Female 65 years

Deranged LFTs. Jaundiced. Type 1 diabetes. On lisinopril. ANA 1/640. Negative other auto-antibodies. Mildly raised IgM, normal IgG. FIB4 3.3. ? DILI ? PBC.

Specimen: Native liver, needle biopsy.

Macroscopic description:
Core.

Immunohistochemistry:
Orcein, PSR.

Female 57 years

Jaundice. ALT 1500, AMA M2 +ve, ANA 1/640. Hypothyroidsim. Started on pred 28/7/22. From EPR, viral serology -ve.

Specimen: Native liver, needle biopsy.

Macroscopic description:
Core.

Immunohistochemistry:
NA.

Male 37 years

Known Crohn's disease. Admitted from clinic with abdominal pain, ascites and transaminitis. Super-urgent liver transplant.

Specimen: Liver explant (H&E and EPSR).

Macroscopic description:
Liver explant weighing 2021g and measuring 245 x 175 x 105mm. There is a mottled, haemorrhagic cut surface.

Immunohistochemistry:
N/A.

Male 60 years

History of acute myeloid leukaemia. Treated with allogenic stem cell transplant (x2). Chronic skin changes. Bilirubin 88, ALP 329, ALT 139, ferritin 4000.

Specimen:

Liver biopsy (H&E, EPSR, perls, victoria blue).

Macroscopic description:
One tan core measuring 26mm. Bisected at 20mm.

Immunohistochemistry:
N/A.

Female 42 years

Distal colonic Crohn's disease diagnosed 2009. Started on infliximab. Now abnormal LFTs and strongly positive ANA.

Specimen:

Liver biopsy (H&E & EPSR).

Macroscopic description:
Liver core.

Immunohistochemistry:
N/A.

Female 45 years

Patient from Lithuania, presented with abdominal fullness in RUQ , found to have a liver mass.

Specimen: Right hepatectomy.

Macroscopic description:
14cm cyst, multiloculated.

Immunohistochemistry:
Nil. PAS highlights parasite.

Female 23 years

Fontan-associated liver disease. Persistent LFT abnormalities with raised ALT (79) and GGT (77). IgG 16.72. ANA >1:640.

Specimen: Native liver, needle biopsy.

Macroscopic description:
Core.

Immunohistochemistry:
Reticulin, PSR.

Male 60 years

Previous right colectomy for colon cancer and Whipple's resection for duodenal cancer. Severe pruritus and cholestatic LFTs with intrahepatic biliary dilatation but no hep-jej stricture. ? cause.

Specimen: Native liver, needle biopsy.

Macroscopic description:
Core.

Immunohistochemistry:
Orcein, PSR.

Male 74 years

Suspected cholangiocarcinoma.

Specimen: Liver segmentectomy, segments 2 and left lateral segment 3.

Macroscopic description:
3 cm cystic 'tumour' with brown haemorrhagic contents.

Immunohistochemistry:
Nil.

Male 61 years

Immunosuppressed. Multiple lung nodules and deranged LFTs.

Specimen:

Liver biopsy (H&E and ZN stain).

Macroscopic description:
Cores of tissue.

Immunohistochemistry:
ZN.

Male 74 years

Imaging mildly irregular liver. 11cm large liver lesion right lobe with PVT. ?HCC. ?Background cirrhosis.

Specimen:

Liver biopsy.

Macroscopic description:
Four cores of cream tissue which measure 9mm, 13mm, 15mm, 10mm in 1A.

Immunohistochemistry:
CK7, CK19, Arginase, HepPar1 and ABDPAS stains provided.

Female 27 years

On request form; ?HCC segment II/III NAR. From e patient record; incidental finding in patient with known congenital heart disease.

Specimen: Liver resection, section of lesion and of background liver.

Macroscopic description:
21g liver wedge with 20mm subcapsular lesion clear of the margin, vague nodularity background liver.

Immunohistochemistry:
Lesion; Glutamine synthetase provided. Preserved reticulin, no nuclear B catenin, negative CRP and serum amyloid A, low proliferation fraction Ki67. Background; HVG and reticulin provided.

Male 10 years

Arginosuccinic acidaemia, global developmental delay. USS: hepatomegaly+hyper reflective liver. No biliary dilatation. No splenomegaly. No PTHTN signs on OGD. Chronic diarrhoea and GORD. Gastrostomy dependent.

Specimen:

Liver biopsy.

Macroscopic description:
One tan core 1.2cm.

Immunohistochemistry:
HVG PAS PASD.