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دانلود کتاب Practical Hepatic Pathology: A Diagnostic Approach
دانلود کتاب آسیب شناسی عملی کبد: یک رویکرد تشخیصی
مشخصات کتاب
Practical Hepatic Pathology: A Diagnostic Approach
دسته بندی: بیماری ها: طب داخلی ویرایش: 2 نویسندگان: Romil Saxena سری: Pattern Recognition Series ISBN (شابک) : 9780323442862, 2016056540 ناشر: Elsevier سال نشر: 2017 تعداد صفحات: 730 زبان: English فرمت فایل : PDF (درصورت درخواست کاربر به PDF، EPUB یا AZW3 تبدیل می شود) حجم فایل: 83 مگابایت
قیمت کتاب (تومان) : 35,000
کلمات کلیدی مربوط به کتاب آسیب شناسی عملی کبد: یک رویکرد تشخیصی: آسیب شناسی کبد، کبد، گوارش، آسیب شناسی
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توجه داشته باشید کتاب آسیب شناسی عملی کبد: یک رویکرد تشخیصی نسخه زبان اصلی می باشد و کتاب ترجمه شده به فارسی نمی باشد. وبسایت اینترنشنال لایبرری ارائه دهنده کتاب های زبان اصلی می باشد و هیچ گونه کتاب ترجمه شده یا نوشته شده به فارسی را ارائه نمی دهد.
توضیحاتی در مورد کتاب آسیب شناسی عملی کبد: یک رویکرد تشخیصی
یک جلد از سری محبوب تشخیص الگو، آسیب شناسی کبدی عملی: یک رویکرد تشخیصی حاوی محتوای کاملاً به روز و سازماندهی شده است، که منجر به یک راهنمای واقعاً عملی برای درک آسیب شناسی کبد می شود. دکتر رومیل ساکسنا تفسیری از بیوپسی های کبد را بر اساس یک رویکرد مبتنی بر الگو ارائه می دهد که با شناخت الگوی بافت شناسی غالب آسیب شروع می شود و سپس با شناسایی ویژگی های ثانویه و کار مناسبی که شما را از دام ها به سمت بهترین تشخیص دور می کند، شروع می شود. ویژگی های کلیدی «شاخص بصری» منحصر به فرد در ابتدای کتاب به فصل دقیق و صفحه خاص مورد نیاز برای راهنمایی تشخیصی عمیق اشاره دارد. تصاویر فوق العاده، با کیفیت بالا و تمام رنگی، ویژگی های بیماری شناسی و تغییرات رایج را نشان می دهند. دارای اطلاعات جامع در مورد بیماری‌های اصلی کبد بزرگسالان و کودکان، نئوپلاسم‌های کبدی و ندول‌های پیش نئوپلاستیک، از جمله ویژگی‌های بالینی، آزمایش‌های آزمایشگاهی، یافته‌های تصویربرداری و تشخیص افتراقی. پوشش جنبه های بالینی پیوند کبد به شما امکان می دهد تا آسیب شناسی و عملکرد این روش را درک کنید. مرور "به طور کلی، برای تمرین بالینی بسیار توصیه می شود" "به طور کلی، رویکرد عملی دکتر رومیل ساکسنا به آسیب شناسی کبد، نه تنها برای همه کسانی که روزانه با آسیب شناسی کبد مواجه می شوند، به شدت برای تمرین بالینی توصیه می شود!" بایگانی Virchows.
توضیحاتی درمورد کتاب به خارجی
A volume in the popular Pattern Recognition Series, Practical Hepatic Pathology: A Diagnostic Approach features completely updated and reorganized content, resulting in a truly practical guide to understanding liver pathology. Dr. Romil Saxena presents interpretation of liver biopsies according to a pattern-based approach that begins with recognition of the predominant histological pattern of injury, followed by identification of secondary features and appropriate work-up that lead you away from pitfalls to the best diagnosis. Key Features Unique "visual index" at the beginning of the book references the exact chapter and specific page needed for in-depth diagnostic guidance. Superb, high-quality, full-color images illustrate pathognomonic features and common variations. Features comprehensive information on major adult and childhood liver diseases, hepatic neoplasms and pre-neoplastic nodules, including clinical features, laboratory tests, imaging findings and differential diagnosis. Coverage of the clinical aspects of liver transplantation allows you to understand the pathology and practice of this procedure. Review "Overall, highly recommended for clinical practice" "Overall, Dr. Romil Saxena’s practical approach to liver pathology is highly recommended for clinical practice, not only for all those confronted daily with liver pathology!" Virchows Archive
فهرست مطالب
Cover Serier Page Practical Hepatic Pathology: A Diagnostic Approach Copyright Dedication Contributors Series Preface Preface Acknowledgments Pattern-Based Approach to Diagnosis Virtual Slide Box Section I: Basic Concepts in Liver Pathology 1 - Microscopic Anatomy, Basic Terms, and Elemental Lesions Parenchymal Architecture and Tissue Organization Assessing Parenchymal Architecture in a Biopsy Absence of Portal Tracts Fragmentation Subcapsular Parenchyma Portal Tracts Bile Ducts Hepatic Arteries Portal Veins Hepatic Veins Lobular Parenchyma Hepatocytes Intralobular Biliary Channels Sinusoids Disse Space Electron Microscopy Hepatocytes Sinusoidal Lining Cells Disse Space Utility of Electron Microscopy in Routine Diagnostic Practice Basic Terms and Elemental Lesions Structural Inflammation, Cell Damage, and Necrosis Intracellular Pathology Biliary Lesions Sinusoidal Lesions References Section II: Clinical, Laboratory, and Radiologic Features of Liver Disease 2 - Clinical Features of Liver Disease Definitions and Synonyms Acute Liver Disease Etiology Clinical Manifestations Treatment and Prognosis Acute Liver Failure Subacute Liver Failure Chronic Liver Disease Etiology Assessing the Severity of Cirrhosis Clinical Signs (Stigmata) of Chronic Liver Disease Complications of Liver Cirrhosis Variceal Bleeding Ascites Spontaneous Bacterial Peritonitis Hepatorenal Syndrome Hepatic Encephalopathy Hepatopulmonary Syndrome Portopulmonary Hypertension References 3 - Laboratory Tests in Liver Disease Liver Tests Transaminases “Biliary” Enzymes Measures of Coagulation Other Tests Approach to Evaluation of Abnormal Liver Tests Laboratory Investigation of Acute Liver Injury Laboratory Investigation of Chronic Liver Disease Laboratory Investigation of Liver Disease in Pregnancy Laboratory Investigation of Liver Abnormalities in Systemic Diseases and Disease of Other Organs Connective Tissue Diseases Endocrine Disorders Infectious Diseases Neoplastic Diseases Cardiac Diseases Gastrointestinal Diseases References 4 - Investigative Imaging of the Liver Commonly Used