Histopathology Liver disease Flashcards Preview

Cardio > Histopathology Liver disease > Flashcards

Flashcards in Histopathology Liver disease Deck (59):
1

Benign types


Haemangioma
Liver cell adenoma
Blie duct malformations
Focal nodular hyperplasia

2

Malignant

HCC
Cholangiocarcinoma
Angioarcoma heptaoblastoma
Lymphoma
Metastasis

3

Haemangioma description

Most common benign vascular tumour

4

Haemangioma detection

Incidental pick up and rarely rupture

5

Bile duct malformation epi

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

6

Liver cell adenoma more common in

Women

7

Liver cell adenoma associated with

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

8

FNH Similar features to

Cirrhosis

9

FNH presentation

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

10

HCC epi

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

11

HCC causes

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

12

HCC least common causes

• Haemochromatosis
• A1AT-defiency
• Wilson’s disease

13

Diagnostic test

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

14

Fibrolamellar HCC

Occurs in younger people
No background cirrhosis
Better Prognosis

15

Hepatoblastoma occurs in

Children under 5 years

16

Hepatoblastoma epi

Most frequent liver tumour in children
Most are male

17

Hepatoblastoma Diagnosis

AFP often raised

18

Hepatoblastoma Appearance

Lobulated

19

Hepatoblastoma Prognosis

Good

20

Hepatoblastoma Histological

Different histological variants

21

Angiosarcoma epi

Rare but most common sarcoma of liver
Most common in men

22

Angiosarcoma causes

Thorotrast
Arsenic
Anabolic steroids
Vinyl chloride

23

Angiosarcoma prognosis

Poor

24

Cholangiocarcinoma prognosis

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

Decks in Cardio Class (108):