Liver

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Liver

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Liver

  1. 1. “ Hello ” (after the vacations)
  2. 2. <ul><li>Lets start  </li></ul>
  3. 3. <ul><li>Liver tumors </li></ul>Benign Malignant
  4. 4. <ul><li>Benign and Malignant </li></ul>
  5. 5. <ul><li>Most common Benign tumor </li></ul><ul><li>of Liver is </li></ul><ul><li>Cavernous hemangioma </li></ul>
  6. 6. <ul><li>Red Blue soft nodules </li></ul><ul><li>Less than 2 cms </li></ul><ul><li>Site – under the capsule </li></ul><ul><li>~ can be mistaken for metastasis </li></ul>
  7. 7. Liver cell adenoma <ul><li>Benign </li></ul><ul><li>Common in : </li></ul><ul><li>Can rupture during pregnancy </li></ul><ul><li>Clinical significance : </li></ul>
  8. 8. Liver cell adenoma <ul><li>Pale yellow nodule </li></ul><ul><li>Below the capsule </li></ul><ul><li>Can grow big </li></ul>
  9. 12. Liver cell adenoma <ul><li>Sheets and cords of cells , </li></ul><ul><li>Looks like normal liver </li></ul><ul><li>Portal tracts are absent </li></ul>
  10. 14. <ul><li>Malignant tumors </li></ul>
  11. 15. <ul><li>Most common are – </li></ul><ul><li>metastasis </li></ul><ul><li>Primary Sites : </li></ul>
  12. 20. <ul><li>Primary Malignant tumors </li></ul><ul><li>Hepatoblastoma </li></ul><ul><li>Angiosarcoma </li></ul><ul><li>Hepatocellular carcinoma (HCC) </li></ul>
  13. 21. <ul><li>Hepatoblastoma </li></ul><ul><li>In young people </li></ul><ul><li>Epithelial and mixed type </li></ul>
  14. 22. <ul><li>Angiosarcoma </li></ul><ul><li>Vinyl chloride, </li></ul><ul><li>Arsenic, </li></ul><ul><li>Thorotrast </li></ul><ul><li>… dacades of exposure </li></ul><ul><li>Fatal tumor </li></ul>
  15. 25. Hepatocellular Carcinoma
  16. 26. <ul><li>Global trends </li></ul>
  17. 27. <ul><li>Etiology </li></ul>Viral infection Alcohol Food Toxins
  18. 28. <ul><li>Hepatitis B </li></ul><ul><li>Hepatitis C </li></ul>
  19. 29. <ul><li>Tell some other Oncogenic viruses… </li></ul>
  20. 30. Epstein Barr <ul><li>Burkitt’s Lymphoma </li></ul><ul><li>Nasopharyngeal </li></ul><ul><li>carcinoma </li></ul>
  21. 31. Hepatocellular carcinoma <ul><li>HBV </li></ul><ul><li>HCV </li></ul>
  22. 32. Cervix cancer <ul><li>HPV 16,18 </li></ul>
  23. 33. <ul><li>Human herpes virus 8 </li></ul><ul><li>Kaposi’s sarcoma </li></ul><ul><li>B Cell Lymphoma </li></ul>
  24. 34. <ul><li>HTLV I </li></ul><ul><li>Adult T Cell leukemia lymphoma </li></ul>
  25. 35. What these viruses do ? <ul><li>More cell cycles </li></ul><ul><li>Instable genome after the HBV DNA </li></ul><ul><li>Attachment </li></ul>
  26. 36. <ul><li>Aflatoxin (Aspergillus flavus) </li></ul><ul><li>Mutation of P53 gene </li></ul>
  27. 37. <ul><li>Clinical features </li></ul><ul><li>Upper abdominal pain, </li></ul><ul><li>Fatigue </li></ul><ul><li>Weight loss </li></ul><ul><li>Raised serum Alfa feto pretein </li></ul><ul><li>(~75 % patients) </li></ul>
  28. 38. <ul><li>Gross </li></ul><ul><li>Unifocal </li></ul><ul><li>Multifocal </li></ul><ul><li>Diffuse infiltrating </li></ul>
  29. 42. <ul><li>Microscopy : </li></ul><ul><li>Well differentiated to poor differentiated </li></ul>
  30. 45. <ul><li>Metastasis </li></ul><ul><li>In Lungs , Lymphnodes </li></ul>
  31. 46. <ul><li>Fibrolamellar type </li></ul><ul><li>Young people 20 – 40 yr </li></ul><ul><li>Not associated with HBV </li></ul><ul><li>Single tumor </li></ul><ul><li>Good prognosis </li></ul>
  32. 48. <ul><li>Some other liver Images </li></ul><ul><li>Identify ! </li></ul>
  33. 49. Normal Liver cut section
  34. 51. Fatty Liver
  35. 53. <ul><li>Macronodular cirrhosis </li></ul>
  36. 56. <ul><li>Some good </li></ul><ul><li>Pathology websites </li></ul>
  37. 58. www.pathguy.com
  38. 59. Webpath

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