Imaging Modalities Imaging of Liver Tumors Hemangioma Focal Nodular Hyperplasia Hepatocellular Adenoma Hepatocellular Carcinoma Metastases Cholangiocarcinoma Imaging of Diffuse Liver Disease Hepatic Steatosis Hepatic Fibrosis and Cirrhosis Contrast-Enhanced Sonography Transient Elastography Magnetic Resonance Elastography Summary Section III: Liver Diseases of Childhood 5 - Liver Diseases of Childhood Neonatal Cholestasis Incidence and Demographics Role of Liver Biopsy in Neonatal Cholestasis Biliary Atresia Incidence and Demographics Clinical Manifestations Radiologic Features Pathology Macroscopic Pathology Microscopic Pathology Differential Diagnosis Treatment and Prognosis Neonatal (Giant Cell) Hepatitis Clinical Manifestations Pathology Differential Diagnosis Treatment and Prognosis Alagille Syndrome Incidence and Demographics Molecular Genetics Clinical Manifestations Gross Pathology Microscopic Pathology Differential Diagnosis Treatment and Prognosis Primary Sclerosing Cholangitis Incidence and Demographics Clinical Manifestations Radiologic Findings Microscopic Pathology Diagnosis Treatment and Prognosis Sclerosing Cholangitis Due to Langerhans Cell Histiocytosis Microscopic Pathology Molecular Pathology Treatment and Prognosis Neonatal Sclerosing Cholangitis References Section IV: Metabolic Diseases of the Liver 6 - Medical Genetics and Biochemistry in Diagnosis and Management Clinical Approach Approach to Biochemical and Genetic Investigation Collection, Storage, and Shipping of Specimens Methodologies Involved in Biochemical and Genetic Testing Tandem Mass Spectrometry Methodologies Used for Specific Biochemical Compounds Amino Acids Organic Acids Proteins Enzymes DNA Very Long Chain Fatty Acids and Related Molecules Treatment and Management Newborn Screening–Related Disorders Other Metabolic Liver Diseases Mitochondrial Disorders Genetic Counseling References 7 - Histologic Patterns of Metabolic Liver Diseases Handling Liver Biopsy Specimens for Suspected Metabolic Disease Analysis and Reporting of Liver Biopsy Specimens for Suspected Metabolic Disease Histologic Patterns of Metabolic Liver Disease Metabolic Diseases with Normal Liver Histology Metabolic Diseases with an Inflammatory Pattern Metabolic Diseases with Prominent Lobular Cholestasis Bile Ductules Versus Ducts in Metabolic Disease Metabolic Diseases with a Steatotic Pattern Pathology Diagnosis Pathology Diagnosis Reye Syndrome Urea Cycle Defects Clinical Manifestations Pathology Diagnosis Citrin Deficiency Galactosemia Hereditary Fructose Intolerance Lysosomal Storage Disorders Pathology Diagnosis Acid Lipase Deficiency Niemann-Pick Disease, Type C Cystinosis Diagnosis Bile Acid Synthetic Defects Peroxisomal Diseases Clinical Manifestations Pathology Diagnosis Pathology Diagnosis Genetic Hemolytic Disorders Genetic Metabolic Diseases of Unknown Etiology References 8 - Liver in Wilson Disease Incidence and Demographics Clinical Manifestations Radiologic Features Pathology Gross Pathology Microscopic Features Grading and Staging Ancillary Diagnostic Studies Differential Diagnosis Other Disorders of Hepatic Copper Accumulation Genetics Treatment and Prognosis References 9 - Liver Disease in Alpha-1 Antitrypsin Deficiency Terminology Incidence and Demographics Clinical Manifestations and Natural History of Liver Disease PiZZ PiMZ The “S” Allele Microscopic Pathology Intracytoplasmic Globules Pathology of PiZZ Pathology of PiMZ Pathology of the “S” Variant Ultrastructural Pathology Differential Diagnosis Diagnosis Genetics and Molecular Pathology Treatment and Prognosis References 10 - Liver Disease in Cystic Fibrosis Incidence and Demographics Genetics Pathophysiology Clinical Manifestations of Hepatobiliary Disease Microscopic Pathology Steatosis Neonatal Cholestasis Focal Biliary Cirrhosis Multilobular Cirrhosis Large Bile Duct Disease Diagnostic Studies Therapy References 11 - Liver Disease in Iron Overload Iron Homeostasis HFE Hepcidin and Ferroportin Hepcidin Deficiency/Hepcidin Resistance Hepcidin Excess/Ferroportin Deficiency Microscopic Pathology Iron Pigment Patterns of Iron Deposition Parenchymal Iron Overload Hereditary Hemochromatosis Types 1, 2A, 2B, and 3 Microscopic Pathology Hereditary Hemochromatosis Type 4 (Ferroportin Gain-of-Function Mutations) Hereditary Aceruloplasminemia Dyserythropoietic Syndromes Iron Overload Associated with Alpha-1-Antitrypsin Deficiency Mesenchymal Iron Overload Hereditary Hemochromatosis Type 4 (Ferroportin Loss-of-Function Mutations) Miscellaneous Disorders Microscopic Pathology Mixed Parenchymal-Mesenchymal Iron Overload Genetic Causes African Iron Overload and Hepatic Iron Overload in African Americans Porphyria Cutanea Tarda Nongenetic Causes Dysmetabolic Iron Overload Syndrome Alcoholic Liver Disease Nonalcoholic Fatty Liver Disease Chronic Viral Hepatitis Differential Diagnosis of Severe Iron Overload in Cirrhosis Genetic/Hereditary Causes Advanced Fibrosis/Cirrhosis Spur Cell Anemia in Cirrhosis Alcoholic Liver Disease Role of Liver Biopsy Differential Diagnosis Iron-Free Foci Histologic Grading of Iron Deposition Histologic Effects of Chelation Therapy Effect on Stainable Iron Effect on Fibrosis Ancillary Diagnostic Studies Hepatic Iron Concentration Hepatic Iron Index References 12 - Nonalcoholic Fatty Liver Disease Definitions and Synonyms Incidence and Demographics Clinical Manifestations Radiology Gross Pathology Microscopic Pathology Steatosis Steatohepatitis Inflammation Other Features Fibrosis Variations in Children Special Stains Grading and Staging Differential Diagnosis Alcoholic Liver Disease Nonalcoholic Fatty Liver Disease with Concurrent Liver Disease Nonalcoholic Fatty Liver Disease