Gastrointestinal Pathology for Medical II Students

Lab 3h Macronodular Cirrhosis (56000-48500)

Slide 1 
You will recall from your lecture that cirrhosis is a chronic disease of the liver characterized by diffuse destruction and regeneration of hepatocytes, as well as subsequent fibrous scarring that results in disorganization of the lobular architecture. Put more simply, cirrhosis is characterized by fibrosis of the liver and regenerative parenchymal nodules. Cirrhosis may be divided morphologically into two basic types: micronodular cirrhosis and macronodular cirrhosis. The micronodular pattern has uniform regenerative nodules of lobular size or smaller (3 mm in diameter and less) and in the U.S. is usually caused by alcohol. In macronodular cirrhosis, the regenerative nodules are large and irregular in size and shape. The fibrous septa are often broad. Macronodular cirrhosis corresponds loosely to the older terms "post-necrotic" or "multilobular" cirrhosis and in the U.S. is most often seen following chronic active viral hepatitis.

cirrhosis

Slide 2
Is a low power view of the actual slide in your class set. The hepatic architecture is disturbed by broad bands of fibrosis that completely circumscribe irregularly sized and shaped nodules of regenerating hepatic parenchyma. These nodules range in size from less than 1 mm in diameter to greater than 5 mm in diameter.

fibrosis

Slide 3
Shows at higher power the broad fibrous septa which completely surround regenerating nodules of hepatic parenchyma. This patient's cirrhosis resulted from chronic active hepatitis C and there is ongoing chronic inflammation and necrosis in this liver.

fibrous septa
Slide 4
Is taken at the margin of a regenerative nodule and a fibrous scar (double arrows). Note the irregular contour of the regenerative nodules and the intense chronic inflammation at the interface of the fibrous septa and the hepatic plates. This is an example of ongoing piecemeal necrosis.
piecemeal necrosis

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