病理学之消化系统疾病教学课件[英文版].ppt

4. Gastrointestinal bleeding caused by esophageal varices (上消化道出血). 5. Rupture of the tumor with fatal hemorrhage (肿瘤破裂大出血) 6. Sudden death caused by occlusive tumor thrombosis of R.Atrium (猝死 — 右心瘤栓) Diagnosis 90% of patient have elevated serum levels of APF 注：甲胎蛋白：90%肝癌升高，如＞１０００ng/ml（非常高几乎一定是癌）． 2. Ultrasonography (B超 ) 3. CT 4. FNAB (fine needle aspiration biopsy,细针抽吸活组织检查) Prognosis The median survival is 7 M. Small liver cancer : 82% 3Y and 70% 5Y survival rate after surgical exsection. large liver cancer : 74% 3Y and 58% 5Y survival rate after surgical exsection. Itrahepatic cholangiocarcinoma ( ICC )胆管细胞癌 ICC arise from intrahepatic bile duct epithelium Eiology Parasitic infection ( clonochis sinensis ) of the intrahepatic bile duct. Intrahepatic lithiasis (肝内胆管结石) ＊与肝硬化和HBV感染无关 Morphology Gross appearance Single mass, white and firm, No relationship with Ci Microscopic appearance Adenocarcinoma with fibrous stroma Metastasis ICC has a greater propensity for extrahepatic spread肝外的to lung, bone and adrenal glands in early stage. 肝内静脉瘤栓很少；尸检５０％有血道转移－肺，骨脑等 Combine HCC and ICC It is very rare. 具有HCC和ICC两种成分 AIH的临床病理诊断标准 界面性炎症 3 points 肝细胞玫瑰花结样结构 1 point 浆细胞浸润 1 point 共 5 points 依据：International Autoimmune Hepatitis Group Scoring System （IAIHG – SS） *AIH-G3S3, IAIHG(1999)- SS 5 Points 三.自身免疫性肝病PBC L09-6215 慢性非化脓性破坏性胆管炎 PBC的组织学stages PBC Stage 1 The fiorid duct lesion; Portal hepatitis. The granulomatous destructive cholangitis; the florid duct lesion PBC Stage 2 Ductular reaction and periportal hepatitis L09-6215 PBC的组织学stages Septal fibrosis , scarring bridging necrosis PBC Stage 3 PBC的组织学stages cirrhosis Active FDL / active inflammtory of edema septa PBC Stage 4 PBC的组织学stages 三.自身免疫性肝病PSC 小叶间胆管 “洋葱皮样” 纤维化改变 ANA+ A