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Histopathology Liver disease Flashcards

(59 cards)

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1
Q

Benign types

A

Haemangioma
Liver cell adenoma
Blie duct malformations
Focal nodular hyperplasia

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2
Q

Malignant

A 
HCC
Cholangiocarcinoma
Angioarcoma heptaoblastoma
Lymphoma
Metastasis
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3
Q

Haemangioma description

A

Most common benign vascular tumour

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4
Q

Haemangioma detection

A

Incidental pick up and rarely rupture

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5
Q

Bile duct malformation epi

A 
Common
Incidental finding at surgery
Often misinterpreted as metastasis
Benign
Along with bile duct adenoma
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6
Q

Liver cell adenoma more common in

A

Women

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7
Q

Liver cell adenoma associated with

A

Contraceptive use (this subtype is the least likely to turn malignant)

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8
Q

FNH Similar features to

A

Cirrhosis

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9
Q

FNH presentation

A

Tumour like malformation
Central scar
Can become very large
More common in women

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10
Q

HCC epi

A
  • Most common primary malignant tumour
  • More common in men
  • 5th most common malignancy in men worldwide
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11
Q

HCC causes

A
  • Cirrhosis
  • Hep B/C
  • ASH/NASH
  • Autoimmune hepatitis, chronic biliary disease
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12
Q

HCC least common causes

A
  • Haemochromatosis
  • A1AT-defiency
  • Wilson’s disease
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13
Q

Diagnostic test

A

Alpha-feto protein (large increase) (seen in more than 50% of HCC or testicular)

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14
Q

Fibrolamellar HCC

A

Occurs in younger people
No background cirrhosis
Better Prognosis

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15
Q

Hepatoblastoma occurs in

A

Children under 5 years

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16
Q

Hepatoblastoma epi

A

Most frequent liver tumour in children

Most are male

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17
Q

Hepatoblastoma Diagnosis

A

AFP often raised

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18
Q

Hepatoblastoma Appearance

A

Lobulated

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19
Q

Hepatoblastoma Prognosis

A

Good

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20
Q

Hepatoblastoma Histological

A

Different histological variants

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21
Q

Angiosarcoma epi

A

Rare but most common sarcoma of liver

Most common in men

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22
Q

Angiosarcoma causes

A

Thorotrast
Arsenic
Anabolic steroids
Vinyl chloride

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23
Q

Angiosarcoma prognosis

A

Poor

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24
Q

Cholangiocarcinoma prognosis

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A

Often aggressive with poor prognosis

25
Cholangiocarcinoma associated with
Chronic inflammation of bile ducts (PSC, parasites, pyogenic cholangitis)
26
Metastasis: epi
Most common malignant tumour in the liver | Common primary sites: colon, upper GI,lung, heart
27
Medical | Types
1. Viral hepatitis 2. Alcoholic/non-alcoholic fatty liver disease 3. Autoimmune hepatitis 4. Chronic biliary disease (PSC/PBC) 5. Drug induced liver injury 6. Inherited disorders (Wilson’s. haemochromatosis, A1At-defiency)
28
Hep A
* No carrier state * Faeco-oral transmission * Course can be mild, cholestatic or lead to liver failure * Just acute * Vaccine available
29
Hep B
* Transmission via bodily fluids * Acute and chronic disease * High prevalence worldwide * Can lead to cirrhosis and HCC
30
Hep C
* Usually associated with chronic state * Blood transmission * Often leads to cirrhosis and can lead to HCC
31
Delta virues
* Super/co-infection in pre-existing hepatitis B | * Can lead to fulminant hepatitis
32
Hep E
Hep E
33
(Non-) alcoholic fatty liver disease → causes
``` Alcohol excess Obesity Diabetes Drugs Many more ```
34
(Non-) alcoholic fatty liver disease → can lead to
Fibrosis/cirrhosis
35
(Non-) alcoholic fatty liver disease → can lead to epi
Very common in the western world | High burden on health services
36
Autoimmune hepatitis →blood tests
High ALT High IgG ANA +
37
Autoimmune hepatitis → presentation
Acutely but usually chronic disease
38
Autoimmune hepatitis → can lead to
Cirrhosis
39
Autoimmune hepatitis →treated with
Steroids or immunosupression
40
Primary sclerosing cholangitis | Epi
Often present in young/middle aged males
41
Primary sclerosing cholangitis | Common in
Patients with UC
42
Primary sclerosing cholangitis | Appearance
Typical appearance in biliary tree imaging
43
Primary sclerosing cholangitis | Path
Progressive inflammation and fibrosis of large intra and extra hepatic bile ducts
44
Primary sclerosing cholangitis | Can lead to and increased risk of
Secondary biliary cirrhosis and increased risk of CC
45
Primary sclerosing cholangitis | Tests
AMA negative Well recognised in children p-ANCA+
46
Primary biliary cirrhosis: | Epi
Middle aged females
47
Primary biliary cirrhosis: | Tests
AMA + IgM+ Alk phos raised
48
Primary biliary cirrhosis: | Can lead to
Cirrhosis
49
Drug induced liver injury: | Note
• Any histological picture can b caused by drugs, some are dose dependent some are not. Hugely variable
50
Wilson’s disease | Definition
Autosomal recessive mutation on chromosome 13 | Abberant storage of copper in many organs including the liver
51
Wilson’s disease | Leads to
Liver failure amongst other symptoms
52
Wilson’s disease | Presents in
Often presents in childhood
53
Haemochromatosis: | Definition
Autosomal recessive mutation of HFE gene on chromosome 6
54
Haemochromatosis: | Leads to
Increased iron absorption and storage in the liver
55
Haemochromatosis: | Increased risk of
HCC
56
Alpha – 1 – antitrypsin defiency: mutation
In the A1AT gene on chromosome 14
57
Alpha – 1 – antitrypsin defiency: | Path
Abnormal protein leads to accumulation in the liver
58
Alpha – 1 – antitrypsin defiency: | Increased risk of
HCC
59
Cirrhosis:
irreversible destruction of the liver architecture associated with fibrosis and nodule formation which may follow necrosis

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