Contents
 

Cirrhosis of the liver



13  Patology of the liver

13.5  Cirrhosis of the liver

Pictures

Ascites, liver cirrhosis:
Ascites, liver cirrhosis, Macro, autopsy (70346)

Ascites:
Ascites, Macro, autopsy (72476)

Eyes, jaundice:
Eyes, jaundice, Macro, autopsy (70350)

Eyes, jaundice, Macro, autopsy (70351)

Kidney, cholemic nefrosis:
Kidney, cholemic nefrosis, Macro, autopsy (70360)

Kidney, cholemic nefrosis, Macro, autopsy (70361)

Liver, eclampsia:
Liver, eclampsia, Macro, autopsy (70390)

Liver, eclampsia, Macro, autopsy (70391)

Liver, fibrinous perihepatitis:
Liver, fibrinous perihepatitis, Macro, autopsy (70393)

Notched liver surface in pulmonary emphysema:
Notched liver surface in pulmonary emphysema, Macro, autopsy (70396)

13.5.1  Micronodular, alcoholic cirrhois of Laënnec

13.5.2  Macronodular cirrhosis

13.5.3  Primary billiary cirrhosis

Pictures

Liver, primary biliary cirrhosis:
Liver, primary biliary cirrhosis, Macro, autopsy (70436)

13.5.4  Secondary cirrhosis in biliary obstruction of extrahepatal bile ducts

Pictures

Cholangitis, obstruction of the bile ducts:
Cholangitis, obstruction of the bile ducts, HE 40x (70527)

Cholestatic cirrhosis, chronic choledocholithiasis and cholecystolithiasis, autopsy:
Cholestatic cirrhosis, HE 40x (71360)

13.5.4.2  Alagille-Watson syndrome

Case study:

Alagille-Watson syndrome
Michal Makuša

Case study:

Alagille-Watson syndrome, child
Michal Makuša

13.5.5  Hemochromatosis

Case study:

Familiar hemochromatosis
Michal Makuša

Introduction:

This case study describes familiar hemochromatosis, affecting family members in several generations. Damage of the liver resulted in some family members in liver cirrhosis and cholangiocellular carcinoma. Others show only slight liver dystrophy and laboratory changes.

Pictures

Family tree; hemochromatosis:
Family tree (hemochromatosis case), (73760)

Patient 1

History:

  • male, 54 years
  • hereditary hemochromatosis (homozygotic C282Y)

Clinical signs:

  • liver cirrhosis
  • cholangiocellular carcinoma in liver biopsy

Pictures

Pigmentation of lower legs in a patient with hemochromatosis:
Hemochromatosis, skin pigmentation, CLINIC (73763)

Hemochromatosis, skin pigmentation, CLINIC (73762)

Histology:

Liver biopsy (punction): areas of irregularly arranged tissue with abortive adenoid structures. Iron (Perls), CK7 and CK19 are positive.

Patient 2

History:

  • male, 33 years (son)
  • hereditary hemochromatosis (homozygotic C282Y)

Clinical signs:

Normal size of the liver, no lesions visibe by ultrasound, smooth surface, sharp margins.

Histology:

Liver biopsy (punction): no cirrhosis, increased amount of hemosiderin on the periphery of liver lobules.

Pictures

Hemochromatosis, slight changes, hemosiderin storage within hepatocytes:
Hemochromatosis, liver, HE 60x (73770)

Hemochromatosis, liver, Prussian blue 60x (73769)

Patient 3

History:

  • male, 65 years (brother)
  • examined to rule out liver damage in familiar hemochromatosis (homozygotic C282Y)

Clinical signs:

Examined to rule out liver damage.

Histology:

Liver biopsy (punction): no signs of cirrhosis, large amount of brown pigment within hepatocytes.

Patient 4

History:

  • male, 36 years
  • hereditary hemochromatosis (heterozygotic C282Y/H63D)

Clinical signs:

Admitted to perform liver biopsy.

Laboratory values:

  • ferritin: 766.8 (ref. do 275 µg/l)
  • trasferrin: 2.23 (ref. 2.27  –  3.15 g/l)
  • iron: 43.3 (ref. 7.2  –  29.0 µmol/l)
  • iron, binding capacity: 0.77 (ref. 44.8  –  71.6 µmol/l)

Histology:

Liver biopsy (punction): focal macrovacuolar steatosis (cca 10% of hepatocytes) with prominent hemosiderin intracytoplasmatic pigmentation.

Patient 5

History:

  • female, 45 years
  • positive family history
  • heterozygotic C282Y/-)

Clinical signs:

Examined to rule out liver damage by liver biopsy.

Histology:

Liver biopsy (punction): macrovacuolar steatosis, diffuse slight increase of hemosiderin, no other damage of hepatocytes.

Patient 6

History:

  • female, 22 years
  • familiar hemochromatosis (heterozygotic C282Y/-)

Clinical signs:

The liver without clinical changes.

Laboratory values:

  • ferritin: 37.72 (ref. do 275 µg/l)
  • iron: 25.3 (ref. 7.2  –  29.0 µmol/l)

Patient 7

History:

  • female, 18 years
  • familiar hemochromatosis (heterozygotic C282Y/H63D)

Clinical signs:

The liver without clinical changes.

Laboratory values:

  • ferritin: 31.84 (ref. do 275 µg/l)
  • železo: 22.4 (ref. 7.2  –  29.0 µmol/l)

13.5.6  Hepatolenticular degeneration, Wilson disease

13.5.7  Venostasis of the liver

13.5.7.1  Congestion of the liver in thrombosis of liver veins (Budd-Chiari syndrome)


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