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BSG Pathology Section Liver Slide Seminar, Birmingham, March 12 2008

BSG Pathology Section Liver Slide Seminar, Birmingham, March 12 2008 Clinical Summaries - Stefan Hübscher Prof. Stefan Hubscher Case 1 Male, age 52. Recent onset of jaundice and abnormal LFTs. AST 793 (normal 5-43), ALP 655 (70-330), bilirubin 172 (1-22).

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BSG Pathology Section Liver Slide Seminar, Birmingham, March 12 2008

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  1. BSG Pathology Section Liver Slide Seminar, Birmingham, March 12 2008 Clinical Summaries - Stefan Hübscher Prof. Stefan Hubscher Case 1 Male, age 52. Recent onset of jaundice and abnormal LFTs. AST 793 (normal 5-43), ALP 655 (70-330), bilirubin 172 (1-22). ANA positive (1:100), SMA positive, IgG 19.5 (normal 6-16). Liver biopsy.

  2. Case 2 • Female, age 54 • Potential donor liver retrieved from another centre in the UK • Died from subarachnoid haemorrhage. No history of alcohol. • Liver not used because of macroscopic appearance - generally fatty, atrophy of segment 5 in right lobe • Wedge biopsies taken from left lobe, segment 5 and segment 6. Slide submitted is from left lobe biopsy.

  3. Dr Judy Wyatt • Case 3 • Female, age 3 • Developed ALL age 2½. • Presented with acute veno-occlusive disease during 6TG treatment which settled with supportive treatment. Changed to 6MP. • 1 year later, presented with haematemesis, due to bleeding oesophageal varicies. • One year after that developed respiratory failure, requiring continuous oxygen. • Diagnosis – hepatopulmonary syndrome. Liver transplant performed. • Liver 520g, nodules up to 11mm.

  4. Case 4 • Male, age 48. Presented 2 years earlier with bleeding oesophageal varices. • Diabetes 20 years, recently become insulin dependent. BMI 33. • Liver transplant for cryptogenic cirrhosis.

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  6. Prof Alastair Burt • Case 5 • Male, age 18. • Cystic fibrosis, recurrent chest infection. Developed bleeding oesophageal varices. Some deterioration of general synthetic function. • Underwent combined lung/liver transplantation – block from explant.

  7. Case 6 • Male, age 55 • History of highgrade B cell non-Hodgkin’s lymphoma, treated with several rounds of chemotherapy. Liver function tests abnormal - underwent laparoscopic biopsy (large wedge specimen). • Clinical diagnosis = hepatic involvement by lymphoma.

  8. The end

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