Cardiovascular Physiology - Regulation of Cardiac Pumping
Autoimmune Liver Disease - Kuwait
1. Autoimmune Liver Diseases: AIH, PBC, PSC Neil Theise, MD Depts. of Pathology and Medicine (Digestive Diseases) Beth Israel Medical Center – Albert Einstein College of Medicine New York City
20. Gender: Women Age: Middle aged to older Associated diseases: Scleroderma Hashimoto’s thyroiditis CREST syndrome Sjogren’s syndrome, etc…. Serologic markers: AMA (ASMA, ANA) Primary Biliary Cirrhosis (PBC):
21. Gender: Women Age: Middle aged to older Associated diseases: Scleroderma Hashimoto’s thyroiditis CREST syndrome Sjogren’s syndrome, etc…. Serologic markers: AMA (ASMA, ANA) Bile ducts involved: Medium to small ducts ONLY Primary Biliary Cirrhosis (PBC):
40. Gender: Men Age: Teens to 30’s Primary Sclerosing Cholangitis (PSC):
41. Gender: Men Age: Teens to 30’s Associated diseases: Inflammatory bowel disease ( U.C. or Crohn’s) 70% have IBD 70% of IBD will develop PSC Primary Sclerosing Cholangitis (PSC):
42. Gender: Men Age: Teens to 30’s Associated diseases: Inflammatory bowel disease ( U.C. or Crohn’s) 70% have IBD 70% of IBD will develop PSC Serologic markers: ANCA…? Primary Sclerosing Cholangitis (PSC):
43. Gender: Men Age: Teens to 30’s Associated diseases: Inflammatory bowel disease ( U.C. or Crohn’s) 70% have IBD 70% of IBD will develop PSC Serologic markers: ANCA…? Ducts involved: Large extrahepatic to small intrahepatic Primary Sclerosing Cholangitis (PSC):
44. Gender: Men Age: Teens to 30’s Associated diseases: Inflammatory bowel disease ( U.C. or Crohn’s) 70% have IBD 70% of IBD will develop PSC Serologic markers: ANCA…? Ducts involved: Large extrahepatic to small intrahepatic At increased risk for: Cholangiocarcinoma Primary Sclerosing Cholangitis (PSC):
69. Primary Biliary Cirrhosis (PBC) Primary Sclerosing Cholangitis (PSC) vs. Age Gender Assoc’d Dx 40-60 Female RA, CREST Scleroderma Sjogren’s 10-30 Male Ulcerative Colitis Crohn’s Disease
70. Primary Biliary Cirrhosis (PBC) Primary Sclerosing Cholangitis (PSC) vs. Age Gender Assoc’d Dx 40-60 Female RA, CREST Scleroderma, Sjogren’s 10-30 Male Ulcerative Colitis Crohn’s Disease
71. Primary Biliary Cirrhosis (PBC) Primary Sclerosing Cholangitis (PSC) vs. Age Gender Assoc’d Dx 40-60 Female RA, CREST Scleroderma, Sjogren’s 10-30 Male Ulcerative Colitis Crohn’s Disease
72. Primary Biliary Cirrhosis (PBC) Primary Sclerosing Cholangitis (PSC) vs. Age Gender Assoc’d Dx Ducts Affected 40-60 Female RA, CREST Scleroderma, Sjogren’s Small to medium 10-30 Male Ulcerative Colitis Crohn’s Disease All ducts
73. Primary Biliary Cirrhosis (PBC) Primary Sclerosing Cholangitis (PSC) vs. Age Gender Assoc’d Dx Ducts Affected Method of Dx 40-60 Female RA, CREST Scleroderma, Sjogren’s Small to medium Biopsy 10-30 Male Ulcerative Colitis Crohn’s Disease All ducts MRCP/ERCP
74. vs. P S C S UC KS P B C B UCKS NOT Primary Biliary Cirrhosis (PBC) Primary Sclerosing Cholangitis (PSC) MNEMONIC!!!
75. vs. P S C S UC KS P B C B UCKS NOT Primary Biliary Cirrhosis (PBC) Primary Sclerosing Cholangitis (PSC) MNEMONIC!!!
Notes de l'éditeur
Fig. 16.1A. Variation in the severity of fibrosis in chronic biliary disease. These two slides are taken from a single block of liver obtained at transplantation from a patient with primary biliary cirrhosis. One area shows established cirrhosis (A). In an adjacent area there is preservation of normal vascular relationships with no evidence of fibrosis (B). (P = portal tract, H = hepatic venule). H&E.
Fig. 16.1B. Variation in the severity of fibrosis in chronic biliary disease. These two slides are taken from a single block of liver obtained at transplantation from a patient with primary biliary cirrhosis. One area shows established cirrhosis (A). In an adjacent area there is preservation of normal vascular relationships with no evidence of fibrosis (B). (P = portal tract, H = hepatic venule). H&E.
Fig. 12.7B. Metaplasia of gallbladder mucosa in chronic cholecystitis. (A) A lobule of pyloric glands is seen in the lamina propria. The surface epithelium is of gastric foveolar type. (B) Intestinal metaplasia with columnar and goblet cells; endocrine cells were identified by immunohistochemistry. H&E.
Fig. 11.8B. (A) Suppurative cholangitis with cholangitic abscess (*) and remnants of the bile-duct epithelium (arrow) in a case of bacterial cholangitis. (B) Non-suppurative cholangitis showing epithelial damage (arrow) and periductal infiltration of lymphocytes and plasma cells in primary biliary cirrhosis. H & E.
Fig. 11.7B. Biliary epithelial dysplasia associated with hepatolithiasis. (A) Lining epithelium of a large intrahepatic bile duct shows micropapillary hyperplasia with cellular dysplasia. H & E. (B) Close-up of micropapillary hyperplasia with mild dysplasia illustrating nuclear pseudostratification. H & E.
Fig. 15.62. Intrahepatic cholangiocarcinoma. This peripheral tumour has replaced the entire left lobe.
Fig. 15.63. Intrahepatic cholangiocarcinoma. This lobectomy specimen contains a hard, yellow-white tumour that arose near the hilum and spread peripherally.
Fig. 15.65. Cholangiocarcinoma. Poorly formed glands with frequent mitoses. H&E.
