Fatty change 28 22016 Contents Slide Fatty change liver Jar Fatty liver Case 1 discussion How to examine a slide Examine the slide by the naked eye to see the general structure eg ID: 612777
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Slide1
Practical 1Fatty change
28
/2/2016Slide2
Contents
Slide:
Fatty change- liver
Jar:
Fatty liver
Case 1 discussionSlide3
How to examine a slide
Examine the slide by the naked eye to see the general structure
e.g
appendix, blood vessel,…etc
Examine by the lowest power to see the general structure of the organ + to localize the site of the lesion
By the intermediate power, examine the area of the lesion and describe it
The highest power is used only if you want to examine special types of cells
e.g
, plasma cells,
esinophils
….etc.
The higher the power you use , the smaller the area you see under the microscopeSlide4
Slide (1) Fatty change liver
There is preserved lobular architecture of the liver.
Some
hepatocytes
show small fat vacuoles inside the cytoplasm with central nuclei (
microvesicular
steatosis
)
Some
hepatocytes
are distended with clear fat vacuoles which push the nucleus to one side (
macrovesicular
steatosis
- signet ring appearance)Slide5
Remember normal liverSlide6Slide7Slide8Slide9Slide10Slide11Slide12Slide13Slide14
How to comment on a given jar
Gross description of Pathology Jars
NE: any mass 3S 3C
Size, Shape, Surface
Color, Consistency, C/S
Border (or capsule), Number
Cavity or Cyst
Size, Shape, Surface
Wall, Lining, Content
Slide15
Fatty change of liver
Specimen:
A triangular-shaped slice of liver
:
Surface:
The liver has shreddy peritoneal covering and smooth outer surface.
Color:
Yellow.
Consistency:
Soft.
Cut section
: Shows rounded edges (sharp due to preservative) with yellow surface and greasy to touch
.
Slide16Slide17Slide18Slide19Slide20
Case study of first session
A 55-year-old obese, diabetic patient presents with symptoms of liver disease and is found to have mildly elevated liver enzymes. A liver biopsy examined with a routine
hematoxylin
and eosin (H&E) stain reveals abnormal clear vacuoles in the cytoplasm of most of the
hepatocytesSlide21
Case I
What is your diagnosis of the case?
What is the gross and
microscopc
picture of the case?
What is the substance that most likely form these
cytoplasmic
vacuoles in this case?
What is the pathogenesis of this case?
How to confirm your diagnosis by special stains?
Is this lesion reversible or not?Slide22
Case I
Diagnosis…. Fatty change liver
Substance inside
hepatocytes
… triglycerides
Pathogenesis…..
Confirm the
dagnosis
by special stains on frozen section
The case is reversibleSlide23
Gross picture… describeSlide24
Microscopic picture…. describe