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biopsy
 Manaen
What is the biopsy of liver?
The doctor may decide to confirm the
diagnosis by putting a needle through
the skin (biopsy) to take a sample of
tissue from the liver.
Ultra
sound is
 used to
identify
   the
location
 for the
 biopsy.
Why we use the biopsy?
• Although liver biopsy is often recommended it
  is not always necessary.
• A liver biopsy may be performed to determine
  severity of disease.
• A treatment must be needed or can be
  deferred.
• Biopsy may be performed if another liver
  disease.
How to exam
the biopsy?
histology foundation
                Liver lobules:
                •Central vein
                •Liver cell
                •Portal vein
                •Bile duct
                •Sinusoids
                •Hepatic artery
Normal Liver




Recall that blood flows into the liver via the hepatic veins (in the portal
triad) and out of the liver via the central veins in the lobules.
Alcoholic Cirrhosis




Alcohol coming from the gut first makes contact with the hepatocytes nearest the
portal triad. These liver cells, therefore, will be affected first by the toxicity of alcohol.
The fibrosis (in blue in this trichrome stain) is coming "from the outside in" with
respect to the lobule. At this stage, the lobules themselves are spared.
Congestive Cirrhosis




As the heart fails, blood is backed up in the venous system. The central veins
(arrow), you recall, eventually empty into the inferior vena cava. Since the
heart is "backed up," you can see the red blood pooling near the central vein
of some lobules. In this process, fibrosis occurs "from the inside out."
Hepatitis




 The Hepatitis B virus is extremely contagious and causes widespread necrosis
of the liver. The destruction encompasses both the lobules and the
interstitium making this tissue almost unrecognizable. Fortunately, you
received the HBV vaccine when you started medical school. And since 1991, it
is recommended that all newborns receive it as well.
liver cirrhosis




This is a cross section of a liver of a patient who died of liver cirrhosis. The
centrilobular cells were spared, but those closer to the connective tissue
septae died. The type of pathology thus determines which model of liver
lobules is most applicable.
liver cirrhosis
hepatocellular carcinoma
Fatty liver
Exercise time
 what is it?
Normal!
Medicine is a new beauty.
        Thanks
        Manaen
• http://www.up.ac.za/academic/medicine/tele
  med/Hist/svk/week02e.html

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Liver Biopsy

  • 2. What is the biopsy of liver? The doctor may decide to confirm the diagnosis by putting a needle through the skin (biopsy) to take a sample of tissue from the liver.
  • 3. Ultra sound is used to identify the location for the biopsy.
  • 4.
  • 5. Why we use the biopsy? • Although liver biopsy is often recommended it is not always necessary. • A liver biopsy may be performed to determine severity of disease. • A treatment must be needed or can be deferred. • Biopsy may be performed if another liver disease.
  • 6. How to exam the biopsy?
  • 7. histology foundation Liver lobules: •Central vein •Liver cell •Portal vein •Bile duct •Sinusoids •Hepatic artery
  • 8.
  • 9.
  • 10. Normal Liver Recall that blood flows into the liver via the hepatic veins (in the portal triad) and out of the liver via the central veins in the lobules.
  • 11. Alcoholic Cirrhosis Alcohol coming from the gut first makes contact with the hepatocytes nearest the portal triad. These liver cells, therefore, will be affected first by the toxicity of alcohol. The fibrosis (in blue in this trichrome stain) is coming "from the outside in" with respect to the lobule. At this stage, the lobules themselves are spared.
  • 12.
  • 13. Congestive Cirrhosis As the heart fails, blood is backed up in the venous system. The central veins (arrow), you recall, eventually empty into the inferior vena cava. Since the heart is "backed up," you can see the red blood pooling near the central vein of some lobules. In this process, fibrosis occurs "from the inside out."
  • 14.
  • 15. Hepatitis The Hepatitis B virus is extremely contagious and causes widespread necrosis of the liver. The destruction encompasses both the lobules and the interstitium making this tissue almost unrecognizable. Fortunately, you received the HBV vaccine when you started medical school. And since 1991, it is recommended that all newborns receive it as well.
  • 16. liver cirrhosis This is a cross section of a liver of a patient who died of liver cirrhosis. The centrilobular cells were spared, but those closer to the connective tissue septae died. The type of pathology thus determines which model of liver lobules is most applicable.
  • 19.
  • 23. Medicine is a new beauty. Thanks Manaen