Enlarged, activated, or blastic T lymphocytes, eosinophils, and other inflammatory cells • Bile duct damage Lymphocytic infiltration and epithelial cell injury affecting interlobular ducts • Endotheliitis Subendothelial venous inflammation with lifting and…
Metaplasia → dysplasia → carcinoma sequence • Progression from preexisting adenocarcinoma Considered “metaplastic carcinoma” like that in breast • Gallstones present in 40-68% of cases Clinical Issues • 1-12% of all gallbladder carcinomas…
PLD occurring in 30-90% of patients Age-dependent increase in number and size of liver cysts Higher prevalence of PLD in women • Isolated PLD affecting < 0.01% of population • Asymptomatic in…
Gross AppearanceThe cut surface shows numerous variably sized cystic spaces admixed with solid areas. Minimal uninvolved liver tissue is present at the resection margin . Loose Myxoid StromaLow-power view shows…
Incidence ranges from < 1% to 7.3% in autopsy studies Clinical Issues • Majority discovered incidentally Clinically silent – Tumors under 4 cm rarely symptomatic When symptomatic, present with abdominal pain, hepatomegaly,…
Radiolucent cholesterol stones Risk factors: Old age, female sex, obesity, hyperlipidemia Radiopaque pigment stones Risk factors: Chronic hemolysis, biliary infection, and gastrointestinal diseases affecting bile salt reabsorption Clinical Issues • More…
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…
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…
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…
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…
