1 / 61

Biliary diseases Vascular diseases Parasites Tumors Liver transplantation

Liver Pathology 4:. Biliary diseases Vascular diseases Parasites Tumors Liver transplantation. Causes of Large Bile Duct Obstruction. Extrahepatic Biliary Atresia (EHBA). Reovirus 3 Rotavirus Immune targeting?. Loop of small intestine. Kasai Hepatic Portoenterostomy. EHBA Rx.

nixie
Download Presentation

Biliary diseases Vascular diseases Parasites Tumors Liver transplantation

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Liver Pathology 4: • Biliary diseases • Vascular diseases • Parasites • Tumors • Liver transplantation

  2. Causes of Large Bile Duct Obstruction

  3. Extrahepatic Biliary Atresia (EHBA) • Reovirus 3 • Rotavirus • Immune • targeting?

  4. Loop of small intestine Kasai Hepatic Portoenterostomy EHBA Rx Liver Transplantation

  5. Primary Sclerosing Cholangitis (PSC) ERCP: endoscopic retrograde cholangiopancreatography

  6. , fewer Crohn’s

  7. Primary Biliary Cirrhosis (PBC) Guys’ Hospital Report London, 1851 Addison & Gull Mrs. Elizabeth Peacock

  8. PBC: Primary biliary cirrhosis---- Chronic nonsuppurative destructive cholangitis • middle-aged women • + AMA (anti-mitochondrial • antibodies); M2 subtype • Alkaline Phosphatase • IgM • AMA directed against inner • mitochondrial membrane • PDC-E2 (pyruvate dehydrogenase • complex-E2) PDC-E2 Molecular Mimicry? Gram – bacteria HLA II • Assoc. with other autoimmune • dis: e.g. RA, sicca, celiac, scleroderma bile duct T T AMA florid bile duct lesion T

  9. Vascular Disease & • the Liver • Veins • Sinusoids • Arteries • Liver is often involved in heart disease or other outflow problems • (“hepatic venous • outflow obstruction”)

  10. Budd-Chiari Syndrome (Hepatic venous outflow obstruction) • oral contraceptives • coagulopathy (prot. S, C, • factor V Leiden def., • anti-cardiolipin Ab’s • tumor invasion of hep. V’s • or IVC: renal cell CA + HCC • small vein disease: VOD ascites

  11. Peliosis hepatis: blood lakes of the liver -HIV, C17-alkylated steroids (OC’s, anabolic steroids; systemic inflamm.

  12. Infarct: Arterial disease (PAN, ligation, chemoRx installation) Portal vein: Zahn infarct

  13. P.V. Pylephlebitis: -perforated ulcer, -ruptured appendix, etc.

  14. Schistosomiasis: Pre-sinusoidal, intrahepatic portal hypertension (Symmers’ “clay pipestem fibrosis”)

  15. pancreas

  16. LIVER-CELL ADENOMA -oral contraceptives -hepatocyte nuclear factor 1α (HNF-1α) mutations -benign hepatocytes, bld vessels, NO b.d.’s

  17. FOCAL NODULAR HYPERPLASIA (FNH) -malformation: central scar with artery, outgrowth of cirrhosis-like mass

  18. HCC • 75% of pts have cirrhosis • 75% are serum AFP + • Risks: Cirrhosis due to HBV, HCV, alcohol, hemochromatosis • Invades veins: portal vein/hepatic vein/IVC-to lungs

More Related