Outside the Context of Metabolic Syndrome Drug-Induced Fatty Liver Disease Abnormalities of Lipid Metabolism Nutritional Causes Total Parenteral Nutrition Starvation and Dietary Effects Celiac Disease Chronic Liver Diseases Hepatitis C Virus Infection Wilson Disease Ancillary Diagnostic Tests Genetics Treatment and Prognosis References Section V: Infectious Diseases of the Liver 13 - Acute Viral Hepatitis Histologic Patterns of Injury in Acute Viral Hepatitis Acute “Lobular” Hepatitis (Prototypical Acute Hepatitis) Gross Pathology Microscopic Pathology Clinicopathologic Course Related to Special Patterns of Hepatic Necrosis and Regeneration Histologic Clues to the Causative Virus Hepatitis A Hepatitis E Hepatitis B Hepatitis C Other Viruses Causing Acute Hepatitis Hepatitis D (Delta) Virus Clinical Manifestations and Natural History Pathology Herpesviruses Epstein-Barr Virus Liver Disease Caused by Epstein-Barr Virus. Primary EBV infection occurring in children is largely asymptomatic or minimally sym... Pathology. The most remarkable histopathologic feature of EBV-related hepatitis is the presence of a dense lymphocytic inflammat... Diagnosis. Diagnosis of infectious mononucleosis is established by the detection of heterophilic antibodies to EBV by the Monosp... Cytomegalovirus Liver Disease Caused by Cytomegalovirus. CMV is the most common cause of congenital infection and is reported in 0.2% to 2.2% of... Pathology. Congenital CMV infection may lead to neonatal hepatitis, which is discussed in Chapter 5. Histologically, there is po... Diagnosis. Diagnosis can be made by histology, viral cultures, or serologic tests that detect antibodies or viral proteins. Sero... Human Herpesvirus 6 Herpes Zoster Herpes Simplex Virus Types 1 and 2 Pathology. The histologic findings are distinctive, with randomly distributed, patchy areas of coagulative necrosis that demonst... Adenovirus Pathology Diagnosis Parvovirus Icteric Hemorrhagic Fevers Yellow Fever Virus Liver Disease Caused by Yellow Fever Virus. After 4 to 5 days of incubation, the patient presents with fever, headache, diffuse ... Pathology. The major histologic finding is hemorrhagic hepatocyte necrosis, which is predominantly midzonal (zone 2) but may be ... Diagnosis. Besides epidemiologic and clinical symptoms compatible with yellow fever, serologic enzyme immunoassay must detect Ig... Vaccination and Viscerotropic Disease. The presence of only one serotype of the yellow fever virus enabled the successful develo... Dengue Virus Liver Involvement in Severe Dengue Virus Infections. Severe forms of DENV infection demonstrate high level of viremia leading to... Pathology. A wide spectrum of hepatic histologic changes has been noted in dengue. This comprises fatty change (microvesicular),... Diagnosis Ebola and Marburg Viruses Arenaviruses Hantavirus References 14 - Hepatitis B Incidence and Demographics Molecular Virology Natural History and Clinical Manifestations Treatment Role of Liver Biopsy in Management of Hepatitis B Microscopic Pathology of Chronic Hepatitis B Portal Changes and Interface Hepatitis Lobular Inflammation, Apoptosis, and Necrosis Ground-Glass Cells and Sanded Nuclei Large Cell and Small Cell Changes Fibrosis and Architectural Distortion Immunohistochemical Stains for Viral Antigens in Chronic Hepatitis B Differential Diagnosis of Chronic Hepatitis B Chronic Hepatitis C Other Chronic Hepatitides Other Chronic Liver Diseases Ground-Glass Cells Practical Approach in Evaluating Liver Biopsy Specimens from Patients with Chronic Hepatitis B References 15 - Hepatitis C Incidence and Demographics Molecular Virology Natural History and Clinical Manifestations Treatment Role of Liver Biopsy in Management of Hepatitis C Microscopic Pathology of Chronic Hepatitis C Portal Changes and Interface Hepatitis Lobular Inflammation, Apoptosis, and Necrosis Steatosis and Other Cytoplasmic Changes of Hepatocytes Large Cell Change and Small Cell Change Fibrosis and Architectural Distortion Differential Diagnosis of Chronic Hepatitis C Chronic Hepatitides Hereditary Metabolic Disorders Chronic Biliary Diseases Steatohepatitis Malignant Lymphoma Practical Approach in Evaluating Liver Biopsy Specimens from Patients with Chronic Hepatitis C References 16 - Chronic Hepatitis: Grading and Staging Need for Grading and Staging General Principles of Grading and Staging Grading and Staging Systems Histologic Activity Index Grading Systems Scheuer System Batts and Ludwig System Ishak System METAVIR Algorithm Staging Systems Scheuer System Ishak System METAVIR System Which Is the Best Grading and Staging System Limitations of the Liver Biopsy in Grading and Staging: Sampling Error Limitations of Semiquantitative Scoring: Interobserver Variability Semiquantitative Scoring versus Morphometric Analysis Noninvasive Non–Biopsy-Based Staging Systems References 17 - Human Immunodeficiency Virus Infection of the Liver Pattern of Reactivity of the Reticuloendothelial System Basic Liver Reactivity Pattern to Human Immunodeficiency Virus Infection Visceral Leishmaniasis Hemophagocytic Lymphohistiocytosis Cholangiopathy Pattern Steatosis Pattern Chronic Hepatitis Pattern Coinfection With Human Immunodeficiency Virus and Hepatitis C Virus Coinfection With Human Immunodeficiency Virus and Hepatitis B Virus Hepatitis Pattern With Multifocal Parenchymal Necrosis Cytomegalovirus Herpesvirus Toxoplasmosis Pneumocystis Infection Granulomatous Inflammation Pattern Mycobacterial Infections Mycoses Pattern of Bacterial Infections With Abscess Formation Fibrogenic Pattern Vascular Lesions Peliosis Bacillary Angiomatosis Nodular Regenerative Hyperplasia Mitochondriopathy Pattern Acute Hepatitis and Cholestatic