ISSN:1082-9784    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Liver biopsy interpretation in chronic hepatitis has undergone a number of major conceptual changes during the past three decades. During that period, our understanding of chronic hepatitis as a disease process caused by multiple etiologic factors has enlarged to encompass hepa-titis viruses (B, C, D, and others), hepatotoxic drugs, autoimmune factors, and metabolic diseases such as alpha1antitrypsin deficiency and Wilson's disease. At the same time, it has become clear that “pigeon-holing” patients' biopsies in categories such as “chronic persistent hepatitis” and “chronic active hepatitis” is an unrealistic labelling of specific images which may be modified from day to day by ongoing necroinflammation and fibrosis. Accordingly, recent efforts by hepatic pathologists have been directed at developing histological reporting systems which convey (1) the etiology; (2) the grade of necroinflammation; and (3) the stage of fibrosis/cirrhosis. This review discusses some of the historical aspects of chronic hepatitis as well as the possible scoring systems available today.

ISSN:1082-9784    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The three major chronic inflammatory liver diseases that are felt to have an autoimmune basis are autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), and primary sclerosing cholangitis (PSC). While all can progress to cirrhosis, AIH predominantly affects hepatocytes, and PBC and PSC largely affect bile ducts. Reflecting this pathogenesis, PBC and PSC show many similarities in presenting symptoms, serum biochemical values, and histopathology, many of which are in contrast to those seen in autoimmune hepatitis. The purpose of this review is to provide an overview of the characteristic clinical and histologic features of AIH, PBC, and PSC as well as to discuss classification schemes and overlap syndromes of autoimmune liver disease. This is intended for the general surgical pathologist as an aid in distinguishing AIH, PBC, and PSC from each other and from potential mimics.

ISSN:1082-9784    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The most important iron and copper storage disease are hereditary hemochromatosis and Wilson's disease, respectively- Recently there have been major advances in molecular generics in both disorders. Correct diagnosis by the pathologist requires The integration of clinical information with a wide range of diagnostic modalities, which may include liver histology, special histochemical stains, tissue metal quantitation, electron microscopy, and molecular genetics. As yet, no gold standard tests exist, so each of these laboratory techniques must be appropriately applied and judiciously interpretd.

ISSN:1082-9784    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

nfantile jaundice (conjugated hyperbilirubinemia) is the common presentation of biliary atresia, idiopathic neonatal hepatits infectious hepatitis and metabolic disorders. A timely diagnosis is essential to the management of these children. The investigation of hepatobiliary disease in this age group frequently includes a liver biopsy which, if optimally handled, provides tissue for a focused investigation. This is dependent upon consideration of the history prior to biopsy. The histologic picture, together with special investigations, provides a diagnosis in many instances. In those disorders with histologic change suggestive of a diagnosis ancillary laboratory studies may include special enzyme or compound analyses, as well as molecular studies. This overview provides an approach to the pathologist who may infrequently encounter this problem, and includes biopsy processing, pathology and special investigations.

ISSN:1082-9784    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The primary indication for fine needle aspiration biopsy of the liver is the evaluation of mass lesions. Although FNA biopsy is used most often for the evaluation of primary and metastatic malignancies of the liver, the differential diagnosis includes a variety of nonneoplastic, space-occupying lesions, such as abscesses, cysts, granulomas, xanthogranulomatous processes, and dominant nodules in cirrhosis. In contrast, medical liver diseases are best evaluated by surgical pathology core biopsy. However, nonneoplastic liver diseases may be sampled either intentionally or serendipitously when the radiologist is evaluating a mass lesion. The authors report an example of a liver abscess in a 52-year-old man presenting with fever, right upper quadrant pain and tender hepatomegaly. The cytologic findings of a liver abscess are presented along with the differential diagnosis, cytologic features and the value of ancillary studies.

ISSN:1082-9784    

出版商:OVID    

年代:1999

数据来源: OVID