Alcoholic Liver Disease
Wide spectrum of disease ranging from subclinical to end-stage liver disease ∼ 20-40% of chronic alcoholics who undergo biopsy have histologic evidence of alcoholic liver disease (ALD) Clinical Issues • Very…
Antibody-Mediated Rejection
Preformed antibodies Donor-specific antibodies (DSA) developed after transplantation Microscopic • Hyperacute antibody-mediated rejection (AMR) Fibrin thrombi in portal and central veins and sinusoids Neutrophilic &/or fibrinoid arteritis Patchy or massive hemorrhagic…
Mucinous Cystic Neoplasm
Range: 14-95 years • Predominantly female F:M = 20:1 Macroscopic • 90% of mucinous cystic neoplasms arise in body or tail of pancreas • Usually solitary and large Mean: 7-10 cm • Usually multiloculated…
Acinar Cell Carcinoma
Minority of patients have associated lipase hypersecretion paraneoplastic syndrome Macroscopic • Solid, well-circumscribed, fleshy mass • Average 10 cm in diameter (range: 2-30 cm) Microscopic • Densely cellular with multiple architectural patterns, most…
Hereditary Hemochromatosis
2 most common mutations (C282Y and H63D) account for vast majority of cases • Non- HFE- associated hereditary hemochromatosis occurs less commonly (5-10% of phenotypic cases) • Specific mechanism leading to iron…
Hepatitis C
Estimated 3-4 million persons infected in United States Etiology/Pathogenesis • Common modes of transmission include blood transfusion, needle stick Clinical Issues • Presenting symptoms nonspecific (fatigue, anorexia, nausea) Many patients asymptomatic • Liver…
Diabetes Mellitus
Type 1: Absolute insulin deficiency Type 2: Insulin resistance and inadequate secretion Etiology/Pathogenesis • Unknown and multifactorial Possible autoimmune causes Some genetic causes Diseases of exocrine pancreas Clinical Issues • Laboratory tests…
Solid-Pseudopapillary Tumors
Pseudopapillae formation • Intracytoplasmic eosinophilic hyaline globules, PASD(+) • Uniform round to oval nuclei with finely dispersed chromatin • Neoplastic cells often have nuclear grooves Ancillary Tests • Immunohistochemistry: Nuclear β-catenin, cytoplasmic CD10, loss…
Graft-vs.-Host Disease
Immunosuppressed recipient cannot destroy donor cells Clinical Issues • Represents major hepatic complication after stem cell transplant • Common presenting signs are jaundice and hepatomegaly • Elevated serum alkaline phosphatase and bilirubin • Variably…
Drug-Related Acute Hepatitis
Minority of cases progress to chronic hepatitis and rarely cirrhosis Jaundice, high AST levels, and preexisting chronic liver disease are adverse prognostic factors Microscopic • Most medications produce inflammation-predominant pattern • Most…
