Female 77 years

Cholestatic jaundice. No biliary obstruction on CT/MRCP. Recent co-amoxiclav. Viral serology and autoantibodies negative.

Specimen:

Liver biopsy - medical.

Macroscopic description:
18mm core.

Immunohistochemistry:
Retic, PSR, PAS.

Female 30 years

Previous autoimmune hepatitis. ?flare ?PSC. Currently cholestatic LFTs.

Specimen: Needle core biopsy.

Macroscopic description:
2 cores and a fragment.

Immunohistochemistry:
CK7, orcein, EVG stain.

Female 63 years

Seronegative? acute liver failure but ascites and varices, drug induced liver injury?

Specimen: Explant liver.

Macroscopic description:
Liver 561g, cut surface brown with small yellow nodules.

Immunohistochemistry:
HVG reticulin orcein.

Female 73 years

Nausea and vomiting, jaundice, deranged LFTs +++ pruritis. Viral screen mostly negative, Hep E and leptospira awaited. ANA weakly +ve. Impression: acute hepatitis, ? cause.

Specimen:

Liver biopsy.

Macroscopic description:
One core 20mm.

Immunohistochemistry:
CK7, APASD, masson trichrome.

Female 63 years

Radiological diagnosis of cirrhosis without portal HTN. ? Cause ? NASH.

Specimen:

Liver biopsy.

Macroscopic description:
Two tan cores measuring 25mm and 24mm, bisected at 20mm.

Immunohistochemistry:
Sirius red, Victoria blue.

Female 31 years

Laparoscopic segment 6 + 7 excision of hepatic adenoma.

Specimen: Segment 6/7 resection.

Immunohistochemistry:
Segmental excision 125 x 74 x 50 mm, weighing 143g. Single lesion 25 x 24 x 25 mm with central degeneration and tan coloured. Close to the resection margin.

Immunohistochemistry:
SMA, HMB45, MelanA included. CD117 patchily positive. DOG1 weak cytoplasmic staining in more epithelioid nodules. Ki67.

Male 28 years

On max AZT dose. Elevated ALT ?fibrosis ?inflammation. Further information from EPR: AIH diagnosed 2014 (acute severe presentation, elevated IgG and SMA+). Deranged LFTs following covid infection, Dec 2021. Elevated Immunoglobulins. Intensified immunosuppression. Fibroscan 26.1 kPa (May 22), increased from 11.1 kPa (July 21). Medications - Azathioprine 200mg OD, Prednisolone 10mg, Omeprazole. LFTs at time of biopsy: ALT 163, AlkPhos 176, Bili 23. Recent Immunoglobulins had normal IgG.

Specimen: Medical liver biopsy.

Macroscopic description:
One core of tissue 18mm.

Immunohistochemistry:
None provided.

Female 55 years

Drinks 11-24 units of alcohol per day. Obestity, polygenic hypercholesterolaemia. High Fibroscan score.

Specimen: Needle biopsy.

Macroscopic description:
A single core of liver 24mm in length.

Immunohistochemistry:
Van Gieson.

Female 20 years

Combined liver and kidney transplant.

Specimen: Liver explant.

Macroscopic description:
Explanted liver weighing 1642 and measuring 270 x 170 x 75mm.

Immunohistochemistry:
EPSR.

Female 50 years

In patient, jaundice, ascites. Signs of PHT on imaging.

Specimen: Needle biopsy.

Macroscopic description:
Multiple cores and fragments, longest 12mm, shortest 1mm.

Immunohistochemistry:
Van Gieson.

Male 71 years

Presented with acute severe hepatitis. Viral screen negative. Normal Igs, unremarkable autoimmune serology. Being treated for prostate cancer with bicalutamide.

Specimen: Needle biopsy.

Macroscopic description:
3 cores of tan tissue measuring between 4mm and 7mm in length.

Immunohistochemistry:
HVG.

Female 53 years

Liver lesions, ?colorectal carcinoma metastases.

Specimen: Liver resection.

Macroscopic description:
Non anatomical liver resection segment 5/6. 1.2cm white lesion beneath the capsule well clear of margins. 4 other NARs received.

Immunohistochemistry:
Glutamine synthetase.

Female 61 years

Advanced liver disease of uncertain aetiology. Presented with portal hypertension with variceal bleed and encephalopathy. Turner's syndrome.

Specimen: Liver explant.

Macroscopic description:
Explant weighing 632g and measuring 186 x 110 x 70mm. Micronodular appearances with nodules measuring 1-2mm.

Immunohistochemistry:
EPSR and reticulin both blocks.