150b - Liver Histology and Basic Pathology

Question 1

What is structure C?

Answer 1

Portal vein

Question 2

Which metabolite of alcohol causes liver injury?

What enzyme ususally clears this metabolite?

Answer 2

Acetaldehyde

Converted to acetate by ALDH2

Question 3

Describe the two-hit hypothesis of steatohepatitis

Answer 3

1. Fat accumulation -> steatosis
2. Oxidative stress to hepatocytes -> steatohepatitis

Question 4

Which liver cells cause fibrosis?

Answer 4

Hepatic stellate cells

• Normally quiescent
• Activated by injury or inflammation
• -> Division and proliferation
  
  • -> Kupffer cell activation
  • -> Deposition of scar matrix

Question 5

What is structure B?

Answer 5

Hepatic artery

Question 6

What is structure A?

Answer 6

Bile duct

Question 7

What is structure D?

Answer 7

Central vein

Question 8

What is the histologic hallmark of acetaminophen overdose?

Answer 8

Centrilobular necrosis (zone 3)

• The centri-lobular hepatocytes typically metabolize acetaminophin
• Hepatocytes around portal tracts (zone 1) will be normal)

Question 9

List 4 histologic changes that may occur in steatohepatitis

Answer 9

• Ballooning cells
• Mallory bodies
• Inflammatory infiltrate (neutrophils)
• Pericellular and Perivenular fibrosis