Male 61 years

Heterogenous pattern liver; known significant alcohol intake. Elevated ALT/AST/ gamma GT; viral screen negative. Auto-antibodies negative.

Specimen:

Liver biopsy.

Macroscopic description:
2 cores of liver combined length 18mm.

Immunohistochemistry:
Retic and Masson trichrome provided.

Male 62 years

Abnormal liver function tests; positive AMA; elevated IgM; Elevated Alkaline phospatase; elevated Gamma GT; positive ANA; NEGATIVE for anti-smooth muscle; LKM1;

Specimen:

Liver biopsy.

Macroscopic description:
2 cores liver combined length 20m.

Immunohistochemistry:
Retic and HVG provided.

Male 61 years

PSC, recurrent cholangitis, intrahepatic duct stones. Liver Transplant.

Specimen: Liver expant.

Macroscopic description:
Bile stained cirrhotic liver 2972g, with frequent intrahepatic calculi.

Immunohistochemistry:
Two blocks, A1 and A2. A1 also Shikata, van Gieson, CK7.

Female 57 years

Coeliac disease. IDDM since 21 years old. Raised ALT and bilirubin, drop in albumin +ANA. Raised IgG A M treated with prednisolone. AIH? index grading? acute/chronic/cirrhosis?

Specimen:

Liver biopsy.

Macroscopic description:
Two cores 25 and 30mm both bisected.

Immunohistochemistry:
Nil.

Female 46 years

Liver mets of unknown primary. Lesion in right lobe targeted.

Specimen: Targeted liver biopsy.

Macroscopic description:
One core 16mm long.

Immunohistochemistry:
None.

Male 58 years

Chronic liver disease due to haemochromatosis diagnosed in 2020. HCC 24mm seg 8 previous TACE, also 8mm LIRADS 4 lesion segment 5.

Specimen: Liver explant.

Macroscopic description:
Liver 2249g, nodular appearance. Lesions 21mm in segment 8, and 8mm segment 5. This is segment 8 lesion and background liver.

Immunohistochemistry:
Segment 8 lesion, also background liver Perls and van Gieson.

Female 79 years

On TPN for short bowel, formula recently changed. Also on Atorvastatin. Increased Bilirubin, jaundice ANA pos >6400, SMA neg IgG 17 ALT 295 TBILI 365 ALP 190.

Specimen:

Liver biopsy, transjugular.

Macroscopic description:
3 cores of tissue 12-17mm.

Immunohistochemistry:
None.

Male 33 years

Known IBD(U), abnormal LFTs for 4 years. MRCP normal, need to rule out small duct PSC. ALT 115, ALP 451, normal bilirubin, clotting and albumin. Immunology/serology negative.

Specimen:

Liver biopsy.

Macroscopic description:
3 cores up to 18mm long.

Immunohistochemistry:
Orcein, DPAS, van Gieson, CK7.

Male 58 years

Chronic liver disease - same explant as case LX6. This is 8mm segment 5 lesion.

Specimen: Liver explant.

Macroscopic description:
Liver 2249g, nodular appearance. Lesions 21mm in segment 8, and 8mm segment 5. This is segment 5 lesion.

Immunohistochemistry:
8mm lesion, two sections. also reticulin, CK34, glutamine synthetase.

Female 78 years

Abnormal Liver function tests; ALT 1100; Alkaline phosphatase 300; Ducts not dilated on imaging; Liver normal on imaging; Autoantibodies negative; Immunoglobulinbs normal; HAV/HBV/HCV negative ; recetn use of Flucloxacillin.

Specimen:

Liver biopsy.

Macroscopic description:
3 cores of liver, combined length 37mm.

Immunohistochemistry:
Retic provided.

Female 70 years

Unexplained abnormal LFTs with ? hepatitis B infection. Indeterminate positive hepatitis B, also rheumatoid arthritis, awaiting immunosuppression medication.

Liver biopsy to determine cause of liver abnormality and to confirm / exclude liver hepatitis B infection.

Specimen:

Liver biopsy.

Macroscopic description:
1 core 18mm long.

Immunohistochemistry:
Retic, CK7, HBsAg.

Male 69 years

OLTx for HCC (Segment IV) / NAFLD cirrhosis - Explant. ?other lesions.

Specimen: Liver explant.

Macroscopic description:
Liver explant, multiple lesions identified. This lesion relatively well defined necrotic yellow coloured tumour with pale white rim measuring up to 30mm in segment VIII.

Immunohistochemistry:
Nil.