Scheuer's Liver Biopsy Interpretation

Cover
Dedication
SCHEUER’S Liver Biopsy Interpretation
Copyright
Preface
Acknowledgements
1 - General Principles of Biopsy Assessment
	Introduction
	Type and adequacy of liver biopsy specimen
	The specimen at the bedside and in the laboratory
	References
2 - Laboratory Techniques
	Processing of the specimen
	Choice of stains
	References
	General reading
3 - The Normal Liver
	Structures and components
		Functional units and nomenclature
		Portal tracts
		Bile ducts
		Hepatic sinusoids, space of Disse and extracellular matrix
			Hepatic Sinusoids
			Space of Disse
		Hepatocytes
		Hepatocellular pigments
	Normal appearances in childhood
	Ageing
	Biopsy of the normal liver
	References
	General reading
4 - Assessment and Differential Diagnosis of Pathological Features
	Differential diagnosis of individual findings
5 - Biliary Disease
	Introduction
	Cholestasis
	Large bile-duct obstruction
		Chronic bile-duct obstruction and biliary cirrhosis
	Cholangitis: infection of the biliary tree
	Primary sclerosing cholangitis
	Primary biliary cholangitis (formerly primary biliary cirrhosis)
		The portal lesion of primary biliary cholangitis
		The progressive lesion of primary biliary cirrhosis
		Overlap syndromes, transitional diseases and autoimmune cholangitis
	Other disorders with intrahepatic bile-duct loss
	References
	General reading
6 - Acute Viral Hepatitis
	Introduction
	Pathological features
		Hepatocellular damage
		The inflammatory infiltrate
		Portal changes
		Histological variants
	Individual causes of viral hepatitis
		Hepatitis A
		Hepatitis B
		Hepatitis C
		Hepatitis D (delta hepatitis)
		Hepatitis E virus LBI-10
	Differential diagnosis of acute viral hepatitis
	Fate and morphological sequelae of acute viral hepatitis
		Resolution
		Scarring
		Fatal outcome or need for liver transplantation
		Chronic hepatitis
		Cirrhosis
		Hepatocellular carcinoma
	References
	General reading
7 - Steatosis, Steatohepatitis and Related Conditions
	Steatosis
		Macrovesicular steatosis
		Microvesicular steatosis
	Alcoholic and non-alcoholic fatty liver disease
		Systematic histological approach to macrovesicular fatty liver disease
		Diabetes mellitus
	Steatohepatitis, alcoholic and non-alcoholic
		Pathological features of steatohepatitis
			Non-alcoholic steatohepatitis
		Histological differential diagnosis
	Other alcohol-related liver lesions
		Alcoholic foamy degeneration
		Fibrosis
		Fetal alcohol syndrome
		Cirrhosis
		Other lesions
	References
	General reading
8 - Drugs and Toxins
	Introduction
	Classification and mechanisms
	Commonly implicated and newer agents
	Morphological categories
		Adaptation
		Non-hepatitic liver-cell damage
			Hepatocellular necrosis
		Acute drug-induced hepatitis
			Differential diagnosis
		Chronic drug-induced hepatitis
			Differential diagnosis
		Steatohepatitis
		Fibrosis and cirrhosis
			Steroid-induced cholestasis
			Differential diagnosis
		Idiosyncratic drug-induced cholestasis
			Differential diagnosis
		Granulomas
		Other lesions
	References
	General reading
9 - Chronic Hepatitis
	Definition and causes
	Classification and nomenclature
	Use of liver biopsy in chronic hepatitis
	Histological features of chronic hepatitis
		Portal changes
		Parenchymal changes
			The periportal lesion: interface hepatitis
			The lobular lesion
	Individual causes of chronic hepatitis
		Chronic hepatitis B
		Chronic hepatitis D (with HBV)
		Chronic hepatitis C
			Pathological features
		Chronic hepatitis E
		Autoimmune hepatitis
			Other conditions with features of autoimmune hepatitis
	Differential diagnosis of chronic hepatitis
	Semi-quantitative scoring: grading and staging
		Interpretation of the results of scoring
	References
	General reading
10 - Cirrhosis
	Introduction
	Diagnosis of cirrhosis by liver biopsy
		Fragmentation
		Abnormal structure
		Hepatocellular changes
			Differential diagnosis
	Assessment of cause
		Pattern of nodules and fibrosis
		Bile ducts
		Blood vessels
		Steatohepatitis
		Evidence of viral infection
		Abnormal deposits
		Anatomical type
	Stage of development
	Histological activity
	Complications
	References
	General reading
11 - Neoplasms and Nodules
	Introduction
	Neoplasms and nodules in adults
		Benign lesions
			Hepatocellular adenoma
			Focal nodular hyperplasia
			Nodular regenerative hyperplasia
			Bile-duct adenoma
			Biliary cystadenoma
			Haemangioma
			Mesenchymal and neural tumours
			Inflammatory pseudotumour
		Malignant lesions
			Precursors of hepatocellular carcinoma
			Hepatocellular carcinoma
			Fibrolamellar carcinoma
			Bile-duct carcinoma (cholangiocarcinoma)
			Angiosarcoma
			Epithelioid haemangioendothelioma
	Extrahepatic malignancy and the liver
		Metastatic tumour
		Lymphomas and leukaemias
			Hodgkin’s disease
		Non-Hodgkin’s lymphoma and other haemopoietic malignancies
	Neoplasms and nodules in children
		Benign lesions
		Mesenchymal hamartoma
		Infantile haemangioendothelioma
		Malignant lesions
			Hepatoblastoma
			Sarcoma and lymphoma
			Hepatocellular carcinoma
	Cytopathological diagnosis
		Normal or reactive liver
