Liver neoplasms - Revision history

Mitchell: /* Hematopoietic tumors */ added a case

2017-01-31T23:15:23Z

Hematopoietic tumors: added a case

← Older revision		Revision as of 23:15, 31 January 2017
Line 380:		Line 380:
	==Hematopoietic tumors==		==Hematopoietic tumors==
	A [[File:1 MM 1 Covenant 680x512px.tif\|One liver core was normal (Row 1 Left 40X).]]		A [[File:1 MM 1 Covenant 680x512px.tif\|One liver core was normal (Row 1 Left 40X).]]
			<br>
	B [[File:2 MM 1 Covenant 680x512px.tif\|A triad with a proliferated bile ductule, otherwise normal (Row 1 Right 400X).]]		B [[File:2 MM 1 Covenant 680x512px.tif\|A triad with a proliferated bile ductule, otherwise normal (Row 1 Right 400X).]]
	<br>		<br>
	C [[File:3 MM 1 Covenant 680x512px.tif\|The other core showed a mass of tumor mashed against normal liver (Row 2 Left 40X).]]		C [[File:3 MM 1 Covenant 680x512px.tif\|The other core showed a mass of tumor mashed against normal liver (Row 2 Left 40X).]]
			<br>
	D [[File:4 MM 1 Covenant 680x512px.tif\|Tumor cells showed round to ovoid nuclei without pattern and with grey cytoplasm that proved to be CD138 positive (Row 2 Right 400X).]]		D [[File:4 MM 1 Covenant 680x512px.tif\|Tumor cells showed round to ovoid nuclei without pattern and with grey cytoplasm that proved to be CD138 positive (Row 2 Right 400X).]]
			<br>
	Plasmacytoma appearing as a tumor mass. A. One liver core was normal. B. A triad with a proliferated bile ductule, otherwise normal. C. The other core showed a mass of tumor mashed against normal liver. D. Tumor cells showed round to ovoid nuclei without pattern and with grey cytoplasm that proved to be CD138 positive.		Plasmacytoma appearing as a tumor mass. A. One liver core was normal. B. A triad with a proliferated bile ductule, otherwise normal. C. The other core showed a mass of tumor mashed against normal liver. D. Tumor cells showed round to ovoid nuclei without pattern and with grey cytoplasm that proved to be CD138 positive.

	A. [[File:1 B cell lym liver 1 680x512px.tif\|Apparent inflamed fibrous tract with lobular inflammatory collections in adjacent liver (Row 1 Left 40X).]]		A. [[File:1 B cell lym liver 1 680x512px.tif\|Apparent inflamed fibrous tract with lobular inflammatory collections in adjacent liver (Row 1 Left 40X).]]
			<br>
	B. [[File:2 B cell lym liver 1 680x512px.tif\|Apparent inflamed fibrous band between two relatively hepatocyte regions (Row 1 Right 40X).]]		B. [[File:2 B cell lym liver 1 680x512px.tif\|Apparent inflamed fibrous band between two relatively hepatocyte regions (Row 1 Right 40X).]]
	<br>		<br>
	C. [[File:3 B cell lym liver 1 680x512px.tif\|Apparent piecemeal necrosis with bile ductular proliferation (Row 2 Left 200X).]]		C. [[File:3 B cell lym liver 1 680x512px.tif\|Apparent piecemeal necrosis with bile ductular proliferation (Row 2 Left 200X).]]
			<br>
	D. [[File:4 B cell lym liver 1 680x512px.tif\|Apparent portal inflammation with unaffected interlobular bile duct (Row 2 Right 200X).]]		D. [[File:4 B cell lym liver 1 680x512px.tif\|Apparent portal inflammation with unaffected interlobular bile duct (Row 2 Right 200X).]]
	<br>		<br>
	E. [[File:5 B cell lym liver 1 680x512px.tif\|Apparent lobular infiltrate with small masse.]]		E. [[File:5 B cell lym liver 1 680x512px.tif\|Apparent lobular infiltrate with small masse.]]
			<br>
	F. [[File:6 B cell lym liver 1 680x512px.tif\|Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma.]]		F. [[File:6 B cell lym liver 1 680x512px.tif\|Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma.]]
			<br>
	B cell lymphoma mimicking hepatitis with fibrosis. A. Apparent inflamed fibrous tract with lobular inflammatory collections in adjacent liver. B. Apparent inflamed fibrous band between two relatively hepatocyte regions. C. Apparent piecemeal necrosis with bile ductular proliferation. D. Apparent portal inflammation with unaffected interlobular bile duct. E. Apparent lobular inflammation with collections a bit too large for usual lobular inflammation. F. Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma.		B cell lymphoma mimicking hepatitis with fibrosis. A. Apparent inflamed fibrous tract with lobular inflammatory collections in adjacent liver. B. Apparent inflamed fibrous band between two relatively hepatocyte regions. C. Apparent piecemeal necrosis with bile ductular proliferation. D. Apparent portal inflammation with unaffected interlobular bile duct. E. Apparent lobular inflammation with collections a bit too large for usual lobular inflammation. F. Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma.

