Female 35 years

New onset severely deranged LFTs, no previous history. Admitted with severe jaundice and very deranged LFTs, ALT >1000 (<40), bilirubin 205 (2-21), alk phos 208 (30-130). ? autoimmune,? drug induced. >.

Specimen:

Liver biopsy.

Macroscopic description:
One core 30mm long.

Immunohistochemistry:
retic, van Gieson, PASD.

Male 75 years

Mixed picture of abnormal LFTs - on Sodium Valproate, risk factors for NAFLD (obesity, HBP and high cholesterol), also previous biliary issues with open cholycystectomy and CBD clearance for stones. Surgical team working up for incisional hernia repair - but noted ongoing abnormal LFTs. MRCP ?? PSC. Biopsy - ? NASH/?DILI or PSC.

Specimen:

Liver biopsy.

Macroscopic description:
Tan core 28mm.

Immunohistochemistry:
HVG, rhodanine.

Male 53 years

HCC on background of treated HCV.

Specimen: Native liver, hepatectomy.

Macroscopic description:
10 mm well circumscribed pale nodule in right lobe.

Immunohistochemistry:
Nil.

Male 67 years

Methotrexate for psoriasis, fatty liver on US, elevated P3NP, fibroscan 6kPa. Risk factors for metabolic liver disease (BMI 32). ? methotrexate liver injury, ? hepatic fibrosis.

Specimen:

Liver biopsy.

Macroscopic description:
One core 29mm long.

Immunohistochemistry:
van Gieson, retic, Cam 5.2.

Male 63 years

MRI shows focal lesion.in segment 4 which has grown. ? HCC or cholangiocarcinoma. AFP not raised.

Specimen: Targeted liver biopsy.

Macroscopic description:
2 cores, up to 17mm.

Immunohistochemistry:
HepPar1, AE1/AE3, CK19, CD34.

Female 36 years

Turner syndrome. Focal liver lesion, ? adenoma.

Specimen: Liver segment 6/7.

Macroscopic description:
Liver segments 6&7, 113g, 90x60x40mm. Contains a 50mm round tumour, slightly paler than surrounding liver.

Immunohistochemistry:
Amyloid A, glutamine synthetase, beta catenin.

Male 25 years

Patient with subacute hepatic failure.

Specimen: Transjugular liver biopsy.

Macroscopic description:
3 cores of tissue, the longest 16mm.

Immunohistochemistry:
van Gieson, DPAS, reticulin.

Female 17 years

Presented with 4 week history of increasing jaundice and itch. Started combined oral contraceptive pill 3 weeks prior to onset of jaundice. Viral and autoimmune serology negative.

Specimen: LIver core biopsies.

Macroscopic description:
3 cores, longest measuring 20mm.

Immunohistochemistry:
None.

Female 30 years

Paracetamol overdose.

Specimen: Native liver, hepatectomy.

Macroscopic description:
Soft pale liver with tan mottling.

Immunohistochemistry:
Nil.

Female 50 years

PBC, urso non-responder. Elevated ALT, ? AIH overlap. ALT 255, ALP 615, bilirubin 53, IgG 15.5.

Specimen:

Liver biopsy.

Macroscopic description:
Two cores 11mm max.

Immunohistochemistry:
Reticulin, Shikata, CK7.

Male 50 years

MBT for AML. Massively deranged LFTs, ALT 600 ? GVHD, ? other liver pathology.

Specimen:

Liver biopsy.

Macroscopic description:
3 cores, max 20mm.

Immunohistochemistry:
van Gieson, PASD.

Male 37 years

OLT for PSC.

Specimen: Explant liver.

Macroscopic description:
Non nodular liver with a focal lesion in segment 7/8 which is pale in colour and measures 18 x 12 x 15 mm.

Immunohistochemistry:
LFAP.