Gastrointestinal Pathology for Medical II Students

Lab 3b Primary Hemochromatosis of the Liver (56000-57410)

The basic pathologic feature in hemochromatosis is the deposition of massive amounts of iron in various organs of the body. Because the liver is the major storage site for iron and plays a key role in all conditions of iron overload, it is often severely affected. The deposition of iron in hepatic parenchymal cells leads to tissue damage, fibrosis, and eventually cirrhosis. The actual molecular mechanism by which iron causes hepatic damage is not known, but it is felt that iron alters oxidative phosphorylation. Hemochromatosis may be primary (hereditary) or secondary (increased dietary intake; multiple transfusions; hemolytic conditions). The changes in the liver in primary hemochromatosis depend on the stage of disease. In the early stages there is deposition of iron in the hepatic parenchymal cells but no alteration of the hepatic architecture. The liver is large and may have a rust or dark brown color.

Slide 1  The example of hemochromatosis in your class set is an example of the late stages of the disease. Bands of fibrosis have completely circumscribed regenerating nodules of hepatic parenchyma. This is an example of cirrhosis caused by a metabolic disease.
Slide 2 Higher magnification shows these chronically inflamed bands of fibrosis (F) surrounding islands of regenerating hepatic parenchyma (arrow). Note that the regenerative nodules lack central veins. Even at this magnification you may be able to appreciate the dark-brown hemosiderin pigment distributed throughout the liver.

Digital Legends for Labs/Cases
Lab 1
1.a | 1.b | 1.c | 1.d | 1.e | 1.f | 1.g | 1.h | 1.i | 1.j | 1.k | 1.l | 1.m
Lab 2
2.a | 2.b | 2.c | 2.d | 2.e | 2.f | 2.g | 2.h | 2.i | 2.j | 2.k | 2.l | 2.m
Lab 3
3.a | 3.b | 3.c | 3.d | 3.e | 3.f | 3.g | 3.h | 3.i | 3.j | 3.k | 3.l

Medical II

Updated March 2, 2007