病理学与病理生理学 消化系统疾病 肝硬化（双语学习）.pptx

Liver CirrhosisSong Wen-gangDepartment of PathologyLuohe Medical CollegeDecember 18, 2014ContentVocabularyCirrhosisSteatohepatitisAutoimmuneSepta (pl)ParenchymalShuntReplicativeSenescenceMyofibroblastPathology Cirrhosis is among the top 10 causes of death in the Western world. Its major causes include chronic viral infections, alcoholic or non-alcoholic steatohepatitis (NASH), autoimmune diseases affecting hepatocytes and/or bile ducts, and iron overload. Cirrhosis is defined as a diffuse process characterized by fibrosis and the conversion of normal liver architecture into structurally abnormal nodules. Pathology Its main characteristics by definition are not focal but rather involve most (if not all) of the diseased liver and include Fibrous septa Parenchymal nodulesPathology Fibrous septa in the form of delicate bands or broad scars around multiple adjacent lobules. Long-standing fibrosis generally is irreversible so long as disease persists or if disease-associated vascular shunts are widespread, although regression is possible if the underlying cause of liver disease is reversed. Pathology Parenchymal nodules, ranging in size from very small(less than 3 mm in diameter—micronodules) to large (over 1 cm—macronodules), encircled by these fibrous bands. Hepatocytes in these nodules derive from two sources: (1) preexistent, long-lived hepatocytes that, by the time cirrhosis is established, display features of replicative senescence; and (2) newly formed hepatocytes capable of replication that are derived from stem/progenitor cells found adjacent to the canals of Hering and small bile ductules—the hepatobiliary stem cell niche. These stem/progenitor cells also give rise to the ductular reactions found at the periphery of most cirrhotic nodules, where parenchyma meets stromal scar, and are accompanied by proliferating endothelial cells, myofibroblasts, and inflammatory cells.ReferenceRobbins Basic Pathology (9th Edition), 507Esophageal Cancer - - risk factors, sym