Female 63 years

Abnormal LFTs, hepatomegaly. Ultrasound scan - fatty liver and enlarged spleen. Raised BMI, metabolic syndrome. To assess for fibrosis/cirrhosis.

Specimen:

Liver biopsy.

Macroscopic description:
A single core of cream and yellow tissue measuring 20mm.

Immunohistochemistry:
Orcein, Masson trichrome.

Female 35 years

Jaundice, bilirubin >400, >2x INR. no drug or alcohol history.

Specimen: Transjugular liver biopsy.

Macroscopic description:
Thin 14mm core plus fragments.

Immunohistochemistry:
HVG orcein reticulin.

Male 47 years

Incidental finding of segment 6 liver lesion. HPB MDM suggests HCC/cholangiocarcinoma.

Specimen: Native liver, atypical segment 6 resection.

Macroscopic description:
31 g wedge of liver, capsule on one surface with lesion visible beneath. Firm pale white lesion 23 x 17 by up to 19 mm. Abuts, but does not invade capsule. Nearest margin 7 mm.

Immunohistochemistry:
NA.

Male 22 years

Bilirubin >500, conjugated, ALP 20e, ALP 250. Non-invasive liver screen and US/MRCP done locally normal. ? BRIC, ? viral - To assess for aetiology of acute liver injury ?/- evidence of necrosis or chronicity. No previous medical or family history. Onset of jaundice for 3 weeks. No history of travel or recent medication. Atypical lymphocytes on blood film, awaiting EBV. Hepatitis A IgM +ve, confirmed on PCR.

Specimen: Liver core biopsy.

Macroscopic description:
One core 22mm long.

Immunohistochemistry:
van Gieson, DPAS, Orcein, CK7.

Female 22 years

Post lung transplant 18 m ago for cystic fibrosis. Recurrent infections. New sclerotic vertebral lesions and a liver lesion at dome. Infective vs other.

Specimen:

Liver biopsy (H&E, MNF116, smooth muscle actin, EBER ISH).

Macroscopic description:
One tan core measuring 18mm.

Immunohistochemistry:
MNF116, smooth muscle actin and EBER ISH provided. Focal staining seen with calponin and caldesmon. Desmin, S100, CD34, STAT6, CD20 and CD3 are negative.

Male 58 years

CT showed a large infiltrative mass in left lobe of liver, left portal vein thrombus and enlarged nodes.

Specimen: Liver resection (H&E, CD31 and ERG).

Macroscopic description:
Left hemihepatectomy containing a subcapsular poorly defined lesion measuring approximately 100mm.

Immunohistochemistry:
ERG and CD31 provided. AE1/AE3. BerEP4, arginase and HepPar1 negative. No WWTR1-CAMTA1 fusion detected.

Female 45 years

Raised ALT 187, ? cause. raised IgG 26.6, +ve ANA ? autoimmune element. Previously on treatment for breast cancer (2020) including tamoxifen. Alk Phos 125, bilirubin 7, albumin 34.

Specimen: Liver core biopsy.

Macroscopic description:
One core 25mm long.

Immunohistochemistry:
van Gieson.

Female 32 years

Liver lesions, suspected benign. Increase in size on recent imaging, unusual imaging. Background siderosis. Two biopsies - one lesional, other non lesional with lesion at end of core.

Specimen: Native liver, separate targeted lesional and non-lesional biopsies.

Macroscopic description:
Cores.

Immunohistochemistry:
Lesional hepatocytes show expanded areas of glutamine synthetase immunopositivity and are liver fatty acid binding protein immunopositive; they are immunonegative for serum amylod A, nuclear beta-catenin, and glypican-3, and there is no increased expression on HSP70.

Female 25 years

Presented with left flank pain. CT showed large 85 x 67 mm lesion within Morrison's pouch which is either extending into or arising from the right lobe of liver.

Specimen: Liver resection, segments 6 and 7.

Macroscopic description:
Liver resection specimen with a 83 x 38 x 80mm multilobulated part-solid, part-cystic lesion and a thin rim of adjacent liver tissue. The lesion has a heterogenous cut surface with yellow and gelatinous areas.

Immunohistochemistry:
N/A.

Female 35 years

Fluctuating transaminitis. UC. [From EPR - diagnosed with PBC 2015, positive AMA (not M2 positive). intermittently raised ALT and IgG. March 2022 - ANA >1/640, ALT 97 (ALT 234 28/02/22), ALP 94, bilirubin 9. Hepatitis A, B, C, E negative, CMV negative.]

Specimen: Native liver, needle biopsy.

Macroscopic description:
Core.

Immunohistochemistry:
Orcein.

Male 45 years

Cirrhosis. High ALT (193), often >100 for years. Fatty liver on Fibroscan CAP.

Specimen: Native liver, needle biopsy.

Macroscopic description:
Core.

Immunohistochemistry:
PSR.

Male 36 years

Chronic liver disease with decompensation.

Specimen: Liver explant (H/E, EPSR, victoria blue submitted).

Macroscopic description:
Liver explant weighing 2268g and measuring 295 x 205 x 83mm. The parenchyma is green tinged with numerous small nodules throughout.

Immunohistochemistry:
EPSR, victoria blue.

Female 10 years

Hepatosplenomegaly with thrombocytopoenia. Cause unknown. No other features. Normal LFTs. Storage disorder?

Specimen:

Liver biopsy.

Macroscopic description:
2 mottled cores 1.6 and 1cm.

Immunohistochemistry:
HVG PAS PASD.