ma. niña regina m.

quibod

what is a liver?
  

largest gland in the body weighs about 1500 gm in adult functions both exocrine gland and endocrine gland
◦ exocrine: secreting bile ducts into the duodenum ◦ endocrine: synthesizing a variety of substances that are released directly into the bloodstream

review on histology of liver…

sheets of connective tissue divide the liver into thousands of small units (lobules) lobule
◦ roughly hexagonal in shape ◦ with portal triads at the vertices and a central vein in the middle ◦ structural unit of the liver

hepatic acinus
◦ difficult to visualize ◦ represents a unit that is of more relevance to hepatic function ◦ oriented around the afferent vascular system

hepatocytes
◦ parenchymal cells of the liver ◦ polygonal cells ◦ joined to one another in anastomosing plates, with borders that face either the sinusoids or adjacent hepatocytes

sinusoids
◦ where hepatocytes make contact with blood ◦ distensible vascular channels lined with highly fenestrated endothelial cells and populated with phagocytic Kupffer cells ◦ Space of Disse
space between endothelium and hepatocytes which collects lymph for delivery to lymphatic capillaries

bile originates as secretions from the basal surface of hepatocytes, which collect in channels called canaliculi these secretions flow toward the periphery of lobules and into bile ductules and interlobular bile ducts, ultimately collecting in the hepatic duct outside the liver

the hepatic duct is continuous with the common bile duct, which delivers bile into the duodenum portal triad
◦ groups of three tubes ◦ a branch of the portal vein, a branch of the hepatic artery and a branch of the bile duct

histochemistry…

Hepatocytes stained standard hematoxylin-eosin stain.

Liver lobule in a rabbit that's been injected with India ink

section of liver, stained to show glycogen. The deep magenta coloration of the cells is evident

PAS reaction

PAS reaction

tissue treated with diastase enzyme before the stain was applied. The staining reaction has been abolished. The use of enzymes of known specificities to establish controlled reactions is a basic technique in histochemistry.

Oil Red O stained liver section. This dye stains fat droplets in bright red.

Resident Macrophages "Kupffer Cells“ stained with hematoxylin-eosin.

Liver section with infiltrate stained for chloroacetate esterase activity (Leder stain, in red). This enzyme is a marker for granulocytes such as neutrophils

Histochemical detection of OTC (ornithine carbamyltransferase) activity in liver. Mice deficient in functional OTC received AAV vectors expressing this enzyme. OTC activity was visualized by a histochemical procedure leading to the deposition of lead sulfide within transduced hepatocytes.

diseases of the liver…

jaundice
◦ caused by increased levels of bilirubin in the system ◦ bilirubin results from the breakup of the hemoglobin of dead red blood cells ◦ normally, the liver removes bilirubin from the blood and excretes it through bile

hepatitis
◦ inflammation of the liver, caused mainly by various viruses but also by some poisons, autoimmunity or hereditary conditions.

cirrhosis
◦ formation of fibrous tissue in the liver, replacing dead liver cells. The death of the liver cells can for example be caused by viral hepatitis, alcoholism or contact with other liver-toxic chemicals.

haemochromatosis
◦ hereditary disease causing the accumulation of iron in the body, eventually leading to liver damage.

An electron micrograph scan of liver cirrhosis, a chronic disease in which cells of the liver are damaged and then replaced by scar tissue.

cancer of the liver

◦ (primary hepatocellular carcinoma or cholangiocarcinoma and metastatic cancers, usually from other parts of the gastrointestinal tract).

Wilson's disease

◦ a hereditary disease which causes the body to retain copper

primary sclerosing cholangitis

◦ an inflammatory disease of the bile duct, autoimmune in nature

primary biliary cirrhosis

◦ autoimmune disease of small bile ducts

Budd-Chiari syndrome
◦ obstruction of the hepatic vein

Gilbert's syndrome
◦ a genetic disorder of bilirubin metabolism, found in about 5% of the population

glycogen storage disease type II
◦ build-up of glycogen causes progressive muscle weakness (myopathy) throughout the body and affects various body tissues, particularly in the heart, skeletal muscles, liver and nervous system

other pediatric diseases associated with liver:
◦ ◦ ◦ ◦ biliary atresia alpha-1 antitrypsin deficiency alagille syndrome progressive familial intrahepatic cholestasis