Line 404:		Line 409:
	[[File:5 02965636298621 sl 31.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]		[[File:5 02965636298621 sl 31.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
	[[File:5 02965636298621 sl 6.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]		[[File:5 02965636298621 sl 6.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
			<br>
			Malignant B cell lymphoma, NOS, in a 63 year old man’s liver. No other specimens were available for further classification. A. Tumor expands a triad and occupies parenchymal regions. B. Bounding a bile duct, modestly sized round to reniform lymphoid cells, many without nucleoli, accompany small round lymphocytes. Some of the larger cells have clefts (arrows). C. CD3 stain shows many of the lymphoid cells are intercalated reactive T cells. D. Ki67 shows less than half the tumor cells, mostly the larger ones, are in proliferative phase, arguing against the notion of a high grade B cell lymphoma. E. CD79A establishes B cell phenotype (CD20 was also positive). F. That the tumor cells are BCL2 positive evinces B cell neoplasia. The cells were CD10, BCL6, and cyclin D1 negative, militating against mantle cell lymphoma and CLL, with no follicular origin identified.

			[[File:4 89735893919405 sl 1.png\| High grade B cell lymphoma involving liver]]
	~~Malignant~~ B cell lymphoma~~, NOS,~~ in a 63 year old ~~man’s liver~~. ~~No other specimens were available for further classification~~. A~~. Tumor expands a triad and occupies parenchymal regions~~. B. ~~Bounding a bile duct~~, ~~modestly sized~~ round to ~~reniform lymphoid cells~~, ~~many without~~ nucleoli~~, accompany small round lymphocytes~~. ~~Some of the larger cells have clefts (arrows)~~. C. ~~CD3 stain shows many of the lymphoid~~ cells are ~~intercalated reactive T cells~~. D. ~~Ki67 shows less than half the tumor cells, mostly the larger ones, are in proliferative phase~~, ~~arguing against the notion of a high grade B cell lymphoma~~. E. ~~CD79A establishes B cell phenotype (CD20 was also positive). F. That the tumor~~ cells are ~~BCL2~~ positive ~~evinces B cell neoplasia. The cells were CD10, BCL6, and cyclin D1 negative, militating against mantle cell lymphoma and CLL, with no follicular origin identified~~.		[[File:4 89735893919405 sl 2.png\| High grade B cell lymphoma involving liver]]
			[[File:4 89735893919405 sl 3.png\| High grade B cell lymphoma involving liver]]
			[[File:4 89735893919405 sl 4.png\| High grade B cell lymphoma involving liver]]
			[[File:4 89735893919405 sl 5.png\| High grade B cell lymphoma involving liver]]<br>
			High grade B cell lymphoma involving liver in a 77 year old woman. A. A band of cancer abuts fibrotic liver with steatosis. B. Cancer cells show primitive, round to ovoid, variably sized, dark nucleoli and an aberrant mitoses. Cytoplasm is scant. C. Cancer cells are CD79a positive. D. Most cancer cell nuclei were positive for Ki-67, overall about 80%. E. A minority of cancer cells are CD10 positive.

	=See also=		=See also=

Mitchell: /* Hematopoietic tumors */

2016-12-27T16:21:27Z

Hematopoietic tumors

← Older revision		Revision as of 16:21, 27 December 2016
Line 394:		Line 394:
	<br>		<br>
	E. [[File:5 B cell lym liver 1 680x512px.tif\|Apparent lobular infiltrate with small masse.]]		E. [[File:5 B cell lym liver 1 680x512px.tif\|Apparent lobular infiltrate with small masse.]]
	F. [[File:6 B cell lym liver 1 680x512px.tif\|Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma.		F. [[File:6 B cell lym liver 1 680x512px.tif\|Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma.]]

	B cell lymphoma mimicking hepatitis with fibrosis. A. Apparent inflamed fibrous tract with lobular inflammatory collections in adjacent liver. B. Apparent inflamed fibrous band between two relatively hepatocyte regions. C. Apparent piecemeal necrosis with bile ductular proliferation. D. Apparent portal inflammation with unaffected interlobular bile duct. E. Apparent lobular inflammation with collections a bit too large for usual lobular inflammation. F. Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma.		B cell lymphoma mimicking hepatitis with fibrosis. A. Apparent inflamed fibrous tract with lobular inflammatory collections in adjacent liver. B. Apparent inflamed fibrous band between two relatively hepatocyte regions. C. Apparent piecemeal necrosis with bile ductular proliferation. D. Apparent portal inflammation with unaffected interlobular bile duct. E. Apparent lobular inflammation with collections a bit too large for usual lobular inflammation. F. Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma.

