Cirrhosis of liver in cystic fibrosis. COMMENT (#40-#41): Although a finely nodular biliary cirrhosis is described, one can also see a coarsely nodular (macronodular) pattern in the livers of longstanding cystic fibrosis.
Finely and coarsely nodular cirrhosis of liver (mucoviscidosis sequelae). COMMENT (#40-#41): Although a finely nodular biliary cirrhosis is described, one can also see a coarsely nodular (macronodular) pattern in the livers of longstanding cystic fibrosis
Chronic myelogenous leukemia with myelofibrosis (of bone marrow)--chronic lymphocytic leukemia usually results in more striking hepatomegaly than CML but this liver is most remarkably enlarged, although no nodular leukemic infiltrates can be seen. Myelofibrosis (fibrosis of bone marrow) may have contributed to the hepatosplenomegaly if hematopoiesis was present in the liver
Cholangiocarcinoma and metastatic oat cell carcinoma in liver. COMMENT: Central carved-out area represents focus of cholangiocarcinoma; nodular areas=metastatic oat cell (lung) tumor (A81-512)
Cardiac cirrhosis. COMMENT: You would expect a centrilobular necrosis and fibrosis in cirrhosis resulting from right-sided heart failure. A resulting fine cirrhosis is present usually as in most of this specimen; however, there are a few areas of broader scars in the center of the specimen.
Biliary cirrhosis secondary to common bile duct atresia. COMMENT: (#36-#37): Biliary cirrhosis--two examples--of the secondary type, i.e., secondary to atresia (or obstruction) of extrahepatic or intrahepatic bile ducts. Both are examples of micronodular cirrhosis. In the first, ectasia of intrahepatic bile ducts can be appreciated. In the second, appreciate the blood-filled submucosal esophageal varices and the enormous spleen with focal subcapsular infarcts (at top) (compare size of spleen with esophagus to appreciate the splenomegaly).
Biliary atresia in 3 y.o. with biliary cirrhosis, esophageal varices and congested spleen. COMMENT: (#36-#37): Biliary cirrhosis--two examples--of the secondary type, i.e., secondary to atresia (or obstruction) of extrahepatic or intrahepatic bile ducts. Both are examples of micronodular cirrhosis. In the first, ectasia of intrahepatic bile ducts can be appreciated. In the second, appreciate the blood-filled submucosal esophageal varices and the enormous spleen with focal subcapsular infarcts (at top) (compare size of spleen with esophagus to appreciate the splenomegaly).
Severe fatty metamorphosis of liver (No number). Comment on L-10 through L-12: Livers are pale, enlarged with ""rolled"" edges--one specimen (L-12) has been stained with Oil Red O to demonstrate the fat present in the tissue.
Marked fatty change of liver (alcoholism). Comment on L-10 through L-12: Livers are pale, enlarged with ""rolled"" edges--one specimen (L-12) has been stained with Oil Red O to demonstrate the fat present in the tissue.
Fatty liver of alcoholism . Comment on L-10 through L-12: Livers are pale, enlarged with ""rolled"" edges--one specimen (L-12) has been stained with Oil Red O to demonstrate the fat present in the tissue.
Alcoholic cirrhosis . COMMENT: Specimens 13-22 are all examples of cirrhosis associated with alcoholism (Laennec's, portal, nutritional, alcoholic)--note that the specimens have a micronodular pattern in general with a generally uniform appearance to the nodules; however, note that some of the livers have nodules of up to about 1 cm. (see note below) and that there may be some variability in nodule size within one specimen. Intervening parenchyma is composed of fibrous septae. Also note that the remaining nodular liver parenchyma is quite pale or yellow = fatty change associated with continued alcohol abuse. Picture corresponding microscopic picture in your mind's eye of fatty change and cirrhosis (remember the definition of cirrhosis). Specimen #22 indicates that microscopically there is necrosis of hepatocytes with an inflammatory response = this is not evident grossly in this specimen. In this series, the small firm livers are good examples of end stage nutritional or alcoholic cirrhosis. NOTE: Although Robbins says that micronodular cirrhosis has nodules of up to 1 cm. in diameter, Dr. Hennigar's measurement of 3mm. and below is more characteristic.
Portal cirrhosis; fatty degeneration. COMMENT: Specimens 13-22 are all examples of cirrhosis associated with alcoholism (Laennec's, portal, nutritional, alcoholic)--note that the specimens have a micronodular pattern in general with a generally uniform appearance to the nodules; however, note that some of the livers have nodules of up to about 1 cm. (see note below) and that there may be some variability in nodule size within one specimen. Intervening parenchyma is composed of fibrous septae. Also note that the remaining nodular liver parenchyma is quite pale or yellow = fatty change associated with continued alcohol abuse. Picture corresponding microscopic picture in your mind's eye of fatty change and cirrhosis (remember the definition of cirrhosis). Specimen #22 indicates that microscopically there is necrosis of hepatocytes with an inflammatory response = this is not evident grossly in this specimen. In this series, the small firm livers are good examples of end stage nutritional or alcoholic cirrhosis. NOTE: Although Robbins says that micronodular cirrhosis has nodules of up to 1 cm. in diameter, Dr. Hennigar's measurement of 3mm. and below is more characteristic.
Adenocarcinoma of bile duct. COMMENT: Tumor involves central portion of specimen--obviously in this and above five specimens, the histologic appearance is crucial to the diagnosis
