Index

Note: Page numbers of article titles are in boldface type.

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A

A1AT deficiency, clinical presentation of, 217

extrahepatic biliary atresia vs., 208, 211

histologic findings in, 217–218

PiZZ phenotype-associated, 217

Acute antibody-mediated OLT rejection, 290

Acute cellular rejection (ACR), diagnostic criteria for,

277–278

endothelitis in, 278–279

histopathologic features of, 277

portal inflammatory infiltrate in, 278

Amiodarone, liver injury and steatohepatitis from,

241–242

Autoimmune hepatitis (AIH), 259–276

defined, 259

diagnosis of, 259–260

absence of antibodies in, 263

antibodies in, 262

International Autoimmune Hepatitis Group

revised criteria for, 260

International Autoimmune Hepatitis Group

scoring criteria for, 261–162

noncoventional antibodies in, 262–263

simplified criteria for, International

Autoimmune Hepatitis Group, 262

differential diagnosis of, chronic hepatitis C in, 270

drug-induced hepatitis in, 270

drug-induced liver injury in, 270

primary sclerosing cirrhosis in, 271

pulmonary biliary cirrhosis in, 271

Wilson disease in, 271

histologic features of, central perivenulitis,

266–267, 269

hepatocytes forming rosettes, 267

immunoglobulin G4-associated, 273–274

microscopic features of, 263

bridging necrosis, 268

hepatocytes forming rosettes, 263, 267

histologic features of cholangitis, 264–265, 269

in acute-onset, 266, 269

inflammatory infiltrate, 264–265

lobular inflammation, 263, 265, 267

portal inflammatory infiltrate, 263, 266

overlap syndromes, autoimmune hepatitis–

primary biliary cholangitis, 272–273

autoimmune hepatitis–primary biliary

sclerosing cholangitis, 273

survival rates, 272

Surgical Pathology 6 (2013) 385–389http://dx.doi.org/10.1016/S1875-9181(13)00044-51875-9181/13/$ – see front matter � 2013 Elsevier Inc. All

B

Bile acid synthetic disorders (BASDs), enzyme defect

in, 223

gene mutation, clinical features, and liver findings

in, 223

Biliary atresia, paucity of bile ducts vs., 216–217

BSEP deficiency, genetic, clinical, histopathologic

features of, 219, 221

C

Chronic hepatitis, autoimmune hepatitis vs., 270

Chronic rejection (CR), diagnostic criteria for, 281

bile duct atrophy/senescence in, 281–282

differential diagnosis of, biopsy in, 281, 283

foam cell obliterative arteriopathy in, 281–282

hepatitis C in, 283–284

primary biliary cirrhosis in, 283

primary biliary sclerosis in, 283

histologic features of, 283

Cirrhosis regression, 295–300

evaluation of fibrosis in, biopsy for, 296

clinical outcomes in, 297

noninvasive biomarkers for, in future, 296

evidence for, 295–296

in HBV replication suppression with nucleos(t)

ide analogues, 296

in hepatitic C virus or hepatitis B virus

infections, 296

histopathologic pattern of, fibrous septa in HCV

cirrhosis, 298

portal tracts interconnected by thin fibrous

septa, 298–299

reduced septum in, 300

pathophysiologic mechanisms sustaining, ECM

enzymatic digestion, 297

hepatocyte cell regeneration, 297–298

point of irreversibility of, 298

resolution of hepatic stellate cells, 297

Cirrhosis regression and subclassification,

295–309

practical issues and future direction in, 306

Cirrhosis subclassification, 300–306

clinical, hepatic venous pressure gradient in, 301

portal hypertension in, 301

collagen proportionate area in, 304–305

correlation with hepatic venous pressure

gradient, 305

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Index386

Cirrhosis (continued )