Mitchell: /* Photos */

2016-12-27T16:20:20Z

Photos

← Older revision		Revision as of 16:20, 27 December 2016
Line 341:		Line 341:
	Image:BileDucts IntraductalPapillaryNeoplasm NonMucinousType HP2 PA.jpg\|Bile Ducts - Intraductal Papillary Neoplasm - High power (SKB)		Image:BileDucts IntraductalPapillaryNeoplasm NonMucinousType HP2 PA.jpg\|Bile Ducts - Intraductal Papillary Neoplasm - High power (SKB)
	</gallery>		</gallery>
	{\|
	[[File:1 papillary cbd aca 1 680x512px.tif\| Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma.]]		A. [[File:1 papillary cbd aca 1 680x512px.tif\| Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma.]]
	[[File:2 papillary cbd aca 1 680x512px.tif\| Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma.]]		B. [[File:2 papillary cbd aca 1 680x512px.tif\| Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma.]]
	<br>		<br>
	[[File:3 papillary cbd aca 1 680x512px.tif\| Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma.]]		C. [[File:3 papillary cbd aca 1 680x512px.tif\| Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma.]]
	[[File:4 papillary cbd aca 1 680x512px.tif\| Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma.]]		D. [[File:4 papillary cbd aca 1 680x512px.tif\| Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma.]]
	<br>		<br>
	[[File:5 papillary cbd aca 1 680x512px.tif\| Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma.]]		E. [[File:5 papillary cbd aca 1 680x512px.tif\| Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma.]]
	[[File:6 papillary cbd aca 1 680x512px.tif\| Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma.]]		F. [[File:6 papillary cbd aca 1 680x512px.tif\| Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma.]]
	\|}
	Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma. ~~<br>~~The papillary tumor comprises mostly variably dilated acini ~~(Row 1 Left 20X), but~~ also shows areas of micropapillae ~~(Row 1 Right 200X)~~. Some areas within the non-invasive tumor showed necrosis, with the black pyknotic nuclei amid red debris ~~(Row 2 Left 400X)~~. Definite invasion was established low power by glands headed in perpendicular directions ~~(Row 2 Right 40X)~~. Embedded in fibroblastic response are non-acinar walls and isolated epithelial groups ~~(Row 3 Left 400X)~~. Also embedded in fibroblastic response are flat glands with nuclei showing loss of polarity (lack of respect for lateral intercellular borders shown by variable orientation to base of gland~~) (Row 3 Right 400X~~).		Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma. A. The papillary tumor comprises mostly variably dilated acini. B. Tumor also shows areas of micropapillae. C. Some areas within the non-invasive tumor showed necrosis, with the black pyknotic nuclei amid red debris. D. Definite invasion was established low power by glands headed in perpendicular directions. E. Embedded in fibroblastic response are non-acinar walls and isolated epithelial groups. F. Also embedded in fibroblastic response are flat glands with nuclei showing loss of polarity (lack of respect for lateral intercellular borders shown by variable orientation to base of gland).

	Notes -		Notes -

Mitchell: /* Cavernous hemangioma */

2016-12-27T16:18:01Z

Cavernous hemangioma

← Older revision		Revision as of 16:18, 27 December 2016
Line 217:		Line 217:

	==Cavernous hemangioma==		==Cavernous hemangioma==
	{\|
	~~[[File:1 CAV 1 680x512px.tif\|Fibrous foci with increased spaces, hepatocyte focus with nonspecific fibrotic bridge (40X).]]~~
	~~[[File:2 CAV 1 680x512px.tif\|Cavernous hemangioma with flat, non-atypical endothelium (200X).]]~~
	~~[[File:3 CAV 1 680x512px.tif\|Tortuous bile ductules, not to be considered generalized in presence of mass (200X).]]~~
	~~[[File:4 CAV 1 680x512px.tif\|Tortuous bile ducts, not to be considered generalized in presence of mass (200X).]]~~
	\|}

	~~Cavernous hemangioma~~. Fibrous foci with increased spaces, hepatocyte focus with nonspecific fibrotic bridge (UL 40X). Cavernous hemangioma with flat, non-atypical endothelium (UR 200X). Tortuous bile ductules, not to be considered generalized in presence of mass (LL 200X). Tortuous bile ~~ducts~~, not to be considered generalized in presence of mass (LR 200X).		A. [[File:1 CAV 1 680x512px.tif\|Fibrous foci with increased spaces, hepatocyte focus with nonspecific fibrotic bridge (40X).]]
			B. [[File:2 CAV 1 680x512px.tif\|Cavernous hemangioma with flat, non-atypical endothelium (200X).]]
			<br>
			C. [[File:3 CAV 1 680x512px.tif\|Tortuous bile ducts/ductules, not to be considered generalized in presence of mass (200X).]]
			D. [[File:4 CAV 1 680x512px.tif\|Tortuous bile ductsductules, not to be considered generalized in presence of mass (200X).]]


			Cavernous hemangioma. A. Fibrous foci with increased spaces, hepatocyte focus with nonspecific fibrotic bridge. B. Cavernous hemangioma with flat, non-atypical endothelium. C. Tortuous bile ductules, not to be considered generalized in presence of mass. D. Tortuous bile ducts, not to be considered generalized in presence of mass.

