肝脏、胆道、外分泌部胰腺疾病.pptxVIP

肝脏、胆道、外分泌部胰腺疾病（Diseases of the Liver, Gall Bladder and Exocrine Pancreas）;病毒性肝炎 酒精性肝病 肝代谢性疾病 肝硬化 原发性肝癌 胆石症、胆管炎和胆囊炎，胆道肿瘤 胰腺炎，胰腺癌;病毒性肝炎 酒精性肝病 肝代谢性疾病 肝硬化 原发性肝癌 胆石症、胆管炎和胆囊炎，胆道肿瘤 胰腺炎，胰腺癌;肝豆状核变性 （Wilson’s Disease）;Micronodular cirrhosis in Wilson disease;Micronodular cirrhosis in Wilson disease;Nearly all patients with neurologic involvement develop eye lession Kayser-Fleischer rings result from a buildup of copper in the eyes and are the most unique sign of Wilson disease. They appear in each eye as a rusty-brown ring around the edge of the iris and in the rim of the cornea. ;;M/56. This patient died from liver failure. The cirrhotic nodules are clearly seen. The liver is a dark brown color because of the heavy iron deposition within the hepatocytes;;A Prussian blue iron stain demonstrates the blue granules of hemosiderin in hepatocytes and Kupffer cells.;The Prussian blue iron stain;Pancreas: Microscopically, islet cells and stroma iron deposition is blue in Prussian blue –stained slide. Grossly, diffuse interstitial fibrosis is present. ;血色病 (hemochromatosis);继发性含铁血黄素沉积症（seconderay hemosiderosis);病毒性肝炎 酒精性肝病 肝代谢性疾病 肝硬化 原发性肝癌 胆石症、胆管炎和胆囊炎，胆道肿瘤 胰腺炎，胰腺癌;肝硬化Liver cirrhosis;肝硬化（liver cirrhosis） ;Gross appearance; basic pathologic change 纤维组织增生 假小叶（pseudolobule） 原有肝脏病变;假小叶（pseudolobule） 广泛增生的纤维组织分割包绕肝细胞（包括原有的肝小叶和再生的肝细胞结节）而形成的大小不等的肝细胞团。 假小叶内中央静脉可缺如、偏位或两个以上，可以出现汇管区。;Histopathology;Pathogenesis; 发病机制： 病因 肝细胞弥漫性坏死 、炎症 网状纤维支架塌陷 纤维组织增生 分割包绕 肝小叶、结节状再生的肝细胞 假小叶 肝小叶结构破坏; 临床病理联系： 1. 门脉高压症 portal hypertension 2. 肝功能不全 hepatic in-sufficiency hepatic failure;门静脉高压症;门脉压力增高原因;2、假小叶压迫小叶下静脉→中央静脉→肝血窦→门静脉回流受阻（窦后性阻塞） ;3、肝动脉与门静脉间异常吻合→动脉血流入门静脉→门静脉压力↑(窦前性);; 淤血性脾肿大（Congestive splenomagely）;Portal Hypertension;2、Ascites腹水，腹膨隆