comparison of Laennec system and Jain-Garcia

system, 303

correlation of portal tract loss with portal pressure,

303

extent of fibrosis correlated with advancing liver

disease, 303

histologic, 300, 305–306

histopathologic, architectural features on, 306

impact of nodule size, septal width, area of

fibrosis, 302

Jain-Garcia system, proposed, 305–306

Laennec system, 302–303

need for, 300–301

need for histologic staging, 301

nodule size and septal width correlation with

compensated cirrhosis, 303–304

quantitative, digital analysis estimation of fibrosis,

305

rationale for, 301–305

CMV infection, in OLT recipients, 287–289

E

EBV infection, in OLT recipients, 289

vs. posttransplant lymphoproliferative

disorder, 289

Extrahepatic biliary atresia (EHBA), defined, 206

diagnostic key points for, 208, 210

differential diagnosis of, 208, 210–211

histologic findings in, lobular changes, 208, 210

portal changes, 208–209

pitfalls in, 211

types of, anatomic, 208

clinical, 208

F

Fibrolamellar carcinoma (FLM), clinical features of,

369

differential diagnosis of, 372

morphologic features of, gross, 371

immunohistochemical, 372

microscopic, 371–372

prognosis in, 372–373

Fibrosing cholestatic hepatitis (FCH),

characterization of, 285

clinicopathologic features of, 287

differential diagnosis of, bile duct obstruction in,

285

chronic rejection mimicking, 285–286

viral hepatitis in, 286–287

histologic features of, bridging fibrosis, 285–286

FIC1 deficiency (PFIC1), ATP8B1 gene mutation in,

217

histologic findings in, genetic, clinical,

histopathologic features of, 217, 219

Focal nodular hyperplasia, in noncirrhotic liver,

340–341, 346–347

G

Giant cell hepatitis (GCH), neonatal, 223–224

H

Hepatic adenoma, characterization of, 338–339

differentiation from hepatic cell carcinoma, 338

in noncirrhotic liver, $-catenin-activated, 339,

342–343

“HNF1” inactivated, 339–341

immunohistochemistry panel in, 339

inflammatory, 339–340, 344–345

Hepatic mass lesion(s), diagnostic approach and

immunohistochemistry of, 333–365

in cirrhotic and noncirrhotic liver, 333–334

in cirrhotic liver, fibrolamellar, 338

hepatocellular carcinoma, 335–338

high-grade dysplastic nodules, 334–335

low-grade dysplastic nodules, 334

macrodegenerative nodules, 334

in noncirrhotic liver, focal nodular hyperplasia,

340–341, 346–347

hepatic adenoma, 338–346

hepatic cell carcinoma, 341

markers in, alpha fetoprotein, 349

ARG1, 345, 348

carbioembryonic antigen, 349

CD10, 349

cytokeratins, 349

glutamine synthetase, 350

GPC3 (glypican), 348–349

heat shock protein 70, 349–350

HepPar-1, 345, 351

MOC31 (EPCAM), 350

metastatic carcinomas, histologic patterns in,

351–358

immunohistochemistry markers for,

350–362

immunohistochemistry stains in differential

diagnosis of, 362

solid architecture, 350–353

with glandular/acinar/papillary differentiation,

353–355, 359

with organoid architecture, 350, 358

with squamous differentiation, 350,

356–357

poorly differentiated of unclear lineage,

cholangiocarcinoma, 342–344

markers for cell lineage, 348

mixed HCC–cholangiocarcinoma, 344

mixed HCC-cholangiosarcoma, 344

Hepatitis E virus (HEV) infection, in OLT recipients,

289–290

Index 387

Hepatocellular adenomas (HCAs), 311–331

biopsy for, indications and performance, 324,

326–327

clinical data for, 312

complications of, hemorrhage and rupture,

321–322, 325

malignant transformation to hepatocellular

carcinoma, 322, 324–329

diagnostic approach to, immunohistochemistry

for glutamine synthetase and serum

amyloid-associated protein, 329

epidemiology of, 311–312

histologic characterization of, 312

immunophenotypical characteristics of, 324

key features of, 311

macroscopic characteristics of, 312

management of, 327–328, 330

pathomolecular classification of, HCA with cellular

atypia, 317–322

steatotic, 312–313

telangictatic/inflammatory subtype, 313–320

unclassified HCA, 320–321

unclassified, 320–321

with cellular atypia, $-catenin activated,

319–323

Hepatocellular carcinoma (HCC), histologic

subtypes, 367–384

combined HCC-CC, classic type, 373–376

diffuse cirrhosis-like, 380

fibrolamellar, 369, 371–373

HCC vs. renal cell carcinoma, 379–380

lymphoepithelioma-like, 379

sarcomatoid, 378–379

scirrhous, 367–370

scirrhous hepatocellular carcinoma, 367–370

steatohepatitic, 380

transitional liver cell tumor, 380

undifferentiated, 379

with stem cell features, 374–380

in cirrhotic liver, classification of, 335

cytoplasmic staining with GPC3, 336

diagnosis of, 335

fibrolamellar variant, 338

in alcoholic cirrhosis, 335, 338

moderatly to poorly differentiated, 335–336

poorly differentiated, 335–336

in noncirrhotic liver, diagnosis of, 341

Hepatocellular carcinoma–cholangiosarcoma

(HCC–CC), classic type, clinical features of, 373

pathologic features of, 373–374

with stem cell features, 374–380

cholangiocellular, 376–378

intermediate, 376–378

lymphoepithelioma-like, 379

practical points, 376

subtypes of, 377

typical, 376–377

I

Idiopathic posttransplant chronic hepatitis (IPTH),

285

Irinotecan, liver injury and steatohepatitis from, 242

L

Late acute rjection (LAR [centrizonal/parenchymal

rejection]), clinical considerations in, 281

defined, 279

differential diagnosis of, primary biliary cirrhosis,

280

viral hepatitis, 279–280

histopathologic features of, vs. hepatitis C and

primary biliary cirrhosis, 280–281

pathology of, 279

central perivenulitis in, 279

Liver injury, drug-induced, autoimmune hepatitis

vs., 270

Liver transplant pathology, 277–293. See also named

pathology.