	=Malignant hepatic neoplasms=		=Malignant hepatic neoplasms=

Mitchell: /* Bile duct hamartoma */

2016-12-27T16:16:05Z

Bile duct hamartoma

← Older revision		Revision as of 16:16, 27 December 2016
Line 180:		Line 180:
	=Benign hepatic neoplasms=		=Benign hepatic neoplasms=
	==Bile duct hamartoma==		==Bile duct hamartoma==
	{\|		A. [[File:1 BDH 1 680x512px.tif\|Trichrome shows fibrous spaces with dilated ducts (20X).]]
	[[File:1 BDH 1 680x512px.tif\|Trichrome shows fibrous spaces with dilated ducts (20X).]]		B. [[File:2 BDH 1 680x512px.tif\|Bizarre, ramifying tubules with dilatations (100X).]]
	[[File:2 BDH 1 680x512px.tif\|Bizarre, ramifying tubules with dilatations (100X).]]		<br>
	[[File:3 BDH 1 680x512px.tif\|Bland epithelial linings (400X).]]		C. [[File:3 BDH 1 680x512px.tif\|Bland epithelial linings (400X).]]
	[[File:4 BDH 1 680x512px.tif\|Surrounding tract with tortuous bile ducts & inflammation, likely secondary to hamartomas (200X).]]		D. [[File:4 BDH 1 680x512px.tif\|Surrounding tract with tortuous bile ducts & inflammation, likely secondary to hamartomas (200X).]]
	\|}
	Bile duct hamartomas. Trichrome shows fibrous spaces with dilated ducts ~~(UL 20X)~~. Bizarre, ramifying tubules with dilatations ~~(UR 100X)~~. Bland epithelial linings ~~(LL 400X)~~. Surrounding tract with tortuous bile ducts & inflammation, likely secondary to hamartomas ~~(LR 200X)~~.
			Bile duct hamartomas. A. Trichrome shows fibrous spaces with dilated ducts. B. Bizarre, ramifying tubules with dilatations. C. Bland epithelial linings. D. Surrounding tract with tortuous bile ducts & inflammation, likely secondary to hamartomas.

	==Bile duct adenoma==		==Bile duct adenoma==
	:''Should '''not''' be confused with [[bile duct hamartoma]].''		:''Should '''not''' be confused with [[bile duct hamartoma]].''

Mitchell: /* Hematopoietic tumors */

2016-12-27T16:11:42Z

Hematopoietic tumors

← Older revision		Revision as of 16:11, 27 December 2016
Line 390:		Line 390:
	D. [[File:4 B cell lym liver 1 680x512px.tif\|Apparent portal inflammation with unaffected interlobular bile duct (Row 2 Right 200X).]]		D. [[File:4 B cell lym liver 1 680x512px.tif\|Apparent portal inflammation with unaffected interlobular bile duct (Row 2 Right 200X).]]
	<br>		<br>
	E. [[File:5 B cell lym liver 1 680x512px.tif\|Apparent lobular infiltrate with small ~~masses (Row 3 Left 200X)~~.]]		E. [[File:5 B cell lym liver 1 680x512px.tif\|Apparent lobular infiltrate with small masse.]]
	F. [[File:6 B cell lym liver 1 680x512px.tif\|Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma.		F. [[File:6 B cell lym liver 1 680x512px.tif\|Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma.

Line 397:		Line 397:
	[[File:5 02965636298621 sl 1.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]		[[File:5 02965636298621 sl 1.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
	[[File:5 02965636298621 sl 2.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]		[[File:5 02965636298621 sl 2.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
			[[File:5 02965636298621 sl 3.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
			[[File:5 02965636298621 sl 4.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
	[[File:5 02965636298621 sl 31.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]		[[File:5 02965636298621 sl 31.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
	~~[[File:5 02965636298621 sl 4.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]~~
	~~[[File:5 02965636298621 sl 5.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]~~
	[[File:5 02965636298621 sl 6.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]		[[File:5 02965636298621 sl 6.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]

Mitchell: /* Hematopoietic tumors */ added a case and changed the format for two others to make them lettered, as i phones will alter the arrangement of images.

2016-12-27T16:10:13Z

Hematopoietic tumors: added a case and changed the format for two others to make them lettered, as i phones will alter the arrangement of images.

