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Teaching

Teaching Cases for 08-Jun-11










Set 1 Case 1

Male 50 years

Raised ALT x3 ULN for 6 months. Obese, diabetic.

H&E 142481


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Set 1 Case 2

Female 34 years

2 weeks malaise, now jaundiced. ALT 700. Increased IgG (40). Positive ANA and SMA. Negative other serology.

H&E 142483


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Set 1 Case 3

Male 25 years

Two week history of cholestatic jaundice. Chronic liver screen negative. Bilirubin 550. Alk phos 276. ALT 76.

H&E 142484


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Set 1 Case 4

Female 44 years

Abnormal LFT - alk phos 802, psoriasis, exclude PBC.

H&E 142485


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Set 1 Case 5

Female 47 years

Known ulcerative colitis, elevated alk phos. ?PSC/other pathology.

H&E 142487


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Set 1 Case 6

Male 58 years

6 cm mass periphery in right lobe of liver, ?primary or secondary malignancy.

H&E 142489


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Set 2 Case 1

Female 43 years

Recently returned from Bangladesh. Jaundice, High ALT.

H&E 142490


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Set 2 Case 2

Female 66 years

Presented to surgeons with jaundice. ALT 1300. IgG 25. Smooth muscle antibodies +ve.

H&E 142492


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Set 2 Case 3

Male 63 years

Previous biopsy 3 years ago - diagnosis autoimmune hepatitis. Recent decompensation.

H&E 142493


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Shikata 142830


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Set 2 Case 4

Female 61 years

Obesity, hypertension, diabetes, low alpha 1 antitrypsin.

H&E 142495


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EVG Elastic van Gieson 142831


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Set 2 Case 5

Male 33 years

HCV. Alcohol excess. Bilirubin 131.

H&E 142496


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H&E 142497


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Set 2 Case 6

Male 49 years

8 months ago had a biopsy very like case 5. Now abstinent but liver failure; transplanted.

H&E 142499


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Set 2 Case 7

Male 37 years

Alcohol-related liver cirrhosis (moderate drinker). Work-up for transplant. Abstinent from alcohol?

H&E 142505


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Set 2 Case 8

Male 74 years

Hepatitis C, PCR +ve. Need to assess for further management.

H&E 142506


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Set 2 Case 9

Male 53 years

Jaundice. ? Mets on ultrasound.

H&E 142507


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Set 3 Case 1

Male 3 years

Steroid resistant nephrotic syndrome.



H&E 142022


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Jones Methenamine Silver 142027


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PASE Periodic acid Schiff (extended) 142032


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Masson Trichrome (MST) 142034


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EVG Elastic van Gieson 142378


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Set 3 Case 2

Female 18 years

Nephrotic syndrome, proteinuria 13g/day, serum albumin 20.



H&E 142036


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PASE Periodic acid Schiff (extended) 142041


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Jones Methenamine Silver 142048


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C1q 142385


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IgA 142386


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IgG 142387


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C3d 142388


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IgM 142063


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Set 3 Case 3

Male 36 years

Nephrotic syndrome. Previous biopsy 1 year ago reported as nephrotic syndrome. Treated with cyclophosphamide and steroids.



H&E 142068


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PASE Periodic acid Schiff (extended) 142110


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IgG 142115


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Masson Trichrome (MST) 142117


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C3d 142133


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EVG Elastic van Gieson 142134


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Congo Red 142141


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Jones Methenamine Silver 142876


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Set 3 Case 4

Male 64 years

Nephrotic syndrome.



PASE Periodic acid Schiff (extended) 142143


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Congo Red 142147


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Jones Methenamine Silver 142148


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H&E 142156


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Jones Methenamine Silver 142163


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Set 3 Case 5

Male 77 years

Haematoproteinuria, hypertension, ischaemic heart disease, diabetes type 2, creatinine 200.



C3d 142172


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C1q 142174


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IgA 142176


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IgM 142179


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IgG 142180


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Congo Red 142182


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EVG Elastic van Gieson 142188


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H&E 142193


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PASE Periodic acid Schiff (extended) 142201


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Set 3 Case 6

Female 16 years

Persistent heavy proteinuria, impaired renal function.



H&E 142211


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Jones Methenamine Silver 142219


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PASE Periodic acid Schiff (extended) 142226


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IgG 142231


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IgM 142236


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C3d 142237


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C1q 142239


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IgA 142379


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Set 3 Case 7

Female 14 years

Nephritis.



EVG Elastic van Gieson 142241


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H&E 142243


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IgG 142245


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IgA 142247


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IgM 142248


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C1q 142250


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C3d 142251


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PASE Periodic acid Schiff (extended) 142252


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Jones Methenamine Silver 142256


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Set 3 Case 8

Male 44 years

Haematoproteinuria, rising creatinine.



H&E 142261


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Jones Methenamine Silver 142265


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PASE Periodic acid Schiff (extended) 142268


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IgG 142271


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IgM 142273


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C3d 142274


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Set 3 Case 9

Female 44 years

Stage 2 chronic kidney disease. Hypertension, proteinuria 1g/day, immunology negative.



H&E 142275


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Jones Methenamine Silver 142278


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PASE Periodic acid Schiff (extended) 142279


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Set 3 Case 10

Female 14 years

Haematuria.



Jones Methenamine Silver 142283


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H&E 142284


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IgG 142286


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IgA 142287


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PASE Periodic acid Schiff (extended) 142288


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C1q 142290


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C3d 142381


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IgM 142415


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Set 3 Case 11

Female 62 years

Acute kidney injury and haematuria.



H&E 142291


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PASE Periodic acid Schiff (extended) 142292


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EVG Elastic van Gieson 142293


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IgG 142294


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IgM 142296


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C3d 142297


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C1q 142298


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Fibrin 142299


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IgA 142420


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Set 3 Case 12

Male 54 years

Vasculitic rash and diarrhoea, creatinine 207, PCR 122, eosinophil count 7, haematuria.



Jones Methenamine Silver 142280


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H&E 142281


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PASE Periodic acid Schiff (extended) 142282


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Set 3 Case 13

Male 56 years

IgG lambda monoclone. Acute kidney injury - creatinine 400.



H&E 142300


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Jones Methenamine Silver 142301


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Jones Methenamine Silver 142302


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Congo Red 142383


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