Liver EQA Scheme Circulation LQ – Autumn 2017

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Case number: / LQ1
Clinical Information: / ALT 1102; Gamma GT 84; Raised IgG. Alk phosphatase normal. ANA positive 1:80; Anti Smooth muscle AB positive. AMA negative. IgM normal. History breast carcinoma
Specimen: / liver biopsy
Age: / 60
Sex: / Female
Macroscopic description: / 2 cores of liver combined length 25mm
Immunohistochemistry: / Reticulin, PAS, Masson
.View Slides: / H&E
reticulin
Masson trichrome
PAS

Morphological assessment:

Clinicopathological diagnosis:

Case number: / LQ2
Clinical Information: / Chronic pancreatic insufficiency. Type 2 diabetic on insulin, Deranged LFTs, fatty liver on ultrasound, elevated fibroscan.
Specimen: / Liver biopsy
Age: / 63
Sex: / Female
Macroscopic description: / Two cores of liver 18mm and 17mm
Immunohistochemistry: / Picro Sirius red, reticulin
View Slides: / H&E
reticulin
Picro Sirius red

Morphological assessment:

Clinicopathological diagnosis:

Case number: / LQ3
Clinical Information: / History of alcohol excess, currently abdominal pain, jaundice. Liver screen normal, ?fatty liver on CT, oesophageal varices
Specimen: / Liver biopsy
Age: / 57
Sex: / Male
Macroscopic description: / Two cores 20mm and 17mm
Immunohistochemistry: / Picro Sirius red, reticulin
View Slides: / H&E
reticulin
Picro Sirius red

Morphological assessment:

Clinicopathological diagnosis:

Case number: / LQ4
Clinical Information: / Abnormal LFTs, AMA strong +ve, fatty liver on ultrasound, ?PBC
Specimen: / Liver biopsy
Age: / 44
Sex: / Male
Macroscopic description: / One core 20mm
Immunohistochemistry: / Picro Sirius red, reticulin,
the Orcein was negative for copper associated protein.
View Slides: / H&E
reticulin
Picro Sirius red

Morphological assessment:

Clinicopathological diagnosis:

Case number: / LQ5
Clinical Information: / 'Liver lesion segment 6/7'. From electronic patient record IgG kappa paraproteinaemia. Section is from background liver.
Specimen: / Non anatomical resection segment 6/7
Age: / 74
Sex: / Male
Macroscopic description: / 292g liver wedge containing a 9cm tumour. The section submitted is from background liver not the tumour.
Immunohistochemistry: / PASD, Masson trichrome, IgG, lamda, kappa, congo red,
View Slides: / H&E
PASD
Masson trichrome
Congo red
IgG
kappa
lamda

Morphological assessment:

Clinicopathological diagnosis:

Case number: / LQ6
Clinical Information: / Recurrent abscess in left lobe of liver.
Specimen: / partial liver resection
Age: / 85
Sex: / Male
Macroscopic description: / Left lobe of liver: segment of liver measuring 135 x 85 x 40mm. On slicing there is a cystically dilated area measuring 20mm. Macropath image has been taken.
Immunohistochemistry: / None
View Slides: / H&E

Morphological assessment:

Clinicopathological diagnosis:

Case number: / LQ7
Clinical Information: / Chronic hepatitis C. Positive mitochondrial antibodies and raised IgG. Type II diabetes and obesity. Liver biopsy to rule out autoimmune hepatitis.
Specimen: / Liver biopsy
Age: / 51
Sex: / Female
Macroscopic description: / One core, 20mm long
Immunohistochemistry: / VG, CK8/18
View Slides: / H&E
van Gieson
CK8/18

Morphological assessment:

Clinicopathological diagnosis:

Case number: / LQ8
Clinical Information: / ? HCC pre-ablation. 18G biopsy.
Specimen: / Liver biopsy segment VI
Age: / 69
Sex: / Male
Macroscopic description: / One core, 12mm long plus fragment.
Immunohistochemistry: / Perls (little tissue left in block).
View Slides: / H&E
Perls

Morphological assessment:

Clinicopathological diagnosis:

Case number: / LQ9
Clinical Information: / Acute Hepatitis. Liver biopsy. Additional information from urgent Liver biopsy booking from 'BG hypothyroidism. A/W Deranged LFT's. Acute hepatitis, Coagulopathy, high IgG hepatitis negative, ? Autoimmune hepatitis'.
Specimen: / Liver biopsy
Age: / 49
Sex: / Female
Macroscopic description: / One green speckled core of Liver tissue measuring 20mm in length.
Immunohistochemistry: / VG, DPAS, Shikata,
View Slides: / H&E
Van Gieson
DPAS
Shikata

Morphological assessment:

Clinicopathological diagnosis:

Case number: / LQ10
Clinical Information: / Increased fibroscan (11) ?NAFLD ?degree of fibrosis.
Specimen: / Liver biopsy
Age: / 53
Sex: / Female
Macroscopic description: / 20mm core
Immunohistochemistry: / Alpha 1 antitrypsin, ubiquitin, cytokeratin 8/18, PASD, HVG
View Slides: / H&E
PASD
HVG
Alpha 1 antitrypsin
CK 8/18
ubiquitin

Morphological assessment:

Clinicopathological diagnosis:

Case number: / LQ11
Clinical Information: / Intra-abdominal mass involving right lobe of liver
Specimen: / Right hemihepatectomy
Age: / 43
Sex: / Female
Macroscopic description: / Segment of liver 265x175x115mm almost completely occupied by a circumscribed haemorrhagic lesion.
Immunohistochemistry: / None
View Slides: / H&E

Morphological assessment:

Clinicopathological diagnosis:

Case number: / LQ12
Clinical Information: / Lesion left lobe liver
Specimen: / Left lobe liver
Age: / 28
Sex: / Female
Macroscopic description: / Liver resection 135x95x60mm with a circumscribed lesion 35x32x24mm
Immunohistochemistry: / None
View Slides: / H&E

Morphological assessment:

Clinicopathological diagnosis:

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