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EQA

Dr J I Wyatt





Dr. Judy Wyatt's presentation pdf document symbol

Case 1

Male 43 years

Unwell for 1 week with lethargy, nausea. No fever. Deranged LFT (ALT - 3407). ultrasound = normal liver. Liver screen - normal.

H&E 246144


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PAS Periodic acid Shiff 246145


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Van Gieson 246146


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Case 2

Male 26 years

Acute illnes, unwell, lethergy, vomiting. Bilirubin >250. ALT >3500. Liver screen so far negative. Cocaine use over 4 months ago, nil recently. Has been having nurofen for headaches. ? cause of LFT disturbance.

H&E 246147


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Haematoxylin van Gieson (HVG) 246148


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PAS diastase (PASD) 246150


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Case 3

Male 59 years

Two weeks history of jaundice. Coagulopathic, ALT >1000, bilirubin >500. Taken nitrofurantoin recently.

H&E 246155


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PAS diastase (PASD) 246152


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Sirius red 246153


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Shikata 246154


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Case 4

Female 32 years

Transplant - non A-E acute hepatitis.

H&E 246156


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Reticulin 246157


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PAS diastase (PASD) 246158


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Van Gieson 246161


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Shikata 246163


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Case 5

Male 17 years

Deranged LFTs, raised ALT and SMA antibody positive. ? autoimmune hepatitis.

H&E 246165


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Sirius red 246168


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PAS diastase (PASD) 246169


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Reticulin 246170


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Case 6

Male 45 years

Acute hepatitis. Positive autoantibodies, ? autoimmune hepatitis.

H&E 246171


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Case 7

Female 33 years

Raised IgG (27.6) and IgM(5.1). Positive AMA, LKM, Persistently abnormal LFTs. ultrasound scan - splenomegaly. ? AIH/PBC overlap.

H&E 246174


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Shikata 246175


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CK07 246178


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Sirius red 246179


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Case 8

Male 48 years

Hepatitis C - previous biopsy. Raised ALT. ? other cause. Further information from server, genotype 3, ferritin 1405, ALT at time of biopsy 580.

H&E 246180


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Sirius red 246181


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Reticulin 246182


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Case 9

Male 23 years

Chronic hepatitis B. Hepatitis B e-antigen negative, ALT fluctuating . Assess fibrosis.

H&E 246183


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Reticulin 246184


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Shikata 246185


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Case 10

Male 32 years

Known HBV positive. HBe antigen positive, HBs antigen positive. Last HBV PCR 3.8 x 10*5. fibroscan 10.1.

H&E 246186


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Reticulin 246187


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Sirius red 246188


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Shikata 246190


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Case 11

Male 37 years

Alcohol-related liver cirrhosis (moderate drinker). Work up for liver transplant. Abstinent from alcohol?

H&E 246191


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Van Gieson 246192


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Case 12

Male 52 years

Transjugular liver biopsy. Abnormal LFTs, raised bilirubin 43 alk phos 381, ANA +ve, anti-DNA antibodies. Hepatitis B and C serology negative. Ultrasound scan - hepatomegaly, distended IVC. Past history cardiomyopathy, IHD and previous cardiac arrest. Clinical diagnosis intrinsic liver disase, ? cardiac related pathology.

H&E 248763


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Sirius red 246193


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Reticulin 246194


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Case 13

Male 57 years

Liver transplant - cryptogenic cirrhosis.

H&E 246197


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PAS diastase (PASD) 246195


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Shikata 246199


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Reticulin 246202


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