Liver Pathology III Flashcards Preview

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Flashcards in Liver Pathology III Deck (33):
1

Budd-Chiari Syndrome

Hepatic vein obstruction or thrombosis leading to ascites/hepatomegaly/abdominal pain/jaundice

2

What are some of the possible causes of Budd-Chiari syndrome?

– Primary myeloproliferative disorders
– Inherited disorders of coagulation
– Antiphospholipid syndrome
– Paroxysmal nocturnal hemoglobinuria
– Intra-abdominal cancers
– Oral Contraceptives

3

What are some pathological findings with Budd-Chiari syndrome?

- Liver will be engorged with blood
- Centrilobar congestion around the central vein

4

What are some risks for sinusoidal obstructive syndrome?

- Bone marrow transplant
- Chemotherapy patients
- Azathioprine

5

Sinusoidal Obstructive Syndrome (AKA Veno-occlusive Disease)

Toxic injury to the sinusoidal endothelium with resulting fibrotic occlusion of small hepatic veins - prognosis is VERY poor

6

What are the clinical manifestations of sinusoidal obstructive syndrome?

Acute RUQ tenderness, hepatomegaly, ascites, weight gain, and jaundice

7

Acute Fatty Liver of Pregnancy

Sudden catastrophic illness occurring exclusively in the 3rd trimester - high mortality rate
• Microvesicular fatty infiltration

8

Focal Nodular Hyperplasia

Solitary nodule that is well demarcated with a central stellate scar found classically in young women

9

What is the malignant potential of focal nodular hyperplasia?

NO malignant potential

10

Nodular Regenerative Hyperplasia

Can be partial or diffuse transformation of the hepatic
parenchyma into small regenerative nodules in the
absence of fibrosis leading to NON-cirrhotic portal HTN

11

What is the liver function like in nodular regenerative hyperplasia?

Normal

12

Who is hepatic adenoma commonly found in?

Young women

13

Hepatic Adenoma

Associated with hormones and oral contraceptives and pregnancy
• Usually solitary lesions
• Cords of normal hepatocytes with absent portal tracts

14

What is hepatic adenoma associated with?

Glycogen storage diseases

15

Hemangioma

Most common benign tumor with red-blue nodules of vascular channels and fibrosis tissue

16

Angiosarcoma

Most common primary sarcoma of the liver
• Malignant vascular tumor

17

What is angiosarcoma of liver associated to exposure to?

Associated with exposure to vinyl chloride, arsenic

18

Hepatoblastoma

Most common malignant tumor of childhood and is found in males more than females

19

What is an elevated marker for hepatoblastoma?

Alpha-fetoprotein

20

What will be seen on histology of hepatoblastomas?

Fetal and embryonic hepatocytes

21

Risk factors for hepatocellular carcinoma includes all EXCEPT:

• Hepatitis C
• Alcoholic liver disease
• Hemochromatosis
• Aflatoxin
• Herpes virus

• Herpes virus

22

What are some risk factors for Hepatocellular Carcinoma?

• Cirrhosis (of any cause) – NASH
– Alcohol
– Hepatitis C
– Hemochromatosis
• Chronic Hepatitis B
• NASH – cases reported in advanced fibrosis
• Food contaminants: Aflatoxin (Africa)
• Hereditary Tyrosinemia (Highest risk – 40%)

23

What are the features of HCC?

Single lesion that is diffusely infiltrative and can range from well to poor differentiation - there are vague clinical symptoms though

24

Fibrolamellar HCC Variant

Usually found in a younger female and is NOT related to cirrhosis of HBV - with areas of dense collagenous fibrosis and polygonal tumor cells

25

What is the prognosis for fibrolamellar HCC?

Better than HCC

26

Which of the following statement about hepatic adenoma is CORRECT?

1. More common in males
2. Contains a central stellate scar
3. Associated with cirrhotic liver
4. Growth is estrogen sensitive
5. High rate of malignant transformation

4. Growth is estrogen sensitive

27

Cholangiocarcinoma

Malignancy of bile ducts (in or out of the liver) - poor prognosis

28

Where do the cholangiocarcinomas generally occur?

90% are extra hepatic with most of these being perihilar

29

What are some risk factors for cholangiocarcinoma?

• Primary sclerosing cholangitis
• Congenital fibropolycystic disease of the biliary system
– Caroli’s Disease
• Cirrhosis

30

What type of cancer are cholangiosarcomas generally?

Adenocarcinomas

31

Klaskin Tumor

Perihilar/hilar extrahepatic tumor at the junction of the L and R hepatic ducts

32

What are the most common metastatic cancers to the liver in adults?

Breast and colon

33

What are the most common metastatic cancers to the liver in children?

Neuroblastoma, Wilm's tumor and rhabdomyosarcoma

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