XVI - The Liver, Gallbladder and Biliary Tree Flashcards Preview

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Flashcards in XVI - The Liver, Gallbladder and Biliary Tree Deck (153)
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1

Marked cell enlargement with irregularly clumped cytoplasm showing large, clear space

Ballooning degeneration (TOPNOTCH) Robbins Basic Pathology, 8th ed,. 633

2

Multiple tiny fat droplets that do not displace the nucleus which appear in such conditions as alcoholic liver disease, Reye syndrome, and acute fatty liver of pregnancy.

Microvesicular steatosis Robbins Basic Pathology, 8th ed, p. 633

3

A single large fat droplet that displaces the nucleus seen in alcoholic liver disease or in the livers of obese or diabetic individuals.

Macrovesicular steatosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 633

4

Diffuse, foamy, swollen appearance to the hepatocyte caused by retained biliary material.

Feathery degeneration(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 633

5

Poorly stained mummified hepatocytes

Coagulative necrosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 633

6

Isolated hepatocytes become shrunken, pyknotic, and intensely eosinophilic.

Apoptosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 633

7

Hepatocyte necrosis is distributed immediately around the central vein, extending into the midzonal area in the setting of ischemia and several drug and toxic reactions.

Centrilobular necrosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 633

8

A pattern of nonrhythmic, rapid extension-flexion movements of the head and extremities, best seen when the arms are held in extension with dorsiflexed wrists, seen in patients with hepatic encephalopathy.

Asterixis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 635

9

A diffuse process characterized by bridging fibrous septa, in the form of delicate bands or broad scars around multiple adjacent lobes, and the conversion of normal liver architecture into structurally abnormal nodules, encircled by fibrotic bands. Liver architecture is disrupted.

Liver Cirrhosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 635

10

Presence of ground-glass hepatocytes, a finely granular, eosinophilic cytoplasm and sanded nuclei, shown by electron microscopy

Hepatitis B infection(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 645

11

Necrotic cells appear to have dropped out with collapse of the sinusoidal collagen reticulin framework where the cells have disappeared; scavenger macrophage aggregates mark sites of dropout.

Hepatocyte cytolysis (in viral hepatitis)(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 647

12

Hepatocytes shrink, become intensely eosinophilic, and have fragmented nuclei; effector T cells may be present in the immediate vicinity.

Hepatocyte apoptosis (in viral hepatitis)(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 647

13

The hallmark of serious liver damage

Fibrosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 647

14

May occur as solitary or multiple lesions, ranging from millimeters to massive lesions, many centimeters in diameter. They are generally produced by gram-negative bacteria such as Escherichia coli and Klebsiella sp.

Pyogenic (bacterial) hepatic abscesses (TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 648

15

Liver is enlarged, soft, yellow and greasy. Lipid accumulates to the point of creating large clear macrovesicular globules, compressing and displacing the nucleus to the periphery of the hepatocyte.

Hepatic Steatosis (Fatty Liver)(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 649

16

Eosinophilic, cytoplasmic inclusions characteristic of alcoholic hepatitis.

Mallory bodies(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 650

17

Almost always accompanied by a brisk sinusoidal and perivenular fibrosis; occasionally periportal fibrosis may predominate.

Alcoholic hepatitis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 650

18

Liver is yellow-tan, fatty, and enlarged, usually weighing over 2 kg. Over the span of years it is transformed into a brown, shrunken, nonfatty organ, sometimes weighing less than 1 kg.

Alcoholic Cirrhosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 650

19

Pattern of cirrhosis in viral hepatitis.

Macronodular(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 650

20

Pattern of cirrhosis in alcoholic hepatitis.

Micronodular(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 650

21

The liver may shrink to 500 to 700 gm and become transformed into a limp, red organ covered by a wrinkled, overly large capsule. Necrotic areas have a muddy red, mushy appearance with blotchy bile staining. Complete destruction of hepatocytes in contiguous lobules leaves only a collapsed reticulin framework and preserved portal tracts.

Massive hepatic necrosis(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 653

22

Golden-yellow granules in the cytoplasm of periportal hepatocytes, which stain blue with the Prussian blue stain.

Hemosiderin(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 655

23

Green to brown deposits of copper in Descemet membrane in the limbus of the cornea.

Kayser-Fleischer rings (TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 656

24

Excessive copper deposition in the liver causing hepatic changes ranging from mild fatty change to massive liver necrosis. In the brain, injury affects the basal ganglia, demonstrating atrophy and cavitation. Kayser-Fleischer rings are characteristic.

Wilson disease(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 655

25

Hepatocytes with round to oval cytoplasmic globular inclusions which are strongly positive in a periodic acid-Schiff stain. By electron microscopy they lie within smooth, and sometimes rough, endoplasmic reticulum.

Alpha-1 antitrypsin Deficiency(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 657

26

A rare disease characterized by microvesicular fatty change in the liver and encephalopathy. Microscopy of hepatocellular mitochondria reveals pleomorphic enlargement and electron lucency of the matrices, with disruption of cristae and loss of dense bodies.

Reye syndrome / "mitochondrial hepatopathies" (TOPNOTCH)Robbins Basic Pathology, 8th ed, p658

27

A chronic, progressive, and often fatal cholestatic liver disease, characterized by a nonsuppurative destruction of small and medium-sized intrahepatic bile ducts florid duct leesion. On cut surface, the liver is hard, with a finely granular appearance, with extraordinary yellow-green pigmentation.

Primary biliary cirrhosis (TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 659

28

A chronic cholestatic disorder, characterized by progressive fibrosis and destruction of extrahepatic and large intrahepatic bile ducts. Affected portal tracts show concentric periductal onion-skin fibrosis and a modest lymphocytic infiltrate. Progressive atrophy of the bile duct epithelium leads to obliteration of the lumen, leaving behind a solid, cordlike fibrous scar.

Primary sclerosing cholangitis (TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 660

29

Liver is slightly enlarged, tense, and cyanotic, with rounded edges. Microscopically, there is congestion of centrilobular sinusoids. With time, centrilobular hepatocytes become atrophic, resulting in markedly attenuated liver cell cords. Liver fibrosis mostly "centrilobular".

Passive congestion of the liver secondary to right-sided heart failure.(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 660

30

Hepatocytes in the central region of the lobule undergo ischemic necrosis. The liver takes on a variegated mottled appearance, reflecting hemorrhage and necrosis in the centrilobular regions, alternating with pale midzonal areas, known traditionally as the "nutmeg" liver.

Passive congestion of the liver secondary to left-sided heart failure.(TOPNOTCH)Robbins Basic Pathology, 8th ed, p. 661