Hepatitis Human Immunodeficiency Virus–Associated Neoplasia Kaposi Sarcoma Acquired Immunodeficiency Syndrome–Associated Lymphomas References 18 - Nonviral Infections of the Liver Bacterial Infections Liver in Sepsis Pathology Pyogenic Abscess Salmonellosis Pathogenesis Liver Disease in Salmonellosis Diagnosis Brucellosis Liver Involvement in Brucellosis Diagnosis Legionellosis Actinomycosis Liver Involvement in Actinomycosis Syphilis Leptospirosis Clinical Manifestations Pathogenesis Pathology Rickettsial Infections Rocky Mountain Spotted Fever Liver Disease in Rocky Mountain Spotted Fever Q Fever Liver Involvement in Q Fever Chlamydial Infection Mycobacterial and Fungal Infections Protozoal Infections Amebiasis Life Cycle in Relation to Liver Disease Pathology Diagnosis Visceral Leishmaniasis (Kala-azar) Life Cycle and Pathogenesis in Relation to Liver Disease Pathology Diagnosis Visceral Leishmaniasis in Acquired Immunodeficiency Syndrome Malaria Life Cycle and Pathogenesis Clinical Manifestations Pathology Diagnosis Parasitic Infections Ascariasis Life Cycle in Relation to Liver Disease Clinical Manifestations Pathology Diagnosis Visceral Larva Migrans/Toxocariasis Life Cycle in Relation to Liver Disease Clinical Manifestations Pathology Diagnosis Capillariasis Life Cycle in Relation to Liver Disease Clinical Manifestations Pathology Diagnosis Strongyloidiasis Life Cycle in Relation to Liver Disease Clinical Manifestations Pathology Diagnosis Schistosomiasis Life Cycle in Relation to Liver Disease Clinical Manifestations Pathology Diagnosis Pentastomiasis Life Cycle in Relation to Liver Disease Clinical Manifestations Pathology Diagnosis Fascioliasis Life Cycle in Relation to Liver Disease Clinical Manifestations Pathology Diagnosis Clonorchiasis and Opisthorchiasis Life Cycle in Relation to Liver Disease Clinical Manifestations Pathology Diagnosis Hydatid Cyst Life Cycle in Relation to Liver Disease Clinical Manifestations Pathology Diagnosis References Section VI: Granulomatous Diseases of the Liver 19 - Hepatic Granulomas: Differential Diagnosis Histologic Patterns of Hepatic Granulomas Epithelioid Granulomas Suppurative Granulomas (Granulomas with Central Microabscess) Microgranulomas Lipogranulomas Foamy Macrophage Aggregates Fibrin-Ring Granulomas Specific Granulomatous Diseases Tuberculosis Pathology Diagnosis Other Mycobacteria Brucellosis Pathology Diagnosis Q-Fever Pathology Diagnosis Systemic Mycoses Candidiasis Pathology Diagnosis Histoplasmosis Pathology Other Mycoses Parasitic Infections Other Infectious Agents Molecular Methods in Paraffin-Embedded Tissues for Detection of Microorganisms Sarcoidosis Pathology Drug-Induced Granulomas Pathology Diagnosis Neoplasia-Associated Granulomas Idiopathic Hepatic Granulomas References 20 - Hepatic Sarcoidosis Incidence and Demographics Clinical Manifestations Radiologic Features Microscopic Pathology Differential Diagnosis Treatment and Prognosis References Section VII: Autoimmune Hepatitis 21 - Autoimmune Hepatitis and Overlap Syndromes Definitions and Synonyms Incidence and Demographics Clinical Manifestations Laboratory Findings Microscopic Pathology Portal Changes and Interface Hepatitis Lobular Inflammation and Damage Cholestasis Fibrosis Overlap Syndromes Overlap with Primary Biliary Cholangitis Overlap with Primary Sclerosing Cholangitis Grading and Staging of Autoimmune Hepatitis Differential Diagnosis Acute or Chronic Viral Hepatitis Celiac Disease Drug-Induced Liver Injury Hereditary Metabolic Diseases Primary Biliary Cholangitis Genetics Treatment and Prognosis References Section VIII: Drug- and Toxin-Induced Liver Injury 22 - Metabolism of Drugs and Xenobiotics General Considerations in Drug Metabolism Factors Affecting Bioavailability of Drugs Enzyme Induction and Inhibition Enzyme Polymorphisms Disease States Clinically Significant Drug-Metabolizing Enzymes and Transporters Cytochrome P450 Enzymes CYP1A2 CYP2B6 CYP2C CYP2D6 CYP3A Conjugating Enzymes Drug Transporters/Phase III Enzymes Role of Drug Metabolism in Drug-Induced Liver Injury Alcohol Use and Risk of Drug-Induced Liver Injury References 23 - Liver Injury Due to Drugs and Herbal Agents Brief Historical Overview Incidence and Demographics Clinical Manifestations Microscopic Pathology Necroinflammatory Patterns (Figures 23.1 to 23.8) Cholestatic Patterns (Figures 23.9 to 23.15) Steatotic Patterns (Figures 23.16 to 23.19) Vascular Injury Patterns (Figures 23.20 to 23.22) Pigments and Other Cytoplasmic Changes Neoplasms Grading and Staging Differential Diagnosis Establishing Causality Ancillary Diagnostic Studies Genetics Treatment and Prognosis Figure Acknowledgments References 24 - Alcohol-Induced Liver Disease Incidence and Demographics Clinical Manifestations Noninvasive Assessment of Alcoholic Liver Disease Blood Tests Imaging Studies Gross Pathology Microscopic Pathology Alcoholic Fatty Liver Alcoholic Steatohepatitis Cirrhosis Histologic Variants Portal Tract Changes Iron Overload Other Changes in Hepatocytes Grading and Staging Role of Liver Biopsy Focal Liver Lesions in Alcoholic Liver Disease Hepatocellular Carcinoma Other Focal Lesions Differential Diagnosis Classical Histologic Features of Alcoholic Liver Disease Other Histologic Variants of Alcoholic Liver Disease Interactions with Other Liver Diseases Genetics Treatment and Prognosis References Section IX: Disorders of the Bile Ducts, Bile Formation, and Secretion 25 - Fibrocystic Liver Diseases Ductal Plate Ductal Plate Malformation von Meyenburg Complex (Microhamartoma, Biliary Hamartoma) Polycystic Liver Autosomal Dominant Polycystic Kidney Disease Autosomal Dominant Polycystic Liver Disease Clinical Manifestations