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In patients with COVID-19-induced pneumonia, shear wave elasticity (SWE) was used to assess liver stiffness. This study included 48 cases of COVID-19-induced pneumonia and 48 cases of normal physical examination. Basic and clinical data, including aspartate aminotransferase (AST), were evaluated. Color ultrasonography was used to test the liver's SWE. A biopsy of the liver was also performed. In patients with COVID-19-induced pneumonia, AST and alanine aminotransferase (ALT) levels were higher than those in the control group. Liver SWE showed that liver stiffness is hard (8.745 [+ or -] 0.2104) compared with the control group (7.386 [+ or -] 0.1521) (P < 0.0001). Pathological biopsy showed that liver inflammation accounted for 89.58%, steatosis accounted for 81.25%, necrosis accounted for 10.42%, and fibrosis accounted for 33.33% in patients with COVID-19- induced pneumonia. ROC curve analysis showed that the SWE is highly sensitive and specific for the diagnosis of liver inflammation and steatosis. The sensitivity was 88.76% and the specificity was 77.01% for the evaluation of liver inflammation. For steatosis, the sensitivity was 90.20%, and the specificity was 78.40%. The SWE of liver is useful to assess liver function and pathological status in COVID-19 patients. Key words: COVID-19, liver, shear wave elasticity (SWE), pathological biopsy, inflammation, Introduction Coronaviruses (CoVs) belong to the Coronavirus genus of the coronaviridae family. All CoVs are pleomorphic RNA viruses containing crown-like peplomers of 80-160 nm in size (Yurdaisik 2020). The RNA [...]

* Context.--Liver biopsy plays an important role in the clinical management of metastases and often requires workup using immunohistochemical (IHC) markers, but the approach varies among institutions. Objective.--To evaluate the utility of a morphologic pattern-based, individualized approach in the workup of hepatic metastases. Design.--All liver biopsies with metastasis between 2015 and 2018 were identified from our institutional database and were reviewed. The morphologic pattern of the metastasis and IHC markers used in each case were recorded. The final identification of primary site of the tumor was assessed based on all the available clinicopathologic data. The academic ranking and practice pattern of the pathologist signing out the case were also recorded. Results.--A total of 406 liver biopsies with metastasis were identified, and the cases were classified as adenocarcinoma (253 of 406; 62%), carcinoma not otherwise specified (12 of 406; 3%), neuroendocrine neoplasm (54 of 406; 13%), poorly differentiated carcinoma (43 of 406; 11%), nonepithelial tumor (24 of 406; 6%), and squamous cell carcinoma (20 of 406; 5%). The primary site was unknown in 39% (158 of 406) at the time of liver biopsy. A primary site was determined in 97% (395 of 406) of all cases, and only 3% (11 of 406) remained true carcinoma of unknown primary. The average number of IHC markers/ case in patients with known primary was 2.6, compared with 5.9 with an initial unknown primary and 9.5 in cases of true carcinoma of unknown primary. Conclusions.--An individualized, case-based approach seems to be highly cost-effective and uses fewer IHC markers compared with preset panels that often comprise 10 or more IHC markers. doi: 10.5858/arpa.2021-0457-OA, The liver is a common site for metastasis, and liver biopsy plays an important role in clinical management in many patients. The liver biopsy is useful for confirming the diagnosis [...]

* Context.--Cholestasis within bile ductules is touted as a key histologic finding in septic patients but is not entirely sensitive or specific. The spectrum of other histopathologic findings in septic patients has not been thoroughly studied. Objective.--To evaluate histologic features in liver biopsies from septic patients, as well as mimics. Design.--For 121 liver samples where sepsis was mentioned in provided clinical information or in the pathologic differential diagnosis, we compiled patient outcome, clinical impression (sepsis or not), and blood culture results. We evaluated each case for inflammatory and cholestatic histologic findings, comparing them between patients with and without clinical sepsis, and between patients with gram-positive versus gram-negative results on blood culture. Results.--Cases from clinically septic patients (n = 77) showed portal mononuclear inflammation (52 cases, 68%), lobular neutrophilic inflammation (45, 58%), ductular reaction (58, 75%), lobular cholestasis (68, 88%), ductular cholestasis (52, 68%), and acidophil bodies (36, 47%). Findings between clinically septic and nonseptic patients were similar, though the latter more often had lobular mononuclear inflammation (19% versus 45%, P = .004). Ductular cholestasis rates were similar in both groups (68% versus 55%, P = .17). Ductular cholestasis had a sensitivity of 68%, a specificity of 45%, a positive predictive value of 68%, and an accuracy of 60% for the diagnosis of sepsis. Gram-positive and gram-negative sepsis caused comparable findings. Conclusions.--Ductular cholestasis can be present in septic and nonseptic liver samples, though its presence does suggest the possibility of sepsis. Other common findings in sepsis include lobular cholestasis, ductular reaction, portal mononuclear inflammation, and lobular neutrophilic inflammation. doi: 10.5858/arpa.2021-0190-OA, Per the Third International Consensus Definitions for Sepsis in 2016, sepsis is a dysregulated host response with life-threatening organ dysfunction due to an overwhelming infection. (1) Sepsis plays a prominent [...]

