PA24.9 | Liver Disease & Tumour Morphology — Practical — Summary & Reflection

REFLECT

Look again at the 2×2 grid image above (Panels A-D).

Without referring to the table, write down — on paper or in your notes — the single most important feature that identifies each panel's diagnosis. Then compare your answer to the table.

If you struggled with Panel B (cirrhosis vs bridging fibrosis) or Panel D (HCC vs regenerative nodule), spend five more minutes on those two sections before your practical session. The difference between cirrhosis and pre-cirrhotic fibrosis, and between a regenerative macronodule and early HCC, is one of the most common sources of examination errors in Year-2 practical pathology.

KEY TAKEAWAYS

The six hepatobiliary lesions in this module follow distinct morphological signatures:

• Steatosis — clear fat vacuoles, peripherally displaced nucleus (macrovesicular).
• Acute viral hepatitis — ballooning degeneration, Councilman bodies, lobular lymphocytic disarray.
• Chronic hepatitis — portal inflammation, interface hepatitis, fibrosis staging; ground-glass cells (HBV).
• Alcoholic hepatitis — Mallory-Denk bodies + neutrophils + zone-3 perivenular fibrosis.
• Cirrhosis — regenerative nodules + fibrous septa; no central vein within nodules; trichrome/reticulin stains confirm.
• HCC — trabecular pattern + bile plugs + atypia + vascular invasion; HepPar-1 positive.

Reading framework: architecture → hepatocyte changes → inflammation/fibrosis → diagnosis. Mastery of this sequence will serve you in every liver practical, every biopsy report, and every clinical encounter with a patient with liver disease.