The liver and liver biopsy



The liver and liver biopsy

The liver biopsy forms an important aspect of the workload of any routine histopathology department. Answer the following questions and include any pictures, diagrams, tables, charts etc you feel are applicable. The word count is 2000 words +/- 10%. Be very aware of plagiarism. Don’t forget to reference using Harvard system.

1. A liver biopsy when examined under the microscope stained with Haematoxylin and Eosin (H&E) reveals the presence of ‘ground glass hepatocytes’. The patent is of central African descent. Provide a picture of these cells (again use the internet) and what main disease process do they represent. Describe what stains and IHC you would use to aid in the differential diagnosis of this disease and why and what is the expected staining pattern. What disease do you think this patient is suffering from? 20%

2. A liver biopsy is performed on a young patient aged 8 years old and when examined microscopically under H&E staining a diagnosis of Wilson’s disease is suspected. Describe Wilson’s disease (aetiology and pathogenesis), its pathological appearance and the stains you would use to aid in the diagnosis and why 25%

3. A liver biopsy is performed on a 73 year old male who seems reticent to give details about his lifestyle. The biopsy shows fatty change, possible Mallory bodies, and early stages of fibrosis and possibly cirrhosis. What do ALL these terms mean (also include any pathogenesis of these terms described) and what condition do they indicate. Again what stains could you use to highlight some of the features described? 25%

4. A female patient has a liver biopsy performed and when examined microscopically there appears to be a multitude of ‘golden granules’ within the cytoplasm of the hepatocytes and also cirrhosis is present. On examination of her physical appearance it is noticed that she has a ‘bronzed look’ to her skin. She also complains of tiredness and pain in the joints and an ECG also indicates cardiac problems. What do you think this condition is and briefly give its underlying causes and prognosis and treatment? What do you think the golden granules can be and how could you differentiate these from other ‘golden granules’ by using other stains. A diagnostic algorithm of differential identity of ‘golden granules’ would be very useful. (good hint there) 30%

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