FIGURES AND TABLES

FIGURE 1.

Trichrome stain of alcoholic cirrhosis with centrilobular sclerosis. Note the absence of artery and interlobular bile duct in the scarred region (center), which represents the sclerosed central vein (Trichrome, 33).

FIGURE 2.

Primary biliary cirrhosis. This portal zone shows a moderate degree of inflammatory (lymphocytic) infiltrate. The hepatic artery is present, but the corresponding interlobular bile duct is absent (10).

FIGURE 3.

Primary sclerosing cholangitis, medium-sized portal zone. A, the left panel shows an interlobular bile duct with periductal, concentric fibrosis (33). The right panel shows a well-formed scar at the site of the missing bile duct (25). B, primary sclerosing cholangitis. Orcein stain shows periportal copper deposition as evidenced by black granules in the periportal hepatocytes. The portal zone is lower right, hepatocytes upper left (80).

FIGURE 4.

Submassive necrosis in regenerative stage of acute hepatitis. A, note the hemorrhage within the stroma and regenerative changes in the surviving hepatocytes (25). B, the trichrome stain shows the hemorrhage as well but also shows in the necrotic areas staining that likely represents residual framework rather than scar (25). C, the reticulin stain shows preservation of the framework at this stage, but it is compressed in the necrotic zones (center) (50).

FIGURE 5.

Hepatitis C with cirrhosis. A, note the lymphoid aggregate typical of hepatitis C and the rounded nodules of the cirrhosis (25). B, interface hepatitis at the edge of a nodule for a Grade 2 on a scale of 4 for necroinflammatory activity (50).

FIGURE 6.

Clear cell type of hepatocellular carcinoma arising in hemochromatosis with cirrhosis. A, routine staining shows two types of tissues on the sample. The left panel shows brown pigment in the cirrhotic liver, the right lacks pigment and the hepatocytes have pale cytoplasm (66). B, reticulin stain reveals that the pigmented areas have intact framework (left panel) consistent with cirrhosis, but the pale cells lack distinct cell plate architecture (right panel) consistent with hepatocellular carcinoma (40). C, iron stain shows 4+ iron in the cirrhotic liver but no iron in the hepatocellular carcinoma (50).

FIGURE 7.

Macroregenerative nodule. The reticulin stain shows an intact cell plate architecture similar to that expected in normal liver or a cirrhotic nodule (50).

FIGURE 8.

Hepatocellular carcinoma, solid type. A, the tumor has a typical hepatocytic appearance with eosinophilic cytoplasm and round, fairly uniform nuclei (66). B, reticulin stain shows absence of cell plate architecture (66).

FIGURE 9.

Epithelioid hemangioendothelioma. A, the tumor shows spindle to epithelioid cells embedded in a myxoid to fibrous stroma. Some cells have a signet ring–like configuration. A normal portal zone has been preserved (bottom center). B, elastochrome stain shows a central vein that has been completely occluded by tumor cells (20).

FIGURE 10.

Angiomyolipoma, epithelioid variant. A, the tumor cells are large, with abundant eosinophilic cytoplasm that tends to retract from the cytoplasmic border, causing a halo-like effect. The nuclei are round, often with prominent nucleoli (50). B, smooth muscle actin immunohistoperoxidase stain shows strong staining of the tumor cells (66).

TABLE 1 - Features of "Hard to Diagnose" Cirrhosis.

TABLE 2 - Features of Alcoholic Cirrhosis.

TABLE 3 - Central Sclerosis.

TABLE 4 - BTD Versus CH.

TABLE 5 - PBC Versus CH.

TABLE 6 - PBC and PSC.

TABLE 7 - Hepatotropic Hepatitis Viruses.

TABLE 8 - Nonviral Causes of Hepatitis.

TABLE 9 - MCH^a Versus RAH.

TABLE 10 - Simple Scoring System for Chronic Hepatitis.

TABLE 11 - Differential Diagnosis: Lesion in Liver Hepatocellular Type.

TABLE 12 - Histologic Features of Hepatocellular Nodules in Cirrhotic Livers.

TABLE 13 - Differential Diagnosis of Hepatocellular Lesions in Noncirrhotic Livers.

TABLE 14 - Differentiating Features: Hepatoblastoma Versus Adenoma.