Liver: Difference between revisions
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→Congestive hepatopathy: +Acute |
→Microscopic evaluation in autopsy: +Report |
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[[File:Steatosis severity at histopathology.jpg|thumb|center|400px|Steatosis grading: a: none. b: mild. c: moderate. d: severe.]] | [[File:Steatosis severity at histopathology.jpg|thumb|center|400px|Steatosis grading: a: none. b: mild. c: moderate. d: severe.]] | ||
*Signs of '''acute liver failure'''. ''Further information in 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 '''congestive hepatopathy''' (indicating heart failure). ''Further information in section below.'' | ||
===Acute liver failure=== | ===Acute liver failure=== | ||
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*'''Acute hepatic congestion''' shows dilated sinusoidal capillaries predominantly in zone 3 of the hepatic acinus.<ref>{{cite web|url=http://www.pathwaymedicine.org/acute-hepatic-congestion|title=Acute Hepatic Congestion|website=Pathway Medicine|accessdate=2020-03-06}}</ref> | *'''Acute hepatic congestion''' shows dilated sinusoidal capillaries predominantly in zone 3 of the hepatic acinus.<ref>{{cite web|url=http://www.pathwaymedicine.org/acute-hepatic-congestion|title=Acute Hepatic Congestion|website=Pathway Medicine|accessdate=2020-03-06}}</ref> | ||
*Typical findings of '''chronic hepatic congestion''' are atrophy of hepatocytes in zone 3, perisinusoidal edema, thrombosis and hemorrhage. Chronic congestion typically displays perivenous and perisinusoidal fibrosis, with fibrous septa that bridge central hepatic veins. In contrast, other causes of distortion and cirrhosis typically have fibrous septa predominantly between portal triads. However, nonalcoholic steatohepatitis also may show perisinusoidal fibrosis in early stages; in later stages, the fibrosis tends to be in the portal triad. Cirrhosis develops in the final stages of congestive hepatopathy. Regenerating hepatocytes tend to grow in a sleevelike pattern along portal tracts, resulting in a nodular liver with preserved portal triads and obliterated or fibrosed hepatic veins, a pattern called "reverse lobulation". This pattern can also be seen in venous obstruction due to Budd-Chiari syndrome.<ref name="WellsFenstad2016">{{cite journal|last1=Wells|first1=Michael L.|last2=Fenstad|first2=Eric R.|last3=Poterucha|first3=Joseph T.|last4=Hough|first4=David M.|last5=Young|first5=Phillip M.|last6=Araoz|first6=Philip A.|last7=Ehman|first7=Richard L.|last8=Venkatesh|first8=Sudhakar K.|title=Imaging Findings of Congestive Hepatopathy|journal=RadioGraphics|volume=36|issue=4|year=2016|pages=1024–1037|issn=0271-5333|doi=10.1148/rg.2016150207}}</ref> | *Typical findings of '''chronic hepatic congestion''' are atrophy of hepatocytes in zone 3, perisinusoidal edema, thrombosis and hemorrhage. Chronic congestion typically displays perivenous and perisinusoidal fibrosis, with fibrous septa that bridge central hepatic veins. In contrast, other causes of distortion and cirrhosis typically have fibrous septa predominantly between portal triads. However, nonalcoholic steatohepatitis also may show perisinusoidal fibrosis in early stages; in later stages, the fibrosis tends to be in the portal triad. Cirrhosis develops in the final stages of congestive hepatopathy. Regenerating hepatocytes tend to grow in a sleevelike pattern along portal tracts, resulting in a nodular liver with preserved portal triads and obliterated or fibrosed hepatic veins, a pattern called "reverse lobulation". This pattern can also be seen in venous obstruction due to Budd-Chiari syndrome.<ref name="WellsFenstad2016">{{cite journal|last1=Wells|first1=Michael L.|last2=Fenstad|first2=Eric R.|last3=Poterucha|first3=Joseph T.|last4=Hough|first4=David M.|last5=Young|first5=Phillip M.|last6=Araoz|first6=Philip A.|last7=Ehman|first7=Richard L.|last8=Venkatesh|first8=Sudhakar K.|title=Imaging Findings of Congestive Hepatopathy|journal=RadioGraphics|volume=36|issue=4|year=2016|pages=1024–1037|issn=0271-5333|doi=10.1148/rg.2016150207}}</ref> | ||
===Report=== | |||
*Even absence of signs of hepatitis or malignancy | |||
*At least if the patient had alcohol abuse, a quantification of cirrhosis. | |||
*Optionally, even absence of congestive hepatopathy and/or steatosis. | |||
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