Chapter 11 Hepatic Diseases
Chapter 11 Hepatic Diseases 1
Normal adult liver weights: 1400 to 1600 gm Dual blood supply: portal vein; hepatic artery bule Acinus normal adult liver Central vein(CV) (terminal hepatic vein Z ones 32 Portal tracts at three ofits apices: PV(branches of the portal vein) HA(Hepatic Artery BD (Bile duct HA- BD hepatic lobule(肝小叶): hepatic micro-architecture
Normal adult liver weights:1400 to 1600 gm Dual blood supply: portal vein; hepatic artery hepatic lobule (肝小叶): hepatic micro-architecture. Central vein (CV) (terminal hepatic vein) Portal tracts at three of its apices: PV (branches of the Portal Vein) HA (Hepatic Artery ) BD (Bile Duct ) 2 normal adult liver
3 cords of hepatocyte hepatic cords Micro-architecture of sinusoid Acinus is lined by fenestrated and discontinuous Endothelial HSCS cell collagen hbors acE 32 T Vascular sinusoids Hepatocytes Bile canaliculus NORMAL LIVER (HSCs: hepatic stellate cells)
cords of hepatocyte : hepatic cords Vascular sinusoids Micro-architecture of sinusoid HSCs (HSCs: hepatic stellate cells) is lined by fenestrated and discontinuous 3
iral hepatitis(病毒性肝炎) This disease-- infective one of the liver caused by a group of hepatitis virus. These viruses ---have a particular affinity for the liver, and cause similar morphologic features of disease Main morphologic changes--- hepatocyte injury and necrosis with inflammation
Viral hepatitis (病毒性肝炎) This disease--- infective one of the liver caused by a group of hepatitis virus. These viruses ---have a particular affinity for the liver, and cause similar morphologic features of disease. Main morphologic changes --- hepatocyte injury and necrosis with inflammation. 4
Etiologic agents: Hepatitis viruses -A. B. C. D. E. The hepatitis viruses(p251, 11-1) HAy HBv HCV ADDy HEy Year of idenification 1973 1965 1989 1977 1980 nn 42. nm 30-60nm 35-nm 32-34nm Agent Icosahedral Enveloped Enveloped Enveloped SsRNA; Unenvelope capsid, SsRNA dsDNA SSRNA replication defective d ssRNA Classification picornavirus hepadnavirus flavivirus unknown caliciviridae #r Transmission fecal-oral close contact fi close contact contact waterborne Incubation period(weeks) 2-6 4-26 2-26 Fuminant 0.1-0.4% rare 4% in coinfection 0.3-3% hepatitis 20% in pregnant women Carrier state None 0.1-1% 0.2-1% 1-10% None Chronic 5-10% >70% 5 coinfection None hepatiti 80% superinfection H Carcinoma No Y No
Etiologic agents: Hepatitis viruses — A．B．C．D．E. The hepatitis viruses (p251, 11-1) HAV HBV HCV HDV HEV Year of idenification 1973 1965 1989 1977 1980 Agent 27-nm 42-nm 30-60nm 35-nm 32-34nm Iscosahedral capsid, ssRNA Enveloped dsDNA Enveloped ssRNA Enveloped ssRNA; replication defective Unenvelope d ssRNA Transmission fecal-oral close contact 血 close contact contact waterborne Classification picornavirus hepadnavirus flavivirus黄 unknown caliciviridae 杯 Incubation period (weeks) 2-6 4-26 2-26 4-7 2-8 Fuminant hepatitis 0.1-0.4% <1% rare 3-4% in coinfection 0.3-3%; 20% in pregnant women Carrier state None 0.1-1% 0.2-1% 1-10% None Chronic hepatitis None 5-10% >70% <5 coinfection None 80% superinfection H. Carcinoma No Yes Yes No No 5