← Older revision		Revision as of 16:10, 27 December 2016
Line 376:		Line 376:
	*[[AKA]] ''metastatic liver disease''.		*[[AKA]] ''metastatic liver disease''.
	==Hematopoietic tumors==		==Hematopoietic tumors==
	{\|		A [[File:1 MM 1 Covenant 680x512px.tif\|One liver core was normal (Row 1 Left 40X).]]
	[[File:1 MM 1 Covenant 680x512px.tif\|One liver core was normal (Row 1 Left 40X).]]		B [[File:2 MM 1 Covenant 680x512px.tif\|A triad with a proliferated bile ductule, otherwise normal (Row 1 Right 400X).]]
	[[File:2 MM 1 Covenant 680x512px.tif\|A triad with a proliferated bile ductule, otherwise normal (Row 1 Right 400X).]]
	<br>		<br>
	[[File:3 MM 1 Covenant 680x512px.tif\|The other core showed a mass of tumor mashed against normal liver (Row 2 Left 40X).]]		C [[File:3 MM 1 Covenant 680x512px.tif\|The other core showed a mass of tumor mashed against normal liver (Row 2 Left 40X).]]
	[[File:4 MM 1 Covenant 680x512px.tif\|Tumor cells showed round to ovoid nuclei without pattern and with grey cytoplasm that proved to be CD138 positive (Row 2 Right 400X).]]		D [[File:4 MM 1 Covenant 680x512px.tif\|Tumor cells showed round to ovoid nuclei without pattern and with grey cytoplasm that proved to be CD138 positive (Row 2 Right 400X).]]
	\|}
	Plasmacytoma appearing as a tumor mass.		Plasmacytoma appearing as a tumor mass. A. One liver core was normal. B. A triad with a proliferated bile ductule, otherwise normal. C. The other core showed a mass of tumor mashed against normal liver. D. Tumor cells showed round to ovoid nuclei without pattern and with grey cytoplasm that proved to be CD138 positive.
	One liver core was normal ~~(Row 1 Left 40X)~~. A triad with a proliferated bile ductule, otherwise normal ~~(Row 1 Right 400X)~~. The other core showed a mass of tumor mashed against normal liver ~~(Row 2 Left 40X)~~. Tumor cells showed round to ovoid nuclei without pattern and with grey cytoplasm that proved to be CD138 positive ~~(Row 2 Right 400X)~~.
	{\|		A. [[File:1 B cell lym liver 1 680x512px.tif\|Apparent inflamed fibrous tract with lobular inflammatory collections in adjacent liver (Row 1 Left 40X).]]
	[[File:1 B cell lym liver 1 680x512px.tif\|Apparent inflamed fibrous tract with lobular inflammatory collections in adjacent liver (Row 1 Left 40X).]]		B. [[File:2 B cell lym liver 1 680x512px.tif\|Apparent inflamed fibrous band between two relatively hepatocyte regions (Row 1 Right 40X).]]
	[[File:2 B cell lym liver 1 680x512px.tif\|Apparent inflamed fibrous band between two relatively hepatocyte regions (Row 1 Right 40X).]]
	<br>		<br>
	[[File:3 B cell lym liver 1 680x512px.tif\|Apparent piecemeal necrosis with bile ductular proliferation (Row 2 Left 200X).]]		C. [[File:3 B cell lym liver 1 680x512px.tif\|Apparent piecemeal necrosis with bile ductular proliferation (Row 2 Left 200X).]]
	[[File:4 B cell lym liver 1 680x512px.tif\|Apparent portal inflammation with unaffected interlobular bile duct (Row 2 Right 200X).]]		D. [[File:4 B cell lym liver 1 680x512px.tif\|Apparent portal inflammation with unaffected interlobular bile duct (Row 2 Right 200X).]]
	<br>		<br>
	[[File:5 B cell lym liver 1 680x512px.tif\|Apparent lobular infiltrate with small masses (Row 3 Left 200X).]]		E. [[File:5 B cell lym liver 1 680x512px.tif\|Apparent lobular infiltrate with small masses (Row 3 Left 200X).]]
	[[File:6 B cell lym liver 1 680x512px.tif\|Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma ~~(Row 3 Right 400X)~~.]]		F. [[File:6 B cell lym liver 1 680x512px.tif\|Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma.
	\|}
	B cell lymphoma mimicking hepatitis with fibrosis.		B cell lymphoma mimicking hepatitis with fibrosis. A. Apparent inflamed fibrous tract with lobular inflammatory collections in adjacent liver. B. Apparent inflamed fibrous band between two relatively hepatocyte regions. C. Apparent piecemeal necrosis with bile ductular proliferation. D. Apparent portal inflammation with unaffected interlobular bile duct. E. Apparent lobular inflammation with collections a bit too large for usual lobular inflammation. F. Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma.
	Apparent inflamed fibrous tract with lobular inflammatory collections in adjacent liver ~~(Row 1 Left 40X)~~. Apparent inflamed fibrous band between two relatively hepatocyte regions ~~(Row 1 Right 40X)~~. Apparent piecemeal necrosis with bile ductular proliferation ~~(Row 2 Left 200X)~~. Apparent portal inflammation with unaffected interlobular bile duct ~~(Row 2 Right 200X)~~. Apparent lobular inflammation with collections a bit too large for usual lobular inflammation. ~~(Row 3 Left 200X)~~. Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma (~~Row 3 Right 400X~~).
			[[File:5 02965636298621 sl 1.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
			[[File:5 02965636298621 sl 2.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
			[[File:5 02965636298621 sl 31.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
			[[File:5 02965636298621 sl 4.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
			[[File:5 02965636298621 sl 5.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
			[[File:5 02965636298621 sl 6.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]


			Malignant B cell lymphoma, NOS, in a 63 year old man’s liver. No other specimens were available for further classification. A. Tumor expands a triad and occupies parenchymal regions. B. Bounding a bile duct, modestly sized round to reniform lymphoid cells, many without nucleoli, accompany small round lymphocytes. Some of the larger cells have clefts (arrows). C. CD3 stain shows many of the lymphoid cells are intercalated reactive T cells. D. Ki67 shows less than half the tumor cells, mostly the larger ones, are in proliferative phase, arguing against the notion of a high grade B cell lymphoma. E. CD79A establishes B cell phenotype (CD20 was also positive). F. That the tumor cells are BCL2 positive evinces B cell neoplasia. The cells were CD10, BCL6, and cyclin D1 negative, militating against mantle cell lymphoma and CLL, with no follicular origin identified.

