Section 1
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Primary biliary cholangitis destroyed intrahepatic bile ducts by autoimmune Dx: Antimitochondrial antibodies Inflamm. bile ducts Turns into cirrhosis Lots of Plasma cells
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Last updated
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Date created
Mar 14, 2020
Cards (68)
Section 1
(50 cards)
Primary biliary cholangitis destroyed intrahepatic bile ducts by autoimmune Dx: Antimitochondrial antibodies Inflamm. bile ducts Turns into cirrhosis Lots of Plasma cells
Cholangiocarcinoma Adenocarcinoma from bile ducts Common in SE Asia from liver fluke Common site is extrahepatic ducts of liver hilum (Klatskin tumor) Poor prognosis
In Hemochromatosis, the original Histo is pink with Brown spots (Hemosiderin) and with the Prussian Blue stain, the Hemosiderin turns Blue. A Blue slide with brown still on the slide is clearly Wilson's Disease
How to decipher brown spots on Histology?
Adenocarcinoma of Gallbladder High risk: stones in cholecystitis Infiltrative glands
Tropical Sprue From a GI bug, presents just like Celiac Antibiotic therapy
Histology of NO villous and lymphocytes in the eputhelium after a GI bug infection
Acute Hepatitis Pink dots- dead hepatocytes (acidophilic bodies) Blue dots- lymphocytes Cells are big and swollen Inflammation in portal area(Know this area by finding the bile duct)
Diffuse B cell lymphoma Rapidly aggressive/fatal Respond well to chemotherapy Fleshy-looking tumor upon gross examination
Hepatic angiosarcoma comes with exposure to vinyl chloride, arsenic, or thorotrast Latent for years BAD prognosis, dead less than 1 year Malignant endothelial lining of blood/lymph vessels
fulminant hepatitis RARE Red area- necrosis Most common reason from drug OD -acetaminophen Poor prognosis with no liver transplant Globs are residual live liver cells
Celiac Disease Reaction from gluten causes villous atrophy, no absorption by loss of SA Tx: Gluten-free diet
Histology of NO villus and lymphocytes in the epithelium
Autoimmune hepatitis Cells with pushed nuclei (Plasma cells) Antibodies present Leads to cirrhosis Therapy Immunosuppression
acute cholecystitis Due to stones by obstruction/high pressure leads to ischemia Chronic will have thickened wall from fibrosis Cause pancreatic obstruction in ampulla
Bile duct hamartoma Many nodules in the liver, flat simple bile ducts NO atypia, dysplasia, complexity Overgrowth of bile ducts- painless
Steatohepatitis NEUTROPHIL inflammation in portal (only liver disease with this trait) MALLORY BODIES (pink worm-like, damaged intermediate filaments in hepatocytes) Main cause is alcohol and obesity
Hepatoblastoma Mostly in infants Most common liver tumor in kids Immature blue small embryonal/mesenchymal cells Responsive to chemotherapy and complete resection, (poor Px w/out) Survival 80%
Budd-Chiari syndrome Thrombosis of hepatic veins Surgically remove clot Blood backs up in liver and causes congestion/necrosis
Focal nodular hyperplasia BENIGN Central scar of fibrosis on Histo- stellar scar on Gross Looks like a liver mass CANT Dx by needle biopsy- will look like anything Common in 20-50 y.o.
Pancreatic Ductal Adenocarcinoma Tumor from dysplastic pancreatic duct From smoking, Peutz Jeghers Fleshy necrotic mass
Primary sclerosing cholangitis Destroys intr/extrahepatic ducts 70% associated with UC Rimming of bile ducts with fibroblasts
Intraductal papillary mucinous neoplasm High grade, rise to cancer Nucelar pleomorphism with stratified
Gastrointestinal Stromal Tumor Stained with CD 117 (express tyrosine kinase-cKit) Spindle-celled cells Most common sarcoma of colon Features: size/ mitotic activity Responds to Imtatinib- Gleevac (tyrosine kinase inh.)
