Liver specimens should be handled as little as possible and with utmost care to
avoid squeezing artifacts
Particular attention should be paid to fragmentation (cirrhosis), NO, size,
shape and color
Important to process needle biopsy specimens separately from other tissues and a
more rapid schedule in the automated tissue processor
Staining
Routine Staining
- H&E
- Massons trichrome or chromotrope-aniline blue
Special Staining
- Victoria blue or orcein : HBsAG, elastic fiber, lipofuscin, ceroid,
copper-binding protein
- D-PAS : GP including A1AT inclusion, ceroid, BM of bile ducts, CMV
inclusion, MAI
Microscopic Exam
Adequate and properly processed specimen without artifact with relevant clinical
and LAB data are important
Should conform to a routine and include all tissue fragments and all structures
of the liver : architecture, portal triads, limiting plate, hepatocytes,
sinusoidal cells and terminal hepatic venules
Usually start with zone 3
Immunohistologic Studies
Development of additional monoclonal antibodies and of highly sensitive
immunohistochemical staining are useful eg
- D-PAS : A1AT deficiency
- AFT : HCC
- CEA and Lewis : bile duct carcinoma
AAT Deficiency
HBsAg in Cytoplasm of Ground Glass Hepatocytes
HBcAg in Nuclei and Cytoplasm
Cytokeratin in Normal and Cirrhotic patients
Liver Histology for Pathologists
Summarized By Thirayost Nimmanon
สรุปโดย ธีรยสถ์ นิมมานนท์
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