Macroscopic Pathology Microscopic Pathology Treatment Solitary (Nonparasitic) Bile Duct Cysts Autosomal Recessive Polycystic Kidney Disease/Congenital Hepatic Fibrosis Clinical Manifestations Macroscopic Pathology Microscopic Pathology Treatment Caroli Disease Clinical Manifestations Macroscopic Pathology Microscopic Pathology Treatment Choledochal Cysts Clinical Manifestations Macroscopic Pathology Microscopic Pathology Treatment References 26 - Primary Biliary Cholangitis Incidence and Demographics Clinical Manifestations Laboratory Findings Liver Enzymes and Immunoglobulins Autoantibodies Antimitochondrial Antibodies Antinuclear Antibodies Other Autoantibodies Radiologic Features Pathology Gross Pathology Microscopic Pathology Nonsuppurative Cholangitis. Nonsuppurative cholangitis is the hallmark of PBC.17,18 However, the distribution is heterogeneous e... Ductular Reaction. Ductular reaction often accompanies the bile duct injury and results from metaplasia of periportal hepatocyte... Bile Duct Loss and Ductopenia. Bile duct loss and ductopenia occur with disease progression, primarily involving the small intra... Portal Inflammation Hepatic Parenchymal Changes Encroachment of the Limiting Plate. The inflammatory cells often spill over from the portal tract into the adjacent parenchyma (... Cholate Stasis. This finding becomes more prominent with disease progression but may not be seen in all cases on needle biopsies... Copper Deposition. Copper is excreted in the bile and copper accumulation occurs in the liver in chronic cholestasis of any etio... Keratin7 Expression. Periportal hepatocytes may strongly express K7 by immunohistochemistry, reflecting acquisition of a biliary... Cholestasis. Although biochemical cholestasis is present early in the disease, cholestasis at the morphologic level occurs years... Fibrosis. Progressive ductular reaction and cholate stasis is accompanied by fibrosis. In early stages, periportal fibrosis may ... Diagnosis Staging Differential Diagnosis Mechanical Large Bile Duct Obstruction Primary Sclerosing Cholangitis Adverse Drug Reaction Autoimmune Hepatitis Viral Hepatitis Granulomatous Inflammation Treatment and Prognosis Variants and Special Diagnostic Considerations Antimitochondrial Antibody–Negative Primary Biliary Cholangitis Asymptomatic Patients with Positive Antimitochondrial Antibody Primary Biliary Cholangitis–Autoimmune Hepatitis Overlap Syndrome Recurrent Primary Biliary Cholangitis in Allograft Liver Nodular Regenerative Hyperplasia References 27 - Primary Sclerosing Cholangitis Incidence and Demographics Clinical Manifestations Laboratory Findings Radiologic Features Gross Pathology Microscopic Pathology Large (Hilar/Parahilar) Bile Ducts Small (Septal/Interlobular) Bile Ducts Small Peripheral Portal Tracts Parenchymal Changes Gallbladder Grading of Primary Sclerosing Cholangitis Differential Diagnosis Primary Biliary Cholangitis Autoimmune Hepatitis Immunoglobulin G4–Related Sclerosing Cholangitis Hepatolithiasis and Recurrent Pyogenic Cholangitis Secondary Sclerosing Cholangitis Other Chronic Liver Diseases Dominant Stricture Genetics Treatment and Prognosis Secondary (Acquired) Sclerosing Cholangitis References 28 - Loss of Intrahepatic Bile Ducts Microscopic Pathology of Loss of Intrahepatic Bile Ducts Pitfalls in Microscopic Diagnosis Liver Diseases Leading to Loss of Intrahepatic Bile Ducts Primary Biliary Cholangitis Microscopic Pathology Primary Sclerosing Cholangitis Microscopic Pathology Secondary Sclerosing Cholangitis Sarcoidosis Acute and Chronic Liver Allograft Rejection Microscopic Pathology Recurrent Primary Biliary Cholangitis and Primary Sclerosing Cholangitis in Liver Allografts Graft-versus-Host Disease Acute Graft-versus-Host Disease Chronic Graft-versus-Host Disease Microscopic Pathology Ischemic Cholangiopathy Microscopic Pathology Drug-Induced Loss of Intrahepatic Bile Ducts Microscopic Pathology Idiopathic Adulthood Ductopenia References 29A - Intrahepatic Cholestasis Transporter Proteins Basolateral (Sinusoidal) Membrane Transporters Apical (Canalicular) Membrane Transporters Bile Salt Export Pump (ABCB11) Multidrug Resistance 1 (ABCB1) Multidrug Resistance 3 Phospholipid Transporter (ABCB4) Multidrug Resistance 2 (ABCC2) Hepatic Basolateral ABC-Transporter Proteins Electroneutral Anion Exchanger Other Hepatocyte Transporters Bile Acids Bile Acid Functions Bile Acid Signaling Enterohepatic Circulation of Bile Cholangiocyte Modification of Bile Ileal Transport of Bile Acids 29B - Intrahepatic Cholestasis Progressive Familial Intrahepatic Cholestasis Etiopathogenesis Incidence and Demographics Clinical Manifestations (Table 29B.2) Laboratory Findings Microscopic Findings PFIC-1 PFIC-2 PFIC-3 Immunohistochemistry Electron Microscopy Treatment (see Table 29B.2) Miscellaneous Causes of “Low-GGT” Intrahepatic Cholestasis Miscellaneous Causes of “High-GGT” Intrahepatic Cholestasis Differential Diagnosis “Benign” Recurrent Intrahepatic Cholestasis Etiopathogenesis Clinical Manifestations Microscopic Findings Treatment Intrahepatic Cholestasis of Pregnancy Etiopathogenesis Clinical Manifestations Microscopic Findings Treatment Disorders of Bilirubin Metabolism Crigler-Najjar and Gilbert Syndromes Dubin-Johnson Syndrome Rotor Syndrome References Section X: Vascular Disorders of the Liver 30 - Vascular Disorders of the Liver Differential Diagnosis of Sinusoidal Congestion Budd-Chiari Syndrome Etiopathogenesis Incidence and Demographics Clinical Manifestations Laboratory Findings Radiologic Features Gross Pathology Microscopic Pathology Treatment and Prognosis Congestive Hepatopathy Etiopathogenesis Incidence and Demographics Clinical Manifestations Laboratory