Cholelithiasis Cholesterol stones (left) most likely in- female, fat, forty, fertile Bilirubin stones (right) black from hemolytic disorder like an infection or intestinal bypass
Chronic hepatitis Cant see where the portal tract starts/ends Fibrotic bridges Little bile ducts On its way to becoming cirrhosis Hep C is most common cause
Gastric Marginal Zone Lymphoma Stained with CD 20 (All B cells) small cells upon Histology Infiltrate glands Germinal Centers, Associated with H.pylori infection
Hepatocellular carcinoma Not all lead to cirrhosis Malignant, too thick cords on Histo Histo has some spots of bile
Hepatic adenoma THIN chords of sinusoids Benign tumor, but can still rupture and kill rarely common with women using oral contraceptives Rarely transforms into hepatocellular carcinoma
Wilson's disease Mutation in ATP7B gene, AR Copper wont stay in its carrier (Ceruloplasmin) and spills in the blood Toxic levels in liver, brain, eyes (Kayser-Fleisher)
Blue Slide with BROWN pigments
chronic pancreatitis Psuedocysts with no lining- ALL FIBROSIS, causes malabsorption and DM from loss islet cells Stimulated by obesity and alcohol
Acute pancreatitis digestion of pancreas from digestive enzymes hemorrhage, acute inflm., fat necrosis from lipase, caused by obstruction and acinar cell injury
Carcinoid Tumor Metastasis to the Liver (Carcinoid Syndrome) Sx: FLUSHING diarrhea, HTN, seen in metastti diseases Dx: 5HIA (Serotonin) Chromagranin A) Low grade, slow growth
Cirrhosis Dx: diffuse fibrosis and 2 regenerative nodules Trichome stain can be used End stage disease
Appendiceal Carcinoid (3) Most common appendiceal tumor NOT METASTATIC CAN CAUSE APPENDICIITIS Common in tip
FAP (familial adenomatous polyposis) 100x polyps in the colon Only treatment for everyone: colorectomy regardless of age Can spread in colon Due to defective APC gene
Fibrolamellar variant of hepatocellular carcinoma Young people Surgical cure rate 50% LARGE eosinophilic cels in bands of collagen
Poorly differentiated Adenocarcinoma Poor prognosis WORSE PROGNOSIS THAN COLON CANCER
Pancreatic serous cystadenoma benign lots of cysts, flat clear epithelium common in older women multicystic spongy look with many little cysts
Appendiceal MUCINOUS CYSTADENOMA Mucin-filled cells, dysplastic epithelium, benign
Mucinous cystic neoplasm in pancreas Tall columnar epithelium with mucin CANT BIOPSY 1/3 Malignant mostly females Stromal cell stains for estrogen receptors Spindle cell ovarian stroma
Mucinous Adenocarcinoma Over half of extracellular is micin WORSE PROGNOSIS THAN COLON CANCER
Acquired iron overload due to ineffective erythropoiesis/ transfusions (lots of Hemosiderin)
WHATS HEMOSIDEROSIS?? Difference in Hemochromatosis?
Colonic Hyperplastic Adenoma Less than 5mm Serrated-looking cells Goblet Cells Usually in LEFT colon
Alpha-1-antitrypsin deficiency Broken Protease Inhibitor from issue on Chr. 14- inflam. cells outgrow causing liver damage/emphysema Large ball of pink globules, dark with PAS stain
Passive congestion Due to right heart failure Nutmeg liver Central vein with atrophy around it in Histo
Ascites from liver lymph due to broken liver Portal hypertension creates caput medusa periumbilical Spider angiomas on skin
A pt. with dilated stomach...? First thought? Signs to prove you're right?
Pseudomyxoma peritonei Mucin in abdomen Origin at the Appendix Invasion of malignant glands MOST COMMON DUE TO APPENDICEAL MUCINOCYSTADENOCARcINOMA
Secondary biliary cholangitis Prolonged obstruction of extrahepatic duct causing damage inside the liver Anything causing biliary obstruction (stones, tumors, fibrosis, biliary atresia) Green liver High cirrhosis Bile backed up in Histology
Hemochromatosis Iron Overload due to NO Hepcidin- blocks Iron release from interstitial cells so too much Iron absorbed in body Builds up in liver, skin, pancreas AR mutation on Chr. 6 HemoSiderin (Iron Store) deposits in hepatocytes (brown) Usually no inflammation, eventually into cirrhosis Tx: Phlebotomy Prussian Blue Stain to prove pigment has iron in it
Say 6 things!
Sessile Serrated Adenoma Bigger than 1cm., serrated, branched glands, Usually in the right colon, PREMALIGNANT POTENTIAL (DNA MISMATCH REPAIR PATH)
Lymphoma will be LCA + Carcinoma will be cytokeratin +
How to Decipher Lymphoma from a Carcinoma?
Hepatic hemangioma benign Blood vessel tumor Potential to rupture and bleed Blood filled lumen on Histo
Section 2
(18 cards)