Hypoxämische Lebernekrosen1. Läppchenzentrale Nekrosen: Eosinrote, kernlose nekrotische Hepatozyten 2. Normales Lebergewebe: In der Umgebung der Portalfelder sind die Leberzellen regelrecht 3. Intermediäre Verfettung: Zwischen ...
Chronische Blutstauung der LeberÄtiologie:- Chronische Insuffizienz der rechten Herzkammerwand- Budd-Chiari-Syndrom (Hindernis zwischen Leber und rechter Vorhof)- Pericarditis constrictiva 1. Läppchenzentrale Erythrozytenvermehrung: ...
Non-alcoholic steatohepatitisSpectrum: Steatosis ↔ Steatohepatitis (NASH) → Fibrose → Zirrhose Etiology:- Individuals with metabolic syndrome (3 of the following 5: obesity, hypertension, diabetes, hypertriglyceridemia, hyperlipidemia)- ...
Alcoholic liver diseaseLeading cause of liver disease in Western nations.Increase in NADH/NAD+ ratio causes ↑ fat production.ROS react with proteins and DNA → cell damage. Alcoholic fatty liver (reversible):- Mostly asymptomatic- ...
Fettleberhepatitis (Steatohepatitis)1. Grosstropfige Leberzellverfettung: Zytoplasmavakuolen, die den Kern zur Peripherie verdrängen 2. Hydropische Schwellung der Hepatozyten: Vorwiegend die läppchenzentralen Hepatozyten sind geschwollen ...
Portale Leberzirrhose1. Pseudolobuli: Regeneratknoten, die keine oder exzentrische Zentralvenen einschliessen 2. Septen: Kollagenfaserreiche Bindegewebsstreifen, die die Portalfelder untereinander oder mit der Zentralvene ...
CirrhosisCondition caused by chronic damage to the liver. Etiology:- Hepatotoxicity→ Long-standing alcohol abuse (one of the most common causes of chronic liver disease in the USA)→ Medications (e.g., acetaminophen, ...
CholestaseIntra- und/oder extrazelluläre Ablagerung von Galle.- Das morphologische Korrelat eines Ikterus (Bilirubinkonzentration >20 mg/dl) 1. Gallepigment: v.a. läppchenzentral. Gallenthromben sind rundliche, ...
Akute VirushepatitisViren:Hepatitis A-E, EBV, CMV, Gelbfieber, Coxsackie, Herpes, verschiedene Formen des hämorrhagischen Fiebers 1. Leberzelldegeneration: Nekrotische Hepatozyten werden als Councilman-Körper bezeichnet. ...
Autoimmune hepatitis- Most often in young women- Associated with HLA-DR3 and DR4, Hashimoto's thyroiditis, Grave's disease Symptoms:Nonspecific symptoms: Fatigue, abdominal pain, weight loss- Signs of acute liver failure ...
Primary biliary cholangitisChronic progressive liver disease of autoimmune origin that is characterized by destruction of the intralobular bile ducts. - Associated with autoimmune hepatitis and Sjögren's syndrome- F: M = 9:1 ...
Primär-biliäre ZirrhoseStadium I: Gallengangsläsion in den Portalfeldern Stadium II: Proliferation der Ductuli Stadium III: Faservermehrung mit septaler Narbenbildung- Schwund der Gallengänge (vanishing bile duct) Stadium ...
HemochromatosisUnusually high absorption of iron (4 mg/day; normal = 1 mg/day). - Age ~50 years (slighly later in women) Types:- Primary (hereditary) hemochromatosis: Genemutation in HFE on chromosome 6 → C282Y ...
EisenüberladungFrage an Pathologie:- Bestätigung einer Eisenüberlatung (Genotyp vs. Phänotyp)- Ausmass der Eisenüberladung und Fibrose- Behandlungseffekte Eisenpigment: Grobkörniges, intrazytoplasmatisches Pigment ...
Alpha-1 antitrypsin deficiencyMode of inheritance: autosomal codominant.- Gene is called SERPINA1 on chromosome 14. - Normal is M (50%)/M (50%); PiMM = 100% function→ S Mutation → 25% function; PiSS = 50% function→ Z Mutation ...
Morbus WilsonNormal consumption of copper: 1-2 mg/day. Extra is excreted in bile (90%) and urine. Genetic defect in autosomal recessive ATP7B transport protein (chromosome 13) that results in the excess copper being ...
Malignant hepatic tumorsMetastatic liver disease- Most common malignant lesion of the liver- Primary tumor site: gastrointestinal tract (colon, stomach, pancreas), lungs, and breasts Intrahepatic cholangiocellular carcinoma ...
Benign liver tumors1. Cavernous hemangioma- Most common- Mass of blood vessels- Usually <1.5 cm, asymptomatic- If large → rupture & intraperitoneal bleeding- Diagnosis: US, CT scan, MRI 2. Focal nodular hyperplasia (FNH)- ...
ZirrhoseMikronoduläre Leberzirrhose:- 1-3 mm grose Parenchymregeneratknoten- Chronische Hepatitis B oder C, alkoholbedingte Fettleberhepatitis Makronoduläre Leberzirrhose:- Regeneratknoten >3 mm gross- Wenn ...
Budd-Chiari syndromeEtiology:- Secondary to conditions associated with hypercoagulability (most common):→ Polycythemia vera (most important cause) → Paraneoplastic thrombocytosis→ Pregnancy→ Clotting disorders (e.g., ...
CholestasisAny condition affecting bile formation or secretion (nonobstructive intrahepatic cholestasis), or leading to biliary obstruction. Etiology:- Inherited disorders: Dubin-Johnson syndrome, Rotor's syndrome- ...
Primary sclerosing cholangitisProgressive chronic inflammation of both the intrahepatic and extrahepatic bileducts.- M > F- ∼90% of PSC patients have IBD (from these patients, 87% have ulcerative colitis and 13% have Crohn's disease) ...
Hepatocellular carcinomaMalignant, most often solitary tumor of the liver. Etiology:- Liver cirrhosis (80% of cases)- Risk factors independent of cirrhosis: → Chronic hepatitis B or C virus infection→ Nonalcoholic steatohepatitis ...
EchinococcosisParasitic disease caused by small tapeworms of the genus Echinococcus.- Echinococcus granulosus causes cystic echinococcosis.- Echinococcus multilocularis causes alveolar echinococcosis. - Definitive ...
Liver tissue architectureZone I – periportal zone:- Viral hepatitis- Toxins (eg, cocaine) Zone II – intermediate zone:- Yellow fever Zone III – pericentral vein (centrilobular) zone:- Affected 1st by ischemia- High concentration ...
CholangiocarcinomaRisk factors:- Chronic inflammation of the gallbladder, bile ducts, or liver→ Chronic cholangitis, especially primary sclerosing cholangitis (most common risk factor)→ Chronic liver disease- Congenital ...