Findings Radiologic Features Gross Pathology Microscopic Pathology Treatment and Prognosis Sinusoidal Obstruction Syndrome/Veno-occlusive Disease Etiopathogenesis Incidence and Demographics Clinical Manifestations Laboratory Findings Radiologic Features Gross Pathology Microscopic Pathology Treatment and Prognosis Sickle Cell Disease Etiopathogenesis Incidence and Demographics Clinical Manifestations Laboratory Findings Radiologic Features Gross Pathology Microscopic Pathology Treatment and Prognosis Preeclampsia Etiopathogenesis Clinical Manifestations Laboratory Findings Radiologic Features Gross Pathology Microscopic Pathology Hemolysis, Elevated Liver Enzymes and Low Platelets (HELLP) Syndrome Clinical Manifestations Laboratory Findings Radiologic Features Gross Pathology Microscopic Pathology Portal Vein Thrombosis Etiopathogenesis Incidence and Demographics Clinical Manifestations Laboratory Findings Radiologic Features Gross Pathology Microscopic Pathology Treatment and Prognosis Idiopathic Noncirrhotic Portal Hypertension Obliterative Portal Venopathy Etiopathogenesis Incidence and Demographics Clinical Manifestations Laboratory Findings Radiologic Features Gross Pathology Microscopic Pathology Treatment and Prognosis Nodular Regenerative Hyperplasia Etiopathogenesis Incidence and Demographics Clinical Manifestations Laboratory Findings Radiologic Features Gross Pathology Microscopic Pathology Treatment and Prognosis Diseases of the Hepatic Artery Ischemic Hepatitis Etiopathogenesis Incidence and Demographics Clinical Manifestations Laboratory Findings Microscopic Pathology Treatment and Prognosis Amyloidosis Clinical Manifestations Laboratory Findings Radiologic Features Gross Pathology Microscopic Pathology References Section XI: Tumors and Tumor-like Lesions of the Liver 31 - Premalignant and Early Malignant Hepatocellular Lesions in Chronic Hepatitis/Cirrhosis Clinical Setting and Target Population: Surveillance Nomenclature Dysplastic Foci Dysplastic Nodules Small Hepatocellular Carcinoma Dysplastic Nodules as Hepatocellular Carcinoma Precursors Natural History of Premalignant Lesions Dysplastic Nodules and Early Hepatocellular Carcinoma: Role of Imaging Premalignant and Early Malignant Hepatocellular Nodules in Daily Clinical Practice Basic Histopathologic Features (Elementary Lesions) Parenchymal Changes Nonparenchymal Changes Key Diagnostic Points Stromal Invasion Biomarkers Nodule in Nodule Liver Biopsy Diagnostic Criteria in Liver Biopsy Nodule Management References 32 - Benign Hepatocellular Tumors Definitions and Synonyms Focal Nodular Hyperplasia Hepatocellular Adenoma Incidence and Demographics Clinical Manifestations Radiologic Features Focal Nodular Hyperplasia Ultrasonography and Contrast-Enhanced Ultrasound Magnetic Resonance Imaging Hepatocellular Adenoma Ultrasonography and Contrast-Enhanced Ultrasound Magnetic Resonance Imaging Differential Diagnosis Gross Pathology Microscopic Pathology Focal Nodular Hyperplasia Hepatocellular Adenoma Genotype-Phenotype Classification of Hepatocellular Adenoma HNF1α-Inactivated Hepatocellular Adenoma β-Catenin–Activated Hepatocellular Adenoma Inflammatory Hepatocellular Adenoma Hepatocellular Adenoma, Not Otherwise Specified Immunohistochemistry Histologic Variants Differential Diagnosis Genetics HNF1α-Inactivated Hepatocellular Adenoma: HNF1A Gene β-Catenin–Activated Hepatocellular Adenoma: CTNNB1 Gene Inflammatory Hepatocellular Adenoma Telomerase Reverse Transcriptase Promoter Treatment Focal Nodular Hyperplasia Hepatocellular Adenoma References 33 - Hepatocellular Carcinoma Epidemiology and Risk Factors Hepatotropic Viruses Other Etiologic Factors Clinical Manifestations Gross Pathology Microscopic Pathology Tumor Cells Growth Patterns Immunohistochemistry Histologic Variants Fibrolamellar Hepatocellular Carcinoma Clear Cell Hepatocellular Carcinoma Steatohepatitic Hepatocellular Carcinoma Sarcomatoid Hepatocellular Carcinoma Sclerosing Hepatocellular Carcinoma Grading and Other Prognostic Factors Differential Diagnosis Molecular Genetics Natural History and Treatment References 34 - Benign and Malignant Tumors of Bile Ducts Benign Tumors or Tumor-like Lesions Solitary Bile Duct Cyst Clinical Manifestations Pathology Differential Diagnosis Ciliated Hepatic Foregut Cyst Clinical Manifestations Pathology Differential Diagnosis Bile Duct Hamartoma Clinical Manifestations Radiologic Features Pathology Gross Pathology. On gross examination, bile duct hamartomas are small, ranging from 2 to 5 mm in diameter. They are usually mult... Microscopic Pathology. Microscopically, bile duct hamartomas are composed of a variable number of ductal structures embedded in ... Differential Diagnosis Adenocarcinoma. Bile duct hamartomas need to be distinguished from malignant neoplasms in the liver such as metastatic adenocarc... Peribiliary Gland Hamartoma. Benign lesions that can be confused with bile duct hamartomas are peribiliary gland hamartomas (see... Prognosis Peribiliary Gland Hamartoma (Bile Duct Adenoma) Clinical Manifestations Radiologic Features Pathology Gross Pathology. Grossly, peribiliary gland hamartoma is a round or ovoid, well-demarcated but not encapsulated lesion that is u... Microscopic Pathology. Histologically, peribiliary gland hamartoma is composed of tubules and acini, which are lined by a single... Differential Diagnosis Mucinous Cystic Neoplasm Clinical Manifestations Radiologic Features Pathology Gross Pathology. Grossly, these cystic neoplasms are typically large, ranging in size from several centimeters to more than 20 c... Microscopic Pathology. Microscopically, the locules are lined by a columnar epithelium that is almost always