Context.--The histologic features in patients with acute-on-chronic liver failure (ACLF) are evolving, and histologic indicators of patients' poor prognosis are not yet fully established. Objective.--To evaluate the independent histologic predictors of 28-day mortality in ACLF patients on core-needle liver biopsies. Design.--Core-needle biopsies from patients with a diagnosis of ACLF (n = 152) as per the European Association for the Study of the Liver criteria were included during 8 years. Liver biopsies from 98 patients with compensated chronic liver disease were included as disease controls for histologic comparison. Features of ongoing changes, such as hepatic necrosis, hepatic apoptosis, cholestasis, hepatocyte degeneration, bile ductular proliferation, Mallory-Denk bodies, steatosis, and extent of liver fibrosis, were analyzed for predicting short-term mortality (28 days). A P value of Results.--In our cohort of ACLF patients, the following etiologies for acute decompensation were identified: alcohol, 47 of 152 (30.9%); sepsis, 24 of 152 (15.7%); hepatotropic viruses, 20 of 152 (13.1%); drug-induced liver injury, 11 of 152 (7.2%); autoimmune flare, 9 of 152 (5.9%); mixed etiologies, 5 of 152 (3.2%); and cryptogenic, 36 of 152 (23.6%). On histologic examination, hepatic necrosis (P Conclusions.--Dense lobular necroinflammatory activity is a clinically independent histologic predictor of 28-day short-term mortality in patients with ACLF., Acute-on-chronic liver failure (ACLF) syndrome is characterized by abrupt hepatic decompensation secondary to acute insult in patients with chronic liver disease (CLD), having high short-term mortality. (1-3) The diagnosis and [...]

The article discusses the increasing evidence regarding the association between nonalcoholic fatty liver disease and a risk of cardiovascular disease in the case of such patients. The different treatment methodologies and management regime for the same are highlighted.

Background: Bipotent liver progenitor (oval) cells with the ability to differentiate into hepatocytes and biliary epithelium have recently been identified in human subjects with hepatitis C. Animal studies suggest that [...]

Background: The prevalence of portopulmonary hypertension (PPHTN) in patients with cirrhosis and refractory ascites is unknown. Its presence may preclude patients from receiving a transjugular intrahepatic portosystemic shunt or liver [...]

Byline: Toshihiko Mori (), Kazushige Nagai (), Michio Mori (), Masayoshi Nagao (), Masakatsu Imamura (), Mikio Iijima (), Keiko Kobayashi () Abstract: A 4-month-old boy, with late-onset argininosuccinate lyase (ASL) deficiency with hepatomegaly, was treated by protein restricted diet and arginine supplementation he was followed for 3 years. Hepatomegaly and mild liver dysfunction persisted without significant hyperammonemia. He maintained normal psychomotor development to the age of 12 months, but, at 3 years of age, his developmental status is in the borderline normal range. Liver biopsy performed at 12 months of age demonstrated swollen and pale hepatocytes with abnormal glycogen deposition and mild periportal fibrosis. A subsequent liver biopsy at 3 years of age showed progressive liver fibrosis in the periportal and central areas, which extended into the liver lobule. These findings suggest that liver impairment in ASL deficiency may advance without significant hyperammonemia and underline the importance of repeated liver biopsy in this disorder, even when the plasma ammonia level is well controlled. Author Affiliation: () Department of Pediatrics, Otaru Kyokai Hospital, 1-6-15 Suminoe, Otaru, Hokkaido 047-8510, Japan, JP () Department of Pathology, Otaru Kyokai Hospital, Otaru, Hokkaido 047-8510, Japan, JP () Department of Pediatrics, Nishi-Sapporo Hospital, Sapporo, Hokkaido 063-0005, Japan, JP () Department of Pathology, Hokkaido Children's Hospital and Medical Center, Otaru, Hokkaido 047-0261, Japan, JP () Department of Biochemistry, Faculty of Medicine, Kagoshima University, Kagoshima 890-8520, Japan, JP Article History: Received Date: 11/01/2002 Accepted Date: 30/07/2002

Byline: Gareth P. Jevon (1) Keywords: Key words: chronic hepatitis, pathology, biopsy, grade Abstract: The liver biopsy is essential to the investigation and management of chronic liver disease. The pathologist provides an etiologic diagnosis, reports the grade of disease activity and stage of fibrosis, and comments on any response to therapy. Recent progress in our understanding of chronic hepatitis, its causes, prognosis, and therapy, has influenced the revision of its nomenclature and classification. The use of a descriptive or numerical scoring system allows the pathologist to provide reproducible, clinically relevant information in the surgical pathology report. Author Affiliation: (1) Department of Pathology, Children's and Women's Health Centre of British Columbia, 4450 Oak Street, Vancouver, British Columbia, Canada V6H 3V4, CA

Researchers discuss the advantages and disadvantages of the four types of liver biopsy: percutaneous, transjugular, laparoscopic, and fine-needle aspiration guided by ultrasound or CT images.

Measuring the amount of iron in a liver biopsy specimen may be a good way to determine total body iron in patients with thalassemia. Thalassemia is a blood disease that can be treated with a bone marrow transplant. However, one side effect of the treatment is excessive amounts of iron in the body. Blood-letting can reduce the amount of iron in the body but doctors need some accurate way of measuring the remaining iron. Researchers determined that the amount of total body iron stores is about 10 times the level in the liver.

Intravenous injection of recombinant human alpha-L-iduronidase from a transfected Chinese hamster ovary cell line into homozygous Hurler syndrome affected mice results in the rapid uptake of the enzyme by the liver. Biopsy of the liver reveals abundant levels of the enzyme in the lysosomes of Kupffer cells and hepatocytes. Microscopic studies reveal the normalization of the lysosomal storage of the enzyme in the kidney glomeruli, liver and spleen.

Analysis of the three-dimensional structure of rat liver 3alpha-hydroxysteroid/dihydrodiol dehydrogenase revealed a hydrophobic amino acid concentration in a cavity, situated near the top of a barrel. Three residues, Tyr-55, Asp-50 and Lys-84, which were located at the barrel periphery, were not involved in catalysis.