Glandular component may contain conventional ductal-type, clear cell, or signet ring cell components Ancillary Tests • p63 is positive in squamous component • Mucin stain, CK7, CK20, CEA, and CA19-9 highlight adenocarcinoma…

 Slightly dilated and irregular in shape  Lined by single layer of bland endothelial cells • Secondary involutional changes in central portion • Peripheral cellular areas show proliferation of vascular channels in loose…

 Varices, ascites if portal hypertension present  Jaundice variably present • Cutaneous, gastrointestinal, neuroophthalmic, musculoskeletal, renal, hematological manifestations also common • Nonspecific elevations in transaminases, alkaline phosphatase • Plasma vitamin A levels may be…

 Commonly implicated drugs: Anabolic steroids, oral contraceptives, prochlorperazine, thiabendazole, warfarin • Cholestatic hepatitis: Cholestasis with inflammation and hepatocellular damage  Macrolide antibiotics (erythromycin), antipsychotics (chlorpromazine), numerous other drugs • Prolonged cholestasis/ductopenia: Cholestasis >…

Portal Tract Showing Paucity of Bile DuctsPortal tract in a case of chronic ductopenic rejection contains a hepatic artery and portal vein but no interlobular bile duct. Intimal Foam Cell…

 Amyloid deposits are congophilic and show “apple green” birefringence under polarized light  Birefringence is best demonstrated by turning light to maximum and pulling color filters out • Immunohistochemistry  P glycoprotein: Present…

 Grade 3 tumors: Poorly differentiated neuroendocrine carcinoma (small or large cell type) Tumor in Ampullary RegionLow-power view shows a well-differentiated neuroendocrine neoplasm infiltrating the ampullary region. The overlying mucosa is…

 Causes nonzonal or “geographic” necrosis • Drug-induced liver injury • Chronic passive congestion Diagnostic Checklist • Consider in systemically ill patients or those at risk for thrombosis with rapid, extreme rise in aminotransferases…

 Usually in context of inflammatory process  Reportedly 2nd most common type of gallbladder polyp • Metaplastic polyp, mucosal hyperplasia, inflammatory polyp, localized papillary hyperplasia • Historically, a.k.a. metaplastic polyp, mucosal hyperplasia, inflammatory…

 Ductal plate malformation  Biliary microhamartoma Etiology/Pathogenesis • Developmental malformation resulting from aberrant construction/remodeling of embryonic bile ducts  Majority are sporadic  Also associated with several fibropolycystic liver diseases Clinical Issues • Reportedly occurs…