mucinous (Fig. 34.7... Differential Diagnosis Ciliated Hepatic Foregut Cysts and Solitary Bile Duct Cysts. These are usually small, asymptomatic, and incidental findings. The... Cystic Variant of Intraductal Papillary Neoplasm. It may be challenging to distinguish mucinous cystic neoplasm from a cystic va... Cystadenocarcinoma and Cystic Cholangiocarcinoma. It may be difficult to determine if a cystadenocarcinoma represents malignant ... Intraductal Papillary Neoplasm of Bile Duct Incidence and Demographics Clinical Manifestations Radiologic Features Pathology Gross Pathology. Grossly, the bile ducts involved are variably dilated. Papillary and fragile tumors are present on the inner su... Microscopic Pathology. IPNB shares many features with IPMN of the pancreas. Similar to IPMN, the involved ducts are dilated, con... Differential Diagnosis Mucinous Cystic Neoplasm. IPNB may mimic mucinous cystic neoplasm, particularly when the former becomes cystic; however, the lac... Biliary Dysplasia (Biliary Intraepithelial Neoplasia). Caution should be practiced to discriminate IPNB from biliary dysplasia o... Malignant Tumors Cholangiocarcinoma Clinical Manifestations Radiologic Features Pathology Gross Pathology. CCs are generally firm, gray-white to tan tumors (Fig. 34.15). They may present as a single mass with or withou... Microscopic Pathology. Microscopically, CC may mimic metastatic adenocarcinoma from any site; thus, thorough clinical and imagin... Differential Diagnosis Benign Biliary Tumors. Typical features of CC are the complex cribriform glands, nuclear pleomorphism, hyperchromasia, mitotic f... Hepatocellular Carcinoma. Although mucin is not always present, its presence can help distinguish CC from HCC. Immunohistochemic... Metastatic Adenocarcinoma. Although to some extent immunohistochemistry may help to distinguish CC from metastatic carcinoma fro... Epithelioid Hemangioendothelioma. Epithelioid hemangioendothelioma can be misdiagnosed as ICC because its intracytoplasmic vascu... Combined Hepatocellular-Cholangiocarcinoma. Combined hepatocellular-cholangiocarcinoma (HCC-CC), also known as mixed tumor or he... References 35 - Liver Tumors of Childhood Epithelial Tumors Hepatoblastoma Incidence and Demographics Clinical Manifestations Current Classification Radiologic Features and Gross Pathology Microscopic Pathology Pathology of Treated Hepatoblastoma Staging of Pediatric Liver Tumors Variants of Hepatoblastoma and Tumors Probably Related to Hepatoblastoma Genetics and Molecular Pathology Treatment and Prognosis Pleomorphic and Anaplastic Hepatoblastoma, Hepatoblastoma with Hepatocellular Carcinoma–Like Features, and Transitional Liver Ce... Clinical Manifestations Radiologic Features and Gross Pathology Microscopic Pathology Differential Diagnosis Treatment and Prognosis Fibrolamellar Hepatocellular Carcinoma Incidence and Demographics Clinical Manifestations Radiologic Features and Gross Pathology Microscopic Pathology Differential Diagnosis Genetics and Molecular Pathology Treatment and Prognosis Hepatocellular Carcinoma Incidence and Demographics Clinical Manifestations Radiologic Features and Gross Pathology Microscopic Pathology Differential Diagnosis Genetics and Molecular Pathology Treatment and Prognosis Liver Cell Adenoma Focal Nodular Hyperplasia Other Rare Malignant Epithelial Tumors Mesenchymal Tumors Hamartoma of the Liver Incidence and Demographics Clinical Manifestations Radiologic Features and Gross Pathology Microscopic Pathology Differential Diagnosis Genetics and Molecular Pathology Treatment and Prognosis Undifferentiated (Embryonal) Sarcoma Incidence and Demographics Clinical Manifestations Radiologic Features and Gross Pathology Microscopic Pathology Differential Diagnosis Genetics and Molecular Pathology Treatment and Prognosis Hepatobiliary Rhabdomyosarcoma Incidence and Demographics Clinical Manifestations Radiologic Features and Gross Pathology Histopathology Differential Diagnosis Treatment and Prognosis Malignant Extrarenal Rhabdoid Tumor Incidence and Demographics Clinical Manifestations Radiologic Features and Gross Pathology Microscopic Pathology Differential Diagnosis Genetics and Molecular Pathology Treatment and Prognosis Vascular Tumors Infantile Hemangioma Incidence and Demographics Clinical Manifestations Radiologic Features and Gross Pathology Histopathology Differential Diagnosis Treatment and Prognosis Epithelioid Hemangioendothelioma Pediatric Angiosarcoma Incidence and Demographics Clinical Manifestations Radiologic Features and Gross Pathology Microscopic Pathology Treatment and Prognosis Tumors of the Perivascular Epithelioid Cell References 36 - Miscellaneous Liver Tumors and Tumor-like Lesions Cavernous Hemangioma Incidence and Demographics Clinical Manifestations Radiologic Features Gross Pathology Microscopic Pathology Differential Diagnosis Treatment and Prognosis Epithelioid Hemangioendothelioma Brief Historical Overview Incidence and Demographics Clinical Manifestations Radiologic Features Gross Pathology Microscopic Pathology Differential Diagnosis Treatment and Prognosis Angiosarcoma Incidence and Demographics Clinical Manifestations Radiologic Features Gross Pathology Microscopic Pathology Differential Diagnosis Treatment and Prognosis Lymphangioma Incidence and Demographics Clinical Manifestations Radiologic Features Gross Pathology Microscopic Pathology Differential Diagnosis Treatment and Prognosis Angiomyolipoma Incidence and Demographics Clinical Manifestations Radiologic Features Gross Pathology Microscopic Pathology Differential Diagnosis Treatment and Prognosis Focal Fatty Change Incidence and Demographics Clinical Manifestations Radiologic Features