Nodular Regenerative Hyperplasia
Typically 1-3 mm • No fibrous septa between nodules But focal sinusoidal or periportal fibrosis can be seen • Inflammation is absent Bile ducts and hepatic arterioles are normal Top Differential Diagnoses…
Idiopathic Neonatal Hepatitis
Once known etiologies are excluded, then considered idiopathic • By mid-2000s, idiopathic neonatal hepatitis (INH) comprised only 15-30% of neonatal cholestasis due to increased ability to detect and diagnose metabolic and…
Intraductal Oncocytic Papillary Neoplasm
Often classified as having high-grade dysplasia given architectural complexity • Neoplastic cells have abundant granular eosinophilic cytoplasm with large nuclei, prominent nucleoli • Both intracytoplasmic and intercellular lumina found, many containing mucin,…
Glycogenic Hepatopathy
Pale, enlarged hepatocytes may be mistaken for normal or interpreted as fixation artifact • Fatty liver disease Pale, enlarged hepatocytes may be misinterpreted as ballooning hepatocyte degeneration • Glycogen storage disease No…
Herpes Simplex Virus
Characterized by ground-glass or smudged nuclei with margination of chromatin • Multinucleated cells with nuclear molding are less common compared with mucocutaneous HSV infections • Immunohistochemistry with antibodies directed against HSV1/HSV2 confirm…
Adenovirus
Infected hepatocytes may be slightly enlarged and multinucleated May show hemorrhagic appearance in areas of necrosis • Varicella-zoster virus hepatitis • CMV hepatitis Gross AppearanceThis liver specimen from an autopsy case shows…
Pseudocysts
Pseudocyst on CTCT shows a unilocular cyst located in the head of the pancreas, consistent with a pancreatic pseudocyst . Pseudocyst With Hemorrhagic FluidGross photograph shows a pseudocyst in the…
Tyrosinemia
Distinguished clinically • Hereditary fructose intolerance Distinct ultrastructural features • Neonatal hemochromatosis Diagnostic Checklist • Fibrosis with variable amounts of steatosis and cholestasis; requires clinical correlation • High risk of hepatocellular carcinoma Micronodular Cirrhosis…
Venoocclusive Disease
Marked CongestionIn severe cases, venoocclusive disease is characterized by marked congestion in the sinusoids and can be accompanied by areas of hemorrhage . Congestion and Plate AtrophyEndothelial injury in sinusoids…
Dubin-Johnson Syndrome
Grossly Evident PigmentGross photograph of liver core biopsies embedded in the paraffin block show dark regions corresponding to the pigment within centrizonal hepatocytes. Cytoplasmic PigmentH&E section shows coarse granular pigment…