		Cirrhosis and liver-cell dysplasia
		Hepatocellular adenoma
			Focal nodular hyperplasia
			Haemangioma
		Hepatocellular carcinoma
		Hepatoblastoma
		Cholangiocarcinoma
		Angiosarcoma
		Lymphoma
		Metastatic tumours
	References
	General reading
12 - Vascular Disorders
	The hepatic arteries
		Shock, heart failure and heatstroke
	The portal veins
		Portal hypertension
	The hepatic sinusoids
		Peliosis hepatis
		Disseminated intravascular coagulation
		Sickle-cell disease
	Venous congestion and outflow obstruction
		Cardiac failure and congestive hepatopathy
		Obstruction to large veins
		Sinusoidal obstruction syndrome/veno-occlusive disease
	References
	General reading
13 - Childhood Liver Disease and Metabolic Disorders
	Introduction
	Diagnostic approach to neonatal liver biopsy
	Neonatal hepatitis
	Extrahepatic biliary atresia
	Choledochal cyst
		Autoimmune sclerosing cholangitis
		Langerhans cell histiocytosis
	Paucity of intrahepatic bile ducts in childhood
	Fibropolycystic diseases
		Congenital hepatic fibrosis
		Caroli’s disease (congenital dilatation of the intrahepatic bile ducts)
		Microhamartoma
		Polycystic disease
	Inherited metabolic disorders
		Cystic fibrosis
		Storage disorders: general remarks
		Glycogen storage diseases (glycogenoses)
		Alpha1-antitrypsin deficiency
		Gaucher’s disease (glycosyl ceramide lipidosis)
		Niemann–Pick disease (sphingomyelin lipidosis)
		Wolman’s disease and cholesterol ester storage disease
		Galactosaemia
		Disorders of ureagenesis
		Reye’s syndrome
	Parenteral nutritions
	Hyperbilirubinaemias
	Inherited cholestatic syndromes
	Cirrhosis in childhood
	References
	General reading
14 - Disturbances of Copper and Iron Metabolism
	Wilson’s disease (hepatolenticular degeneration)
	Iron overload
		Siderosis
		Numerical assessment of tissue iron
	Primary iron overload disorders
		Classic HFE-related hereditary haemochromatosis
		Other primary iron overload disorders
	Secondary iron overload disorders
		Neonatal haemochromatosis
		Iron overload in haematological disorders
		Liver disease of varied aetiology
	References
	General reading
15 - The Liver in Systemic Disease and Pregnancy
	Introduction
	Granulomas
	Viral diseases
		Cytomegalovirus infection
		Infectious mononucleosis
		Acquired immune deficiency syndrome
			Drug-related hepatotoxicity
			Opportunistic infections and infestations
			AIDS cholangiopathy
			Peliosis hepatis
			Lymphomas
			Chronic hepatitis
			Steatosis and other changes
	Rickettsial, bacterial and fungal infections
		Q fever
		Brucellosis
		Typhoid fever
		Cat-scratch disease
		Tuberculosis
		Leprosy
		Spirochaetal infection
			Syphilis
			Leptospirosis
			Lyme disease
		Candidiasis
		Histoplasmosis
		The liver in sepsis
	Parasitic diseases
		Toxoplasmosis
		Malaria
		Visceral leishmaniasis (kala-azar)
		Amoebiasis
		Schistosomiasis
		Liver flukes
		Ascariasis
		Larval diseases
	Gastrointestinal disorders and the liver
		Chronic inflammatory bowel disease
	Haematological disorders and the liver
		Haemophilia
		Extramedullary haemopoiesis
	The liver in rheumatoid, immune-complex and collagen diseases
	Amyloidosis and light-chain deposition
	The liver in the porphyrias
	Non-specific reactive changes
	The liver in pregnancy
		Acute fatty liver of pregnancy
		Pre-eclampsia/eclampsia
		HELLP syndrome
	References
		Intrahepatic cholestasis of pregnancy
	General reading
16 - The Liver in Organ Transplantation
	Introduction
	Liver transplantation
		Assessment of the donor liver
		The liver allograft biopsy: general considerations
		Graft rejection
			Antibody-mediated (humoral) rejection
			Acute (cellular) rejection
			Chronic (ductopenic) rejection
		Other causes of graft dysfunction
			Infection
			Biliary obstruction
			Thrombosis
			Drug toxicity
			Immunosuppression withdrawal
			Recurrent disease
			De novo autoimmune hepatitis
			Neoplastic disease
			Late liver-allograft dysfunction
		Differential diagnosis in transplant biopsies
	Renal transplantation
	Bone marrow transplantation
	References
	General reading
17 - Electron Microscopy and Other Techniques
	Introduction
	Electron microscopy of liver biopsies
	The normal liver and examples of ultrastructural changes in disease
		Hepatocyte (liver cell, parenchymal cell)
			The nucleus
			Structural changes
			Mitochondria
			Structural changes
			Endoplasmic reticulum
			Structural Changes
			Lysosomes
			Structural changes
			Peroxisomes
			Structural changes
			Golgi apparatus
			Structural changes
			Cell sap (cytosol)
			Structural changes
			Bile canaliculus
			Structural changes
			Glycogen
			Structural changes
		Kupffer cell
			Structural changes
		Endothelial cell
			Structural changes
		Hepatic stellate cell (Ito cell)
		Pit cell (large granular lymphocyte)
		Extracellular vesicles
	Immunoelectron microscopy
	Scanning electron microscopy
	Immunohistochemistry
	Gene array, gene sequencing and molecular analysis
		Other Techniques
	References
	General reading
Glossary
Index
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Information about COVID-19 and the liver
	References
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