Microscopic Pathology Differential Diagnosis Treatment and Prognosis Lymphoma Incidence and Demographics Clinical Manifestations Radiologic Features Microscopic Pathology Differential Diagnosis Treatment and Prognosis Hepatosplenic T-Cell Lymphoma Incidence and Demographics Clinical Manifestations Microscopic Pathology Differential Diagnosis Treatment and Prognosis Hairy Cell Leukemia Systemic Mastocytosis Langerhans Cell Histiocytosis Inflammatory (Myofibroblastic) Pseudotumor Incidence and Demographics Clinical Manifestations Radiologic Features Gross Pathology Microscopic Pathology Differential Diagnosis Treatment and Prognosis Miscellaneous Primary Benign Tumors of the Liver Miscellaneous Primary Malignant Tumors of the Liver Common Metastatic Tumors References Section XII: Concepts in Liver Pathology 37 - Clinical Aspects of Liver Transplantation History of Liver Transplantation Current Trends Indications in Adults Hepatitis C Hepatitis B and Hepatitis A Nonalcoholic Fatty Liver Disease Alcoholic Liver Disease Autoimmune Hepatitis Cholestatic Liver Disease Primary Biliary Cholangitis Primary Sclerosing Cholangitis Hepatocellular Carcinoma Acute Liver Failure Indications in Children Patient Evaluation Elderly Patients Obese Patients Patients with Substance Abuse Patients with Comorbidities Retransplantation Pediatric Patients Donor and Allograft Evaluation Extended Criteria Donors Physiologic Extended Criteria Donors Medical History Extended Criteria Donors Partial Liver Allografts Liver Allograft Allocation Organ Matching Donor and Recipient Operation Organ Procurement from Deceased Donors Liver Transplant Operation Preparation of Allograft Recipient Hepatectomy Implantation of Allograft Closure of Abdomen Anesthesia Posttransplant Course Surgical Complications Primary Nonfunction Biliary Complications Hepatic Outflow Obstruction Rejection Infections Long-Term Renal Failure Malignancy Complications in Pediatric Recipients Posttransplant Immunosuppression Immunosuppression Agents Cyclosporine Tacrolimus Sirolimus/Everolimus Mycophenolate Mofetil Azathioprine Prednisone Induction Therapy Rabbit Antithymocyte Globulin Alemtuzumab Daclizumab Posttransplant Prophylaxis and Treatment of Infections References 38 - Pathology of Liver Transplantation Evaluation of Donor Biopsies Preservation–Reperfusion Injury Clinical Manifestations Microscopic Pathology Differential Diagnosis Rejection Terminology Clinical Manifestations Microscopic Pathology Hyperacute Rejection. Liver biopsies are not performed in the majority of cases of hyperacute humoral rejection because of rapid... Acute Antibody-Mediated Rejection. Histologic features associated with acute AMR consist of endothelial cell hypertrophy, promin... Cellular Rejection. Cellular rejection occurring in the early posttransplant period (acute cellular rejection) demonstrates a cl... Chronic Rejection. The ischemic/fibrotic process of chronic rejection affects the bile ducts and the arteries of the liver allog... Chronic Antibody-Mediated Rejection. Although chronic AMR (cAMR) has not been fully characterized, it has been shown that LT rec... Treatment Central Perivenulitis Recurrent Diseases Recurrent Hepatitis C Clinical Considerations Microscopic Pathology Differential Diagnosis Acute Cellular Rejection. The most clinically significant differential diagnostic problem is the distinction of acute cellular r... Other Conditions. Acute hepatitis C in the allograft has to be distinguished from drug-induced hepatitis. This distinction relie... Recurrent Hepatitis B Clinical Considerations Microscopic Pathology Differential Diagnosis Recurrent Autoimmune Hepatitis Clinical Considerations Microscopic Pathology Differential Diagnosis Recurrent Primary Biliary Cholangitis Clinical Considerations Microscopic Pathology Differential Diagnosis Recurrent Primary Sclerosing Cholangitis Clinical Considerations Microscopic Pathology Differential Diagnosis Recurrent Nonalcoholic Steatohepatitis Clinical Considerations Microscopic Pathology Recurrent Alcohol-Related Liver Disease Clinical Considerations Microscopic Pathology De Novo Diseases Plasma Cell Hepatitis (De Novo Autoimmune Hepatitis) De Novo Viral Hepatitis De Novo Idiopathic Chronic Hepatitis De Novo Malignancy Posttransplant Lymphoproliferative Disease Surgical Complications Biliary Strictures Microscopic Pathology Hepatic Artery Thrombosis and Ischemic Cholangitis Gross and Microscopic Pathology Infections Human Herpesvirus 6 Cytomegalovirus Epstein-Barr Virus Adenovirus Microscopic Pathology Changes in Late Protocol Biopsies Idiopathic Fibrosis Nodular Regenerative Hyperplasia References Section XIII: Evolving Concepts in Liver Pathology 39 - Biphenotypic Primary Liver Carcinoma Microscopic Pathology: A Group of Heterogeneous Tumors Epidemiology and Prognosis References 40 - Regression of Liver Fibrosis: From Myth to Reality Mechanisms of Fibrogenesis Morphologic Patterns of Fibrosis Regression of Fibrosis Regression of Cirrhosis Histologic Assessment of Regression of Fibrosis Conventional Scoring Systems Image Analysis Systems Histologic Assessment of Regression of Cirrhosis Hepatic Repair Complex References 41 - Cirrhosis: A Term in Need of a Makeover What Is Wrong with the Current Concept of Cirrhosis Cirrhosis Is Not a Homogeneous Disease Variations in Gross Morphology Variations in Microscopic Pathology Clinical Staging and Prognostication of Cirrhosis Pathologic Staging of Cirrhosis Regression of Cirrhosis Histologic Assessment of Regression of Cirrhosis Is Cirrhosis a Primarily Fibrotic Process References Index A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
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