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| Liver
Histology |
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[liver diseases]
- Glisson's capsule: contains the organ
- hepatocyte generation: proceeds from portal bile ducts
as stem cells, then transitional cells & head toward central
vein as maturing parenchyma & then terminally differentiated
pericentral hepatocytes; hepatocyte "plates" form the
lobule which is zonally tripartited in ascending number from
portal to central (direction of blood flow) as zones 1 (periportal),
2, & 3 (pericentral).
- space of Disse: between intralobular hepatocytes & sinusoidal
lining endothelial cells
- space of Mall: in continuity with space of Disse but
is between periportal "limiting plate" hepatocytes
and portal stroma (hepato-portal interface)
- portal blood flow: portal vein enters liver hilum and
successively branches smaller and smaller until become conducting
venules which distribute blood into the hepatic sinusoids to
percolate through lobule to central vein.
- sinusoidal "membrane":
- Kupffer cells: hepatic macrophages in lumen of
sinusoids & most numerous periportal
- endothelial cells: form a highly fenestrated sinusoidal
conduit membrane, creating the sinusoidal lumen
- hepatic stellate lipocytic cells of Ito: reside
in space of Disse & are desmin-positive contactile4 cells;
as prominent single vacuoles in PBC3;
as prominent single vacuoles in hypervitaminosis A1 [LMC-02-2879] and,
with appropriate history and elevated serum retinol levels,
a diagnosis of hypervitaminosis can be made2
. They normally4 store lipid (and lipid
soluble vitamin A); they can become4 activated
myofibroblasts that secrete extracellular matrix proteins & proinflammatory
cytokines. Ito produces ADAMTS13, the deficit of which is involved
in TTP.
- liver-associated lymphocytes: greater periportal
concentration and 65% are natural killer T cells.
- hepatic arterial flow: arterial branches accompany the
portal vein branches
- periportal plexus: around portal vein branches & terminally
drain into sinusoids (rarely forming arterioportal anastamoses),
thence to central vein.
- peribiliary plexus: subdivides into capillaries
which then drain into sinusoids, thence to central vein.
- bile flow: intrahepatocytic flow through interconnected
cannaliculi from pericentral hepatocytes progressively toward
the portal zones, entering the canals of Hering (composed of
a mix of hepatocytes & cholangiocytes), then into cholangioles,
then through the "limiting plate" into terminal portal
units into interlobular bile bile ducts
- lymph flow: liver is largest source of lymph in the
body; arise as a fine plexus of endothelial tubes associated
with terminal ends of hepatic arterioles and thereafter follow
the hepatic artery in retrograde fashion and sometimes partly
also associated with the portal vein branches.
- hepatic venous outflow: central veins empty into collecting
venules which merge increasingly to become the hepatic vein exiting
into the vena cava
- the "portal triad":
- portal vein
- hepatic artery
- bile duct
- lymphatics
- nerves: terminal fibers even go into lobule
- stroma
- fixed fibrous cells
- a few lymphocytes
- a few macrophages
References:
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Scheuer PJ, et. al. Pathology of the Liver, 4th
Ed. [text], 2002. (EBS)
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Ludwig & Batts, Practical Liver Biopsy interp,
2nd Ed, 1998 (EBS)
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Frank Mitros' on-line
liver atlas
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Zhou W, et. al., ADAMTS13 is Expressed in Hepatic
Stellate Cells, Lab. Invest. 85:780-788, June 2005 (noted in
June 2005 Modern Pathology).
(posted 2003; latest
addition 27 May 2005) |
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