Liver: Difference between revisions

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==Microscopic evaluation==

[[File:Histopathology of liver zones.jpg|thumb|Pathologies can be topographically classified by liver zones. P: portal tract. V: central vein.]]

A general screening includes:

A general screening includes (with further information in sections below):

*A severity grading of '''previously known liver diseases'''.

*Looking at the '''referral/requisition form''' {{Moderate-begin}}and looking at the medical records{{Moderate-end}} for particular conditions to look for or evaluate. {{Moderate-begin}}Perform a severity grading of '''previously known liver diseases'''.{{Moderate-end}}

:*Commonly, this includes to quantify any '''cirrhosis''', at least if the patient had alcohol abuse.

:*'''Steatosis''' is also common.

*Signs of '''acute liver failure'''.

*Signs of '''malignancy'''. If a tumor is found: {{Further|Liver tumor|linebreak=no}}

*Signs of '''congestive hepatopathy''' (indicating heart failure).

*Signs of '''inflammation''' at least around the portal triads.

===Cirrhosis===

File:Histopathology of steatohepatitis with mild fibrosis in the form of fibrous expansion (van Gieson).jpg|Steatohepatitis with '''mild fibrosis''' (van Gieson's stain).<ref name="BoydCain2020"/>

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</gallery>

~~:*'''Steatosis''' is also common, (see section below).~~

*Signs of '''acute liver failure'''. ''Further information in section below.''

*Signs of '''malignancy'''. If a tumor is found: {{Further|Liver tumor|linebreak=no}}

*Signs of '''congestive hepatopathy''' (indicating heart failure). ''Further information in section below.''

*Signs of '''inflammation''' at least around the portal triads.

===Steatosis===

At least classify steatosis by severity:

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File:Kupffer cell with hemosiderin and hepatocyte with lipofuscin.jpg|Look for Kupffer cells with significant '''hemosiderin deposition''' (shown next to a hepatocyte with lipofuscin pigment.

File:Histology of hepatocyte lipofuscin.jpg|Hepatocyte '''lipofuscin''' is of no real pathologic importance and does not warrant a mention in the report.<ref>{{cite web|url=https://webpath.med.utah.edu/LIVEHTML/LIVER019.html|title=The Internet Pathology Laboratory for Medical Education|website=The University of Utah Eccles Health Sciences Library|accessdate=2020-12-18}}</ref>

File:Kupffer cell with hemosiderin and hepatocyte with lipofuscin, iron stain.jpg|Iron stain can highlight the '''hemosiderin''' (blue stain) in unclear cases.

File:Histology of hepatocyte lipofuscin.jpg|Hepatocyte '''lipofuscin''' alone is of no real pathologic importance and does not warrant a mention in the report.<ref>{{cite web|url=https://webpath.med.utah.edu/LIVEHTML/LIVER019.html|title=The Internet Pathology Laboratory for Medical Education|website=The University of Utah Eccles Health Sciences Library|accessdate=2020-12-18}}</ref>

</gallery>

===Report===

*~~At least if the patient had alcohol abuse, a quantification~~ of ~~cirrhosis~~.

*Presence of any liver disease

*~~Optionally, even~~ absence of hepatitis, malignancy, congestive hepatopathy and/or steatosis.

:*{{Moderate-begin}}Quantification of its severity.{{Moderate-end}}

*{{Comprehensive-begin}}Even absence of hepatitis, malignancy, congestive hepatopathy and/or steatosis.{{Comprehensive-end}}

@@ Line 35: / Line 35: @@
 ==Microscopic evaluation==
 [[File:Histopathology of liver zones.jpg|thumb|Pathologies can be topographically classified by liver zones. P: portal tract. V: central vein.]]
-A general screening includes:
+A general screening includes (with further information in sections below):
-*A severity grading of '''previously known liver diseases'''.
+*Looking at the '''referral/requisition form''' {{Moderate-begin}}and looking at the medical records{{Moderate-end}} for particular conditions to look for or evaluate. {{Moderate-begin}}Perform a severity grading of '''previously known liver diseases'''.{{Moderate-end}}
 :*Commonly, this includes to quantify any '''cirrhosis''', at least if the patient had alcohol abuse.
+:*'''Steatosis''' is also common.
+*Signs of '''acute liver failure'''.
+*Signs of '''malignancy'''. If a tumor is found: {{Further|Liver tumor|linebreak=no}}
+*Signs of '''congestive hepatopathy''' (indicating heart failure).
+*Signs of '''inflammation''' at least around the portal triads.
+===Cirrhosis===
 <gallery mode=packed heights=170>
 File:Histopathology of steatohepatitis with mild fibrosis in the form of fibrous expansion (van Gieson).jpg|Steatohepatitis with '''mild fibrosis''' (van Gieson's stain).<ref name="BoydCain2020"/>
@@ Line 43: / Line 50: @@
 </gallery>
 {{Further|Cirrhosis}}
-:*'''Steatosis''' is also common, (see section below).
-*Signs of '''acute liver failure'''. ''Further information in section below.''
-*Signs of '''malignancy'''. If a tumor is found: {{Further|Liver tumor|linebreak=no}}
-*Signs of '''congestive hepatopathy''' (indicating heart failure). ''Further information in section below.''
-*Signs of '''inflammation''' at least around the portal triads.
 ===Steatosis===
 At least classify steatosis by severity:
@@ Line 74: / Line 75: @@
 <gallery mode=packed heights=180>
 File:Kupffer cell with hemosiderin and hepatocyte with lipofuscin.jpg|Look for Kupffer cells with significant '''hemosiderin deposition''' (shown next to a hepatocyte with lipofuscin pigment.
-File:Histology of hepatocyte lipofuscin.jpg|Hepatocyte '''lipofuscin''' is of no real pathologic importance and does not warrant a mention in the report.<ref>{{cite web|url=https://webpath.med.utah.edu/LIVEHTML/LIVER019.html|title=The Internet Pathology Laboratory for Medical Education|website=The University of Utah Eccles Health Sciences Library|accessdate=2020-12-18}}</ref>
+File:Kupffer cell with hemosiderin and hepatocyte with lipofuscin, iron stain.jpg|Iron stain can highlight the '''hemosiderin''' (blue stain) in unclear cases.
+File:Histology of hepatocyte lipofuscin.jpg|Hepatocyte '''lipofuscin''' alone is of no real pathologic importance and does not warrant a mention in the report.<ref>{{cite web|url=https://webpath.med.utah.edu/LIVEHTML/LIVER019.html|title=The Internet Pathology Laboratory for Medical Education|website=The University of Utah Eccles Health Sciences Library|accessdate=2020-12-18}}</ref>
 </gallery>
 ===Report===
-*At least if the patient had alcohol abuse, a quantification of cirrhosis.
+*Presence of any liver disease
-*Optionally, even absence of hepatitis, malignancy, congestive hepatopathy and/or steatosis.
+:*{{Moderate-begin}}Quantification of its severity.{{Moderate-end}}
+*{{Comprehensive-begin}}Even absence of hepatitis, malignancy, congestive hepatopathy and/or steatosis.{{Comprehensive-end}}
 {{Bottom}}

Liver: Difference between revisions

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