Study, describe and draw slides

N° 96 — small-node cirrhosis of the liver (stained with picrofucsin). Demonstration preparation (see: «Inflam-mation»).

N° 212 — biliary cirrhosis of the liver (stained with hematoxylin and eosin). At low magnification of the microscope it is necessary to find out overdevelopment of the connective tissue around the extended overflown bile ducts and capillaries; lymphoid-histiocytic infiltrates in portal ducts and in the interlobular stroma.

N° 213 — toxic degeneration of the liver—stage of yellow degeneration (stained with hematoxylin and eosin).At low magnification of the microscope define the condition of hepatocytes in the center and on the periphery of the lobules

paying attention to the wide-spread necrosis of the hepatic cells in the center of the lobules; at high magnification — on fatty degeneration of the preserved hepatocytes on the periphery of the lobules.

Test

1. Concept of cirrhosis of the liver.

2. Name characteristic morphological changes of the liver in cirrhosis: a)..., b)..., c)..., d)..., e)....

3. List complications of acute cholecystitis: a)..., b)..., c)..., d)..., e)..., f)....

4. What morphological changes develop in the pancreas in acute pancreatitis: a)..., b)..., c)..., d)..., e)..., f)... .

5. Name macroscopic forms of liver cancer: a)..., b)..., c)....

6. The patient suddenly developed vomiting with blood and died within 2 hours. The autopsy has demonstrated that the stomach is free from ulcerative and erosion defects, its mucous membrane is cyanotic. In the cavity of the stomach there are multiple blood clots. The size of the liver is diminished, the organ is yellow, its surface is even by coarse. There is splenomegaly, ascites (3 liter of fluid). In the lower third of the esophagus there are varicose veins with defects of the walls. Define the disease and its form. Why are the veins of the esophagus dilated? What is the cause of death?

Answers: 1. It is chronic disease characterized by increasing hepatic failure because of cicatricial shrinking and structural reorganization of the liver. 2. a) degeneration and necrosis of hepatocytes, b) the perverted neogenesis of the hepatocytes, c) diffuse sclerosis, d) structural reorganization of the liver, e) deformation of the organ. 3. a) perforation, b) cho-lic peritonitis, c) empyema of the gallbladder, d) purulent cholangitis and cholangiolitis, e) pericholecystitis with formation of the adhesions.

4. a) edema, b) fatty necrosis, c) hemorrhage, d) focuses of pyesis, e) adventitious cysts, f) sequesters. 5. a) nodulose (massive), b) multiple-node, c) diffuse (cirrhosis — cancer). 6. The diagnosis: decompensated cirrhosis of the liver, portal hypertension. Complications—bleeding from varicous veins of the esophagus. The cause of death is acute hemorrhage. Varicose phlebectasia is caused by development of the portal hypertensions and formation of portacaval anastomosis in combination with difficulty of blood outflow from the organs of the abdominal cavity through the portal vein.