	=See also=		=See also=

Mitchell: /* Photos */ added a case with associated carcinoma

2016-09-16T19:12:52Z

Photos: added a case with associated carcinoma

← Older revision		Revision as of 19:12, 16 September 2016
Line 338:		Line 338:
	Image:BileDucts IntraductalPapillaryNeoplasm NonMucinousType HP2 PA.jpg\|Bile Ducts - Intraductal Papillary Neoplasm - High power (SKB)		Image:BileDucts IntraductalPapillaryNeoplasm NonMucinousType HP2 PA.jpg\|Bile Ducts - Intraductal Papillary Neoplasm - High power (SKB)
	</gallery>		</gallery>
			{\|
			[[File:1 papillary cbd aca 1 680x512px.tif\| Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma.]]
			[[File:2 papillary cbd aca 1 680x512px.tif\| Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma.]]
			<br>
			[[File:3 papillary cbd aca 1 680x512px.tif\| Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma.]]
			[[File:4 papillary cbd aca 1 680x512px.tif\| Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma.]]
			<br>
			[[File:5 papillary cbd aca 1 680x512px.tif\| Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma.]]
			[[File:6 papillary cbd aca 1 680x512px.tif\| Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma.]]
			\|}
			Intraductal papillary neoplasm of common bile duct with associated invasive carcinoma. <br>The papillary tumor comprises mostly variably dilated acini (Row 1 Left 20X), but also shows areas of micropapillae (Row 1 Right 200X). Some areas within the non-invasive tumor showed necrosis, with the black pyknotic nuclei amid red debris (Row 2 Left 400X). Definite invasion was established low power by glands headed in perpendicular directions (Row 2 Right 40X). Embedded in fibroblastic response are non-acinar walls and isolated epithelial groups (Row 3 Left 400X). Also embedded in fibroblastic response are flat glands with nuclei showing loss of polarity (lack of respect for lateral intercellular borders shown by variable orientation to base of gland) (Row 3 Right 400X).

	Notes -		Notes -

Mitchell: /* Hematopoietic tumors */ a second liver lymphoma

2016-08-26T15:17:32Z

Hematopoietic tumors: a second liver lymphoma

← Older revision		Revision as of 15:17, 26 August 2016
Line 372:		Line 372:
	[[File:4 MM 1 Covenant 680x512px.tif\|Tumor cells showed round to ovoid nuclei without pattern and with grey cytoplasm that proved to be CD138 positive (Row 2 Right 400X).]]		[[File:4 MM 1 Covenant 680x512px.tif\|Tumor cells showed round to ovoid nuclei without pattern and with grey cytoplasm that proved to be CD138 positive (Row 2 Right 400X).]]
	\|}		\|}
	Plasmacytoma appearing as a tumor mass. One liver core was normal (Row 1 Left 40X). A triad with a proliferated bile ductule, otherwise normal (Row 1 Right 400X). The other core showed a mass of tumor mashed against normal liver (Row 2 Left 40X). Tumor cells showed round to ovoid nuclei without pattern and with grey cytoplasm that proved to be CD138 positive (Row 2 Right 400X).		Plasmacytoma appearing as a tumor mass.
			One liver core was normal (Row 1 Left 40X). A triad with a proliferated bile ductule, otherwise normal (Row 1 Right 400X). The other core showed a mass of tumor mashed against normal liver (Row 2 Left 40X). Tumor cells showed round to ovoid nuclei without pattern and with grey cytoplasm that proved to be CD138 positive (Row 2 Right 400X).
			{\|
			[[File:1 B cell lym liver 1 680x512px.tif\|Apparent inflamed fibrous tract with lobular inflammatory collections in adjacent liver (Row 1 Left 40X).]]
			[[File:2 B cell lym liver 1 680x512px.tif\|Apparent inflamed fibrous band between two relatively hepatocyte regions (Row 1 Right 40X).]]
			<br>
			[[File:3 B cell lym liver 1 680x512px.tif\|Apparent piecemeal necrosis with bile ductular proliferation (Row 2 Left 200X).]]
			[[File:4 B cell lym liver 1 680x512px.tif\|Apparent portal inflammation with unaffected interlobular bile duct (Row 2 Right 200X).]]
			<br>
			[[File:5 B cell lym liver 1 680x512px.tif\|Apparent lobular infiltrate with small masses (Row 3 Left 200X).]]
			[[File:6 B cell lym liver 1 680x512px.tif\|Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma (Row 3 Right 400X).]]
			\|}
			B cell lymphoma mimicking hepatitis with fibrosis.
			Apparent inflamed fibrous tract with lobular inflammatory collections in adjacent liver (Row 1 Left 40X). Apparent inflamed fibrous band between two relatively hepatocyte regions (Row 1 Right 40X). Apparent piecemeal necrosis with bile ductular proliferation (Row 2 Left 200X). Apparent portal inflammation with unaffected interlobular bile duct (Row 2 Right 200X). Apparent lobular inflammation with collections a bit too large for usual lobular inflammation. (Row 3 Left 200X). Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma (Row 3 Right 400X).

