer cells and portal triad macrophages, frustrating definite assessment of bile plugs in canaliculi. The hemosiderosis resulted from the many blood transfusions the patient had received. | |||
==Extrahepatic biliary obstruction== | ==Extrahepatic biliary obstruction== | ||