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Liver EQA Scheme Circulation LR MCQ responses for non-EQA membersAnswer sheet: - keep a record of your responses on this sheet and then transcribe them onto the surveymonkey HYPERLINK "" so that they can be included in the meeting, Bring this sheet with you find your result.You can view either photos or the digital slides on lineCase LR1 56FPBC. Staging. This is 2/3 of the specimen the other 1/3 for research. Also van Gieson, rhodanineAIn keeping with primary biliary cholangitis (PBC) + fibrosis assessmentBIn keeping with autoimmune hepatitis + fibrosis assessmentCOverlap syndrome (AIH/PBC) + fibrosis assessmentDFatty liver disease + fibrosis assessmentELikely drug induced injury + fibrosis assessmentCase LR2 47MElevated Fibroscan. ? Cirrhosis Also Masson trichromeASteatohepatitis +comment on potential aetiologyBFatty liver disease +comment on potential aetiologyCAlcoholic liver diseaseDBridging fibrosis +steatohepatitis+comment on potential aetiologyECirrhosis +steatohepatitis+comment on potential aetiologyCase LR3 91F140x110x40mm liver segment. slicing shows a 65x50x50mm tumour with a variegated appearance including areas of necrosis and haemorrhage. three smaller satellite nodules. section from main lesion.AHepatocellular carcinomaBHaematolymphoid malignancyCNeuroendocrine tumourDAdrenocortical carcinoma metEMet hepatoid carcinomaCase LR4 72F Acute hepatitis, cause? seronegative autoimmune hepatitis? Also Van GiesonADILI drug induced liver injuryBChronic hepatitisCAutoimmune hepatitis (AIH)DAcute hepatitis (DILI, virus, AIH)EOverlap diseaseCase LR5 65FHeptatitic picture, autoimmune, AIH? IgG 19.67g/l, ANA+ (1:100) f actin+ and SMA+. AMA-. Bili 73, ALT 946 ALP 256. Also retic, Shikata, van GiesonAChronic active hepatitisBCirrhosis, autoimmune hepatitisCSevere inflammation with plasma cellsDAcute hepatitis, consider drugs, autoimmune, virusesEHepatitis, consistent with autoimmune, confluent necrosisCase LR6. 73M Liver resection for HCC. Additional nodule visualised on liver. Subcapular liver resection. No special stains.ACholangiocarcinomaBVon Meyenburg complexCMetastatic adenocarcinomaDHaemangioma (sclerosed)EBile duct adenoma/peribiliary gland hamartomaCase LR7 69F Deranged LFT's AST/ALT>800. IgG increased, ?autoimmune hepatitis Also Reticulin and sirius redACombined hepatitis and fatty liver disease/steatohepatitisBHepatitis favouring drug + comment on fibrosisCCirrhosis with ongoing inflammationDHepatitis favouring viral + comment on fibrosisEHepatitis favouring autoimmune (AIH) + comment on fibrosisCase LR8 26MCryptogenic liver cirrhosis. Chronic Budd Chiari? No additional stainsACongestion, consistent with hepatic vein thrombosisBPeliosis hepatisCChronic vascular injuryDCongestion, consistent with portal vein thrombosisEEpithelioid haemangioendotheliomaCase LR9 29FHydatid cyst resection. Segment of liver 85 x 70 x 70 mm with a cyst 68 x 50 x 30 mm.No additional stainsANecrobiotic noduleBParasitic cystCCystadenomaDHydatid cystEHydatic cyst, ? Aleolar typeCase LR10 57FFatty liver, previous positive antibodies and raised IgG. significantly elevated fibroscan suggestive of cirrhosis - liver biopsy to assess/stage disease. Additionals stains: van Gieson, retic, shikata, Cam 5.2ASteatosis, ballooning and Mallory-Denk bodies, fibrosisBAutoimmune hepatitis and steatohepatitis, cirrhosisCCirrhosis, ? alcohol, ? AIH, ? hep BDBridging fibrosis and steatosisECirrhosis, steatohepatitis, alcohol related or NASHCase LR11 75FAbnormal LFTs and jaundice. Extra stains: vG, retic, PASD, shikataAChronic active hepatitis with cirrhosisBAcute hepatitis with bridging necrosis - AIH/drug/virusCCholestasis, suggests large bile duct obstructionDCirrhosis ? viralECirrhosis with inflammation, ? alcoholCase LR12 67MHistory of primary carcinoid lung tumour with solitary liver metastasis. Metastasectomy performed. Liver disc 7.8cm diameter x 3.3cm deep. Nodule measuring 2.2cm, 0.6cm from the deep margin. Also chromogranin, PSA, CK20, CK7, TTF, S100, synaptoAConsistent with metatatic carcinoid tumourBMetastatic carcinoma, ? thyroid originCAdenocarcinoma, probably cholangiocarcinomaDMetastatic adenocarcinoma - not carcinoid - review lung primaryEBile duct adenoma ................
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