	=See also=		=See also=

Mitchell: /* Hepatic metastasis */ added section on lymphomas & a wierd case

2016-08-25T21:42:33Z

Hepatic metastasis: added section on lymphomas & a wierd case

← Older revision		Revision as of 21:42, 25 August 2016
Line 364:		Line 364:
	*[[AKA]] ''liver metastases''.		*[[AKA]] ''liver metastases''.
	*[[AKA]] ''metastatic liver disease''.		*[[AKA]] ''metastatic liver disease''.
			==Hematopoietic tumors==
			{\|
			[[File:1 MM 1 Covenant 680x512px.tif\|One liver core was normal (Row 1 Left 40X).]]
			[[File:2 MM 1 Covenant 680x512px.tif\|A triad with a proliferated bile ductule, otherwise normal (Row 1 Right 400X).]]
			<br>
			[[File:3 MM 1 Covenant 680x512px.tif\|The other core showed a mass of tumor mashed against normal liver (Row 2 Left 40X).]]
			[[File:4 MM 1 Covenant 680x512px.tif\|Tumor cells showed round to ovoid nuclei without pattern and with grey cytoplasm that proved to be CD138 positive (Row 2 Right 400X).]]
			\|}
			Plasmacytoma appearing as a tumor mass. One liver core was normal (Row 1 Left 40X). A triad with a proliferated bile ductule, otherwise normal (Row 1 Right 400X). The other core showed a mass of tumor mashed against normal liver (Row 2 Left 40X). Tumor cells showed round to ovoid nuclei without pattern and with grey cytoplasm that proved to be CD138 positive (Row 2 Right 400X).

	=See also=		=See also=

← Older revision		Revision as of 16:11, 27 December 2016
Line 390:		Line 390:
	D. [[File:4 B cell lym liver 1 680x512px.tif\|Apparent portal inflammation with unaffected interlobular bile duct (Row 2 Right 200X).]]		D. [[File:4 B cell lym liver 1 680x512px.tif\|Apparent portal inflammation with unaffected interlobular bile duct (Row 2 Right 200X).]]
	<br>		<br>
	E. [[File:5 B cell lym liver 1 680x512px.tif\|Apparent lobular infiltrate with small ~~masses (Row 3 Left 200X)~~.]]		E. [[File:5 B cell lym liver 1 680x512px.tif\|Apparent lobular infiltrate with small masse.]]
	F. [[File:6 B cell lym liver 1 680x512px.tif\|Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma.		F. [[File:6 B cell lym liver 1 680x512px.tif\|Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma.

Line 397:		Line 397:
	[[File:5 02965636298621 sl 1.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]		[[File:5 02965636298621 sl 1.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
	[[File:5 02965636298621 sl 2.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]		[[File:5 02965636298621 sl 2.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
			[[File:5 02965636298621 sl 3.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
			[[File:5 02965636298621 sl 4.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
	[[File:5 02965636298621 sl 31.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]		[[File:5 02965636298621 sl 31.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
	~~[[File:5 02965636298621 sl 4.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]~~
	~~[[File:5 02965636298621 sl 5.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]~~
	[[File:5 02965636298621 sl 6.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]		[[File:5 02965636298621 sl 6.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]

