Female 61 years

Abnormal liver function; fatty on ultrasound Additional from lb computer system- patient wheelchair bound with MS; Anti smooth muscle antibody positive; other autoantibodies negative; no record of viral screen; no history of alcohol ; no drug history available.

Specimen:

Liver biopsy.

Macroscopic description:
3 cores.

Immunohistochemistry:
Massons Trichrome and retic provided.

Female 56 years

Post cholecystectomy. Cholestatic LFT's. 3x previous episodes of sepsis - klebsiella 2x E coli. Liver abscess March 2017. Repeat MRCP - possible progressive extrahepatic duct dilatation and mild central intrahepatic duct dilatation. Bili 7, ALP 135, ALT 95, GGT 195, AST 73. ?Cause of deranged LFT's. Positive soluble live antigen. ?Degree fibrosis.

Specimen: Medical liver biopsy.

Macroscopic description:
A core of tan tissue 19mm in length. Processed intact.

Immunohistochemistry:
None.

Male 72 years

Two lesions picked up incidentally on radiology. This section is from one of these . (both lesions were similar).

Specimen: Liver segmentectomy.

Macroscopic description:
Ill defined white lesion, 33/17x15mm, below capsule.

Immunohistochemistry:
CD34.

Male 58 years

AML. BM transplant 7 months previously. Initial GVH then settled. Abnormal LFTs following URTI 2 months previously,treated with erythromycin. Current ALT 557, br 193, ALP 789.

Specimen: liver biopsy.

Macroscopic description:
Two needle cores, each 15mm.

Immunohistochemistry:
N/A.

Male 17 years

Recent diagnosis of UC and admitted with acute severe flare. Treated with hydrocortisone and then infliximab. Marked transaminitis for last 9 months. NILS negative. MRCP does not show large duct PSC. ? small duct PSC/? seronegative AIH. From EPR: recent ALT 161; alk phos 537, max 765 at presentation 9 months ago. Autoantibodies -ve apart from pANCA. Immunoglobulins normal.

Specimen: liver biopsy.

Macroscopic description:
liver biopsy core 28mm long.

Immunohistochemistry:
van Gieson, reticulin, Shikata, CK7

Male 53 years

Clinical information - None given, from electronic record indication for transplantation PSC.

Specimen: liver removed at transplantation (explant).

Macroscopic description:
Green liver, mildly dilated bile ducts towards the hilum, no grossly visible mass lesions. Both of the sections (C6 and C8) are from the hilum - random sections, no lesion visible.

Immunohistochemistry:
None (2x H&E slides).

Female 18 years

18, T1DM, Sturge Weber syndrome & epilepsy. Admitted with DKA, Back on normal insulin. Persistently raised LFTs for 4 months (ALT 302, ALP 178, Bili 5). INR normal. NILS negative apart from positive pANCA. USS previously normal ?cause of deranged LFTS ?drug induced. Patient on Carbamazepine for epilepsy.

Specimen:

Liver biopsy.

Macroscopic description:
One core of tissue measuring up to 27mm in length, plus three smaller fragments.

Immunohistochemistry:
Liver specials show no significant changes.

Male 40 years

Bil 267, ALT 2803, ALP 132, IgG 26.5, ANA 1:640. ?Auto immune hepatitis triggered by Infliximab (x2 doses). Azathioprine previously. Previous medical history: IBD, likely Crohn's. 6/7 steroids before biopsy.

Specimen: Medical liver biopsy.

Macroscopic description:
A tan core measuring 22mm, embedded intact.

Immunohistochemistry:
None

Female 79 years

Previous lung cancer 4.5cm lesion in left lobe of liver. MRI: ?HCC (adenoma less likely). (Metastases also less likely). To characterise. Bili 10, ALP 66, ALT 8, AFP 3. 4 years ago Left upper lobectomy and regional lymph nodes (L5, L6, L9, L11, and station 7). Moderately to poorly differentiated, (15mm) papillary predominant, invasive adenocarcinoma of left upper lobe with background multiple foci of atypical adenomatous hyperplasia and incidental (4mm at least) focus of adenocarcinoma in situ: (TNM 7) pT2a, N0, Mx - PL1. 2012 Ampullectomy: Tubulovillous adenoma with low grade and very focal high grade dysplasia. Previous targeted liver biopsies at at different trust negative.

Specimen: Lesional liver biopsy.

Macroscopic description:
A cream core 16mm embedded intact.

Immunohistochemistry:
None.

Male 38 years

Alcoholic hepatitis on a background of probable cirrhosis. We are considering starting steroids.

Specimen:

Liver biopsy.

Macroscopic description:
2 cores of tissue, 1.5cm + frags.

Immunohistochemistry:
EPSR, retic, PASD, Perls, Orcein.

Female 69 years

Liver lesion. ?Aetiology. Hyper vascular, indeterminate on CT/MR. Difficult biopsy (basically invisible on B mode, navigated by capsular indentation). 1cm core I think lesional. MRI 13mm with capsular retraction, mildly high signal on T2 and low on T1-weighted imaging. Bili 9, ALP 58, ALT 22. Non-insulin dependent diabetes, osteoarthritis, palindromic rheumatism and migraines. Current medications include Loratidine, Sumatriptan, Lansoprazole, Lisinopril, and Co-codam ol. She has allergies to Metformin, Hydroxychloroquine, Amitriptyline, Tramadol, Codeine and Imipramine.

Specimen: Lesional liver biopsy.

Macroscopic description:
Two cores of cream and tan tissue measuring 5 and 14mm. All embedded.

Immunohistochemistry:
None.

Female 32 years

Non-anatomical liver resection segment VI.

Specimen: Liver resection segment VI.

Macroscopic description:
Liver resection 50 x 40 x 30mm. Central scar noted on cut surface.

Immunohistochemistry:
none.