-
What is this stain? What is it testing (what's the pink)? What is significant about there being more pink around the central vein that portal area?
- 1. PAS-stain to show presence of glycogen
- 2. Here it shows the distributionof glycogen contents: glycogen is more densely concentrated around central vein
- 3. Sinusoidal blood travels from periphery to central vein, glycogen is first stored (fed state) and used (fasting state) from hepatocytes around portal area
- 4. Also note: cells in the periphery near the portal area (zone 1) are more vulnerable to toxins while cells near the central vein (zone 3) are more vulnerable to hypoxia
-
What is this? What causes it?
- Fatty Liver: most common cause due to alocholism (obesity and DM also contribute)
- 1. Notice the uniform color change due to excessive lipid accumulation in the hepatocytes
- 2. Histo view showing lipid accumulation in hepatocytic vacuoles. These vascuoles stain red with Oil Red
-
What is this? What are the four arrows indicating?
- Cirrhosis: Ongoing liver damage with liver cell necrosis followed by fibrosis and hepatocyte regeneration, producing a hardened liver with nodular appearance (nodules > 3mm represent macronodular cirrhosis)
- 1. Regenerative nodules consisting of hepatocytes
- 2. Fibrous connective tissue surrounding the regenerative nodules
- 3. Portal tracts are bridged by connective tissue
- 4. Neutrophils are found in collagenous tissue
-
What diesase is this? What do the arrows indicate?
- Cirrhosis: Specifically, this is an example of micronodular cirrhosis (nodules < 3mm); comic finding resulting from chronic alcohol abuse
- 1. Moderate lipid accumlation within hepatocytes (clear zones)
- The remaining arrows point to Mallory's hyaline, a deposition in the hepatocyte cytoplasm that occurs along with necrosis and fatty change it is also called alcoholic hyaline)
- 2. Enlarged, necrotic hepatocyte containing Mallory's hyaline
- 3. nucleus displaced due to presence of lipid droplet in cytoplasm
- 4. Mallory's hyaline is red due to eosinophilic stain
- 5. Enlarged, necrotic hepatocyte containing Mallory's hyaline
- 6. Filamentous Mallory's hyaline
-
What do these images indicate? What are the arrows?
- These are signs of portal hypertension
- Cirrhosis causes restricted blood flow in the liver, increasing pressure transmitted to collateral venous channels. These channels can become highly dilated.
- Top photo: Spider veins or telangiectasia on the abdomen
- Bottom picture: Esophageal varices, a more serious problem that forms when the submucosal veins of the esophagus become dilated
- 1. Varices (blue dilated veings) are seen in the lower esophagus
- 2. A hemorrhage is evident. Varices are easily eroded and can lead to massive GI hemorrhage
-
What is this?
- Hemochromatosis: Liver is dark brown because of extensive iron deposits due to hereditary hemochromatosis (HHC)
- HHC results from mutation in the hemochromatosis gene (HFE) that leads to increased iron absorption from the gut
- Bottom picture: Prussian blue stain for iron revealing extensive deposits of hemosiderin in hepatocytes; note that you can also see evidence of cirrhosis. Excessive iron deposition most severely affects heart (CGF), pancreas (DM), liver (cirrhosis and failure), and joints (arthritis)
-
What disease is this?
Hemochromatosis: Prussian stain blue shows hepatocytes are filled with blue iron granules; this is an early stage before parenchymal damage and fibrosis develop
-
What is this? What causes it?
- Cholestasis: Yellowish-green accumulations of bile pigments are seen here. This results in hepatocyte damage.
- Cholestasis is blockage of bile flow from the liver to the duodenum and is most often due to a biliary tract obstruction (i.e. gallstones or primary biliary cirrhosis).
- In some cases, bile may also accumulate because of other types of hepatocyte injury like liver cirrhosis
-
What is this? What disease often results in it? In the US, what is the most common cause? Worldwide, what is the most common cause? What are the arrows?
- Hepatocellular Carcinoma
- Often arise as a result of cirrhosis
- US: most common cause is chronic alcoholism
- Worldwide: Most common cuase is viral hepatitis
- 1. Neoplasm is large, bulky, and has greenish color because it contains bile
- 2. You can also see smaller, light colored satellite tumors
|
|
