Candidiasis
Liver involvement is common Rare in immunocompetent patients Etiology/Pathogenesis • Candida albicans most common Endogenous commensal that is part of normal flora of GI tract, mouth, respiratory tract, vagina • Risk factors…
Drug-Related Granulomatous Hepatitis
Drugs reportedly responsible for up to 30% of hepatic granulomas • Drug-induced hepatic injury can mimic any other form of liver disease Etiology/Pathogenesis • Many types of offending drugs, including over-the-counter and…
Parasitic Infection
Usually protozoan ( Microsporidia, Cryptosporidia ) or helminth (liver fluke, schistosomiasis, ascariasis) Etiology/Pathogenesis • Cryptosporidium species • Trematodes • Nematodes Clinical Issues • Protozoal infection usually seen in context of AIDS (AIDS cholangiopathy) Can…
Autoimmune Pancreatitis
Often associated with elevated serum IgG4 Similar fibroinflammatory process often affects other organs such as bile ducts, salivary glands, retroperitoneum, and lymph nodes • Associated with many other autoimmune diseases; ANA…
Hepatoportal Sclerosis
Form of noncirrhotic portal hypertension Etiology/Pathogenesis • Associated with conditions that cause increased vascular resistance at presinusoidal level Genetic predisposition Chronic exposure to toxins and medications Prothrombotic states Autoimmune disorders Many…
Infectious Pancreatitis
Should be considered in immunocompromised patients with pancreatitis Pancreatic involvement is usually mild in cases of systemic infection • Acute infection of pancreas is usually secondary event Occurs in 40-70% of…
Large Bile Duct Obstruction
Changes on liver biopsy are secondary to obstructive biliary process Usually clinical and radiographic diagnosis – Liver biopsy often unnecessary unless clinical findings/radiographic studies equivocal or misleading Etiology/Pathogenesis • Multifactorial Gallstones, neoplasms/masses,…
Focal Nodular Hyperplasia
Noncirrhotic background liver • Central stellate scar with radiating septa Microscopic • Localized nodular parenchyma with fibrous septa and stellate central scar Septa contain thick-walled vessels and mononuclear inflammatory infiltrate • Ductular reaction…
Ischemic Cholangitis
Manifestations vary with severity and rapidity of ischemic insult Causes include arterial thrombosis, surgical injury, hypotension Clinical Issues • Prognosis varies depending on rapidity and extent of ischemic insult Severe acute…
Intraductal Tubulopapillary Neoplasm
No grossly visible mucin Clinical Issues • Very rare entity • Majority are discovered incidentally • Age Range: 36-79 years Average: 59 years • Presentation Similar to intraductal papillary mucinous neoplasms (IPMNs) – Symptomatic cases…
