Liver: Difference between revisions
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m →Acute liver failure: H&E stain |
→Microscopic evaluation in autopsy: +Congestive |
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*A severity grading of previously known liver diseases. Quantify any '''[[cirrhosis]]''', at least if the patient had alcohol abuse. | *A severity grading of previously known liver diseases. Quantify any '''[[cirrhosis]]''', at least if the patient had alcohol abuse. | ||
*Signs of acute liver failure. | *Signs of acute liver failure. | ||
*Signs of congestive hepatopathy (indicating heart failure). | |||
===Cirrhosis=== | ===Cirrhosis=== | ||
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===Acute liver failure=== | ===Acute liver failure=== | ||
[[File:Histopathology of acute hepatitis.jpg|thumb|Histopathology of acute hepatitis with lobular disarray and associated lymphocytic inflammation, acidophil body formation (arrow) and bilirubinostasis (H&E stain)<ref name="BoydCain2020"/>]] | |||
Acute liver failure has multiple etiologies, and hence various presentations. Regardless of etiology, the initial hepatic insult that leads to acute liver failure is “hepatitis” in the broadest sense, with extensive hepatocyte injury and necrosis. The initiating process may damage the liver by zonal necrosis (with a centrilobular or acinar zones 3 necrosis being typical of acetaminophen hepatotoxicity), or it may damage the liver by a diffuse hepatitis with necrosis and inflammation as exemplified by acute viral hepatitis A, B, or E infections or other drug hepatotoxicities.<ref name="Lefkowitch2016">{{cite journal|last1=Lefkowitch|first1=Jay H.|title=The Pathology of Acute Liver Failure|journal=Advances In Anatomic Pathology|volume=23|issue=3|year=2016|pages=144–158|issn=1072-4109|doi=10.1097/PAP.0000000000000112}}</ref> | Acute liver failure has multiple etiologies, and hence various presentations. Regardless of etiology, the initial hepatic insult that leads to acute liver failure is “hepatitis” in the broadest sense, with extensive hepatocyte injury and necrosis. The initiating process may damage the liver by zonal necrosis (with a centrilobular or acinar zones 3 necrosis being typical of acetaminophen hepatotoxicity), or it may damage the liver by a diffuse hepatitis with necrosis and inflammation as exemplified by acute viral hepatitis A, B, or E infections or other drug hepatotoxicities.<ref name="Lefkowitch2016">{{cite journal|last1=Lefkowitch|first1=Jay H.|title=The Pathology of Acute Liver Failure|journal=Advances In Anatomic Pathology|volume=23|issue=3|year=2016|pages=144–158|issn=1072-4109|doi=10.1097/PAP.0000000000000112}}</ref> | ||
===Congestive hepatopathy=== | |||
<gallery mode=packed heights=200> | <gallery mode=packed heights=200> | ||
File:Histopathology of | File:Histopathology of congestive hepatopathy.jpg|Histopathology of congestive hepatopathy, with sinusoidal dilation in zone 3. As the severityof the lesion increases, the sinusoids around the central vein become distended with extravasated red cells and there is adjacent hepatocyte plate atrophy.<ref>{{cite journal|last1=Shah|first1=Shailja C.|last2=Sass|first2=David A.|title=“Cardiac Hepatopathy”: A Review of Liver Dysfunction in Heart Failure|journal=Liver Research - Open Journal|volume=1|issue=1|year=2015|pages=1–10|issn=23794038|doi=10.17140/LROJ-1-101}} | ||
*"This is an open access article distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0),"</ref> | |||
</gallery> | </gallery> | ||
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