病理学-肝胆胰疾病 (上).pptx

肝脏、胆道、外分泌部胰腺疾病（DiseasesoftheLiver,GallBladderandExocrinePancreas）;2;3;4;5;6;Reviewnormalstructureandfunctions

Generalprinciplesofhepaticinjury

Viralhepatitis

Alcoholicliverdisease;Reviewnormalstructureandfunctions

Generalprinciplesofhepaticinjury

Viralhepatitis

Alcoholicliverdisease;wedgeshape

dominatetherighthypochondrium

normal:weigh1400-1600gm

variablefrom700-7000gm

;portalandhepatic

bloodsupply;limitingplate;;肝脏的功能;Reviewnormalstructureandfunctions

Generalprinciplesofhepaticinjury

Viralhepatitis

Alcoholicliverdisease;肝损伤的基本病变;一、肝细胞变性、坏死;17;ballooningchange;一、肝细胞变性、坏死;20;Fattychange

Microvesicular/macrovesicular;Fattychange:SudanⅢstaininginfrozensection;一、肝细胞变性、死亡

1.1细胞变性(degeneration);;HBsAg（免疫组化）;1.2细胞死亡(celldeath);

LyticNecrosis:comesfromballooningdegenerationandalwayswithinflammatorycells

点状坏死Spottynecrosis:individually

灶状坏死Focalnecrosis:asmallgroups

碎片状坏死Piecemealnecrosis(interfacehepatitis):necrosisofgroupsofhepatocyteswithinthelimitingplate;桥接坏死Bridgingnecrosis:necrosislinkingtwoportalareas,twocentralarea,oraportalareaandacentralarea

大块/亚大块坏死Massiveandsubmassivenecrosis:

destructionoftheentirelobules(≥2/3)

ormost(1/2~2/3)oftheliverparenchyma.

manifestthefulminatehepatitis.;lyticnecrosis;spotty/focalnecrosis

andballooningdegeneration;;Piecemealnecrosis

Notethe“motheating”oflimitingplate;33;bridgingnecrosis;massive/submassivenecrosis;(2)细胞凋亡（apoptosis）

;acidophilic/eosinophilicchangeinlobule;Apoptosisoflivercells:Councilmanoracidophilicbodies;二、渗出(exudation)

小叶内和汇管区炎细胞浸润

三.增生(proliferation)

实质肝细胞(regeneration)

间质Kupffer细胞(granuloma)

成纤维细胞

小胆管(ductularreaction);三.增生;三、增生;三、增生;granuloma;;ductularreaction;结节状增生（Nodularregeneration）;胆汁淤积（Cholestasis）;;Reviewnormalstructureandfunctions

General