← Older revision		Revision as of 16:10, 27 December 2016
Line 376:		Line 376:
	*[[AKA]] ''metastatic liver disease''.		*[[AKA]] ''metastatic liver disease''.
	==Hematopoietic tumors==		==Hematopoietic tumors==
	{\|		A [[File:1 MM 1 Covenant 680x512px.tif\|One liver core was normal (Row 1 Left 40X).]]
	[[File:1 MM 1 Covenant 680x512px.tif\|One liver core was normal (Row 1 Left 40X).]]		B [[File:2 MM 1 Covenant 680x512px.tif\|A triad with a proliferated bile ductule, otherwise normal (Row 1 Right 400X).]]
	[[File:2 MM 1 Covenant 680x512px.tif\|A triad with a proliferated bile ductule, otherwise normal (Row 1 Right 400X).]]
	<br>		<br>
	[[File:3 MM 1 Covenant 680x512px.tif\|The other core showed a mass of tumor mashed against normal liver (Row 2 Left 40X).]]		C [[File:3 MM 1 Covenant 680x512px.tif\|The other core showed a mass of tumor mashed against normal liver (Row 2 Left 40X).]]
	[[File:4 MM 1 Covenant 680x512px.tif\|Tumor cells showed round to ovoid nuclei without pattern and with grey cytoplasm that proved to be CD138 positive (Row 2 Right 400X).]]		D [[File:4 MM 1 Covenant 680x512px.tif\|Tumor cells showed round to ovoid nuclei without pattern and with grey cytoplasm that proved to be CD138 positive (Row 2 Right 400X).]]
	\|}
	Plasmacytoma appearing as a tumor mass.		Plasmacytoma appearing as a tumor mass. A. One liver core was normal. B. A triad with a proliferated bile ductule, otherwise normal. C. The other core showed a mass of tumor mashed against normal liver. D. Tumor cells showed round to ovoid nuclei without pattern and with grey cytoplasm that proved to be CD138 positive.
	One liver core was normal ~~(Row 1 Left 40X)~~. A triad with a proliferated bile ductule, otherwise normal ~~(Row 1 Right 400X)~~. The other core showed a mass of tumor mashed against normal liver ~~(Row 2 Left 40X)~~. Tumor cells showed round to ovoid nuclei without pattern and with grey cytoplasm that proved to be CD138 positive ~~(Row 2 Right 400X)~~.
	{\|		A. [[File:1 B cell lym liver 1 680x512px.tif\|Apparent inflamed fibrous tract with lobular inflammatory collections in adjacent liver (Row 1 Left 40X).]]
	[[File:1 B cell lym liver 1 680x512px.tif\|Apparent inflamed fibrous tract with lobular inflammatory collections in adjacent liver (Row 1 Left 40X).]]		B. [[File:2 B cell lym liver 1 680x512px.tif\|Apparent inflamed fibrous band between two relatively hepatocyte regions (Row 1 Right 40X).]]
	[[File:2 B cell lym liver 1 680x512px.tif\|Apparent inflamed fibrous band between two relatively hepatocyte regions (Row 1 Right 40X).]]
	<br>		<br>
	[[File:3 B cell lym liver 1 680x512px.tif\|Apparent piecemeal necrosis with bile ductular proliferation (Row 2 Left 200X).]]		C. [[File:3 B cell lym liver 1 680x512px.tif\|Apparent piecemeal necrosis with bile ductular proliferation (Row 2 Left 200X).]]
	[[File:4 B cell lym liver 1 680x512px.tif\|Apparent portal inflammation with unaffected interlobular bile duct (Row 2 Right 200X).]]		D. [[File:4 B cell lym liver 1 680x512px.tif\|Apparent portal inflammation with unaffected interlobular bile duct (Row 2 Right 200X).]]
	<br>		<br>
	[[File:5 B cell lym liver 1 680x512px.tif\|Apparent lobular infiltrate with small masses (Row 3 Left 200X).]]		E. [[File:5 B cell lym liver 1 680x512px.tif\|Apparent lobular infiltrate with small masses (Row 3 Left 200X).]]
	[[File:6 B cell lym liver 1 680x512px.tif\|Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma ~~(Row 3 Right 400X)~~.]]		F. [[File:6 B cell lym liver 1 680x512px.tif\|Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma.
	\|}
	B cell lymphoma mimicking hepatitis with fibrosis.		B cell lymphoma mimicking hepatitis with fibrosis. A. Apparent inflamed fibrous tract with lobular inflammatory collections in adjacent liver. B. Apparent inflamed fibrous band between two relatively hepatocyte regions. C. Apparent piecemeal necrosis with bile ductular proliferation. D. Apparent portal inflammation with unaffected interlobular bile duct. E. Apparent lobular inflammation with collections a bit too large for usual lobular inflammation. F. Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma.
	Apparent inflamed fibrous tract with lobular inflammatory collections in adjacent liver ~~(Row 1 Left 40X)~~. Apparent inflamed fibrous band between two relatively hepatocyte regions ~~(Row 1 Right 40X)~~. Apparent piecemeal necrosis with bile ductular proliferation ~~(Row 2 Left 200X)~~. Apparent portal inflammation with unaffected interlobular bile duct ~~(Row 2 Right 200X)~~. Apparent lobular inflammation with collections a bit too large for usual lobular inflammation. ~~(Row 3 Left 200X)~~. Proof is at high power. All cells are similar to macrophages but are too closely crowded to be macrophages. The monomorphism (one type of cell) should inspire immunohistochemical stains, which showed the patient had a B cell lymphoma (~~Row 3 Right 400X~~).
			[[File:5 02965636298621 sl 1.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
			[[File:5 02965636298621 sl 2.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
			[[File:5 02965636298621 sl 31.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
			[[File:5 02965636298621 sl 4.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
			[[File:5 02965636298621 sl 5.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]
			[[File:5 02965636298621 sl 6.png\|Malignant B cell lymphoma, NOS, in a 63 year old man’s liver]]


			Malignant B cell lymphoma, NOS, in a 63 year old man’s liver. No other specimens were available for further classification. A. Tumor expands a triad and occupies parenchymal regions. B. Bounding a bile duct, modestly sized round to reniform lymphoid cells, many without nucleoli, accompany small round lymphocytes. Some of the larger cells have clefts (arrows). C. CD3 stain shows many of the lymphoid cells are intercalated reactive T cells. D. Ki67 shows less than half the tumor cells, mostly the larger ones, are in proliferative phase, arguing against the notion of a high grade B cell lymphoma. E. CD79A establishes B cell phenotype (CD20 was also positive). F. That the tumor cells are BCL2 positive evinces B cell neoplasia. The cells were CD10, BCL6, and cyclin D1 negative, militating against mantle cell lymphoma and CLL, with no follicular origin identified.

	=See also=		=See also=