BSG Pathology Section Liver Slide Seminar, Birmingham, March 12 2008Clinical Summaries - Stefan Hübscher

  Prof. Stefan Hubscher Case 1Male, age 52.Recent onset of jaundice and abnormal LFTs.AST 793 (normal 5-43), ALP 655 (70-330), bilirubin 172 (1-22).ANA positive (1:100), SMA positive, IgG 19.5 (normal 6-16).Liver biopsy.

• Case 2

• Female, age 54

• Potential donor liver retrieved from another centre in the UK

• Died from subarachnoid haemorrhage. No history of alcohol.

• Liver not used because of macroscopic appearance - generally fatty, atrophy of segment 5 in right lobe

• Wedge biopsies taken from left lobe, segment 5 and segment 6. Slide submitted is from left lobe biopsy.

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• Dr Judy Wyatt

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• Case 3

• Female, age 3

• Developed ALL age 2½.

• Presented with acute veno-occlusive disease during 6TG treatment which settled with supportive treatment. Changed to 6MP.

• 1 year later, presented with haematemesis, due to bleeding oesophageal varicies.

• One year after that developed respiratory failure, requiring continuous oxygen.

• Diagnosis – hepatopulmonary syndrome. Liver transplant performed.

• Liver 520g, nodules up to 11mm.

• Case 4• Male, age 48. Presented 2 years earlier with bleeding

oesophageal varices.• Diabetes 20 years, recently become insulin dependent. BMI

33.• Liver transplant for cryptogenic cirrhosis.

ubiquitin

• Prof Alastair Burt•  • Case 5• Male, age 18.• Cystic fibrosis, recurrent chest infection. Developed

bleeding oesophageal varices. Some deterioration of general synthetic function.

• Underwent combined lung/liver transplantation – block from explant.

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• Case 6• Male, age 55• History of highgrade B cell non-Hodgkin’s lymphoma,

treated with several rounds of chemotherapy. Liver function tests abnormal - underwent laparoscopic biopsy (large wedge specimen).

• Clinical diagnosis = hepatic involvement by lymphoma.

The end