acute antibody-mediated rejection and role of

C4d, 290

acute cellular rejection, 277–279

fibrosing cholestatic hepatitis, 285–287

idiopathic posttransplant chronic hepatitis, 285

late acute rejection, 279–284

plasma cell hepatitis, 284–285

viral infections, 287

CMV, 287–289

EBV, 289

HepE, 289–290

M

MDR3 deficiency, ABCB4 mutation in, 221

genetic, clinical, histopathologic features of, 219,

221–222

histologic findings in, 221

Methotrexate, liver injury and steatohepatitis from,

242–243

N

NASH CRN-modified Brunt methodology, staging of,

234, 235

Nifedipine, liver injury and steatohepatitis from, 242

Nonalcoholic fatty liver disease (NAFLD), diagnosis

of, 228

management of, 252–253

practice guidelines for, 228

patterns in, cirrhosis with steatosis and/or

ballooned hepatocytes, 240

steatosis without hepatobiliary injury, 239

steatosis with pericellular fibrosis, 240

steatosis with swollen hepatocytes, 239

Index388

Nonalcoholic (continued )

with ballooned hepatocytes, 239

prevalence of, 227

Nonalcoholic steatohepatitis (NASH), 227–257

activity score in, 235, 239

diagnositic challenges and pitfalls in, hereditary

hemochromatosis, 242–245

diagnostic challenges and pitfalls in, alcoholic

steatohepatitis, 240–241

burnt-out NASH cirrhosis, 241

centrizonal arterialization, 241

drug-induced liver injury, 241–242

hereditary hemochromatosis, 242–245

metabolic disorders, 245–247

m icrovascular steatosis, 247, 250

portal infammation, 247–251

steatohepatitis with acute/subacute

presentation, 252

differential diagnosis of, 239–240

familial, 252

histologic features of, 228

metabolic disorders in, glycogenic hepatopathy,

245–246

Wilson disease, 247–249

metabolic syndrome and, 227

microscopic features of, 228

focal neutrophil satellitosis, 229, 231

glycogenated cytoplasm, 229, 233

in mild, 229

in moderate, 229

in severe, 229–230

lipogranuloma formation, 229, 231

lobular inflammation, 229–230

Mallory hyaline, 229, 232

pericellular/sinosidal fibrosis, 233–234

pericentral ballooned hepatocytes, 229,

231–232

portal inflammation, 229–230

spotty hepatocyte necrosis, 233–234

microvesicular steatosis, 247, 250

pediatric, 251–252

prognosis in, mortality, 252

risk factors for, 227–228

staging of, Brunt methodology, 234–236

clinical research network (CRN), 234–235

Kuffer cell staining in, 238

trichrome staining quality in, 234-235,

237-238

with bridging fibrosis, 227, 236

with cirrhosis, 227, 236

P

Parenteral nutrition-associated liver disease

(PNALD), differential diagnosis of, 211, 213

histologic findings, giant cell transformation, 211

in portal edema, 211, 213

histologic findings in, ductular proliferation,

211–212

Paucity of bile ducts, Alagille syndrome, 215–216

Jagged1 gene in, 215

Notch2 gene in, 215

differential diagnosis of, 216–217

nonsyndromic, 215

Pediatric cholestatic disorder(s). See also named

disorder.

approach to pathologic diagnosis, 205–225

A1T deficiency, 217–218

bile acid synthetic disorders, 222–223

bile duct paucity, nonsyndromic, 215

syndromic, 215

causes of, intrahepatic, 205

obstructive, 205

common, 205

extrahepatic biliary atresia, 206–211

giant cell hepatitis, 223–224

histologic features in, comparison of prevalence

of, 207

parental nutrition-associated liver disease, 207,

211–213

progressive intrahepatic familial cholestasis, 207,

217, 219–222

sclerosing cholangitis, 213–215

simplified diagnostic approach to, 206

Perhexiline maleate, liver injury and steatohepatitis

from, 242

Plasma cell hepatitis (PCH), as posttransplant

immune-mediated injury, 284–285

studies of, 284

Primary sclerosing cirrhosis (PSC), autoimmune

hepatitis vs., 271

Progressive intrahepatic familial cholestasis (PIFC),

forms of, BSEP deficiency, 217, 219–221

FIC1 deficiency, 217, 219

MDR3 deficiency, 219, 221–222

S

Sarcomatoid hepatocellular carcinoma, 378–379

Scirrhous hepatocellular carcinoma, defined,

367–368

differential diagnosis of, 369

pathologic features of, immunohistochemical,

368–370

microscopic, 367–368

Sclerosing cholangitis, overlap syndrome of, 213, 215

small duct cholangitis variant, 215

types of, 213

Steatotic hepatocellular adenoma, liver fatty acid

binding protein negative, 312–313

T

Tamoxifen, liver injury and steatohepatitis

from, 242

Index 389

Telangectatic/inflammatory hepatocellular adenoma,

immunohistochemistry of, serum amyloid A and

serum reactive protein staining in, 317–318

macroscopic and microscopic views of, 314–316

somatic mosaic G-protein alpha-subunit-

activating mutations in, 319–320

Total parenteral nutrition-associated cholestasis,

extrahepatic biliary atresia vs., 211

W

Wilson disease, autoimmune hepatitis vs., 271