Liver slide seminar

Dr Ranjini Kudva Professor & Head Dept of Pathology

Kasturba Medical College, Manipal, Manipal University

Case 1

• 35 male

• Fever, jaundice, abdominal pain -10 days

• Nausea & Vomiting +

• O/E Liver palpable 2cms

• T Bilirubin – 3 mg/dl, DB -2.5 mg/dl

AST- 850 U/L, ALT- 1200 U/L

ALP - 130 U/L

TP- 7.2 gm/ dl, Alb-4.8 gm/dl

Case 2

• 28 year old pregnant lady

• Fever, generalised weakness & vomiting – 2 wks

• Worsening of symptoms with deep jaundice – 3 days

• Patient drowsy, jaundice ++

• T Bilirubin -18 mg/dl , D B-16.2 mg/dl

• AST – 700 U/L ,ALT 820 U/L, ALP- 120 U/L

• TP-6.2 gm/dl, Alb- 4.8 gm/dl ,

• PT-prolonged

Case 3

• 42 male • Fatigue and weakness – 8 months • Abdominal pain- 2 months • O/E Liver + 3 cm, spleen tip palpable T Bilirubin- 2 mg/dl ,DB- 1.6 mg/dl AST- 60 U/L, ALT-80 U/L, ALP-68 u/L T P- 6.2mg/dl, Alb-3.0 gm/dl HBS Ag + IgG anti HB c +

Case 4

• 3 year boy

• Abd distension, vomiting ,abd pain

• O/E jaundice +

• Mass palpable Rt upper quadrant

Case 5

• 37 male

• Presented to GEC OPD with burning sensation abdomen – 2 weeks

• On investigation - chronic gastritis

• Incidentally detected hepatomegaly

• TB- 2 mg/dl

• AST & ALT- 45 U/l, ALP -150 U/l

Case 6

• 3 month old girl child with jaundice and dark coloured urine

Full Term Normal Delivery with normal birth wt

O/E Hepatomegaly + mild

TB- 5.8mg/dl , DB- 5mg/dl

AST & ALT-120 U/L, ALP- 650 U/L

Case 7

• 45 year lady

• Fatigue, jaundice, pain and swelling knee joint 2 months

• Anorexia and abd pain – 2 weeks

• Liver palpable - 2 cm

• TB-2 mg/dl, DB- 1.5 mg/dl

• AST & ALT – 70 U/L, ALP- 100 U/l

• TP-8.4 gm/dl, Alb – 3.2gm/dl, Glob 5.2 gm/dl

Case 8

• 2 weeks old male baby

• Poor feeding, jaundice and dark urine

• Full Term Normal Delivery,

• small for gestational age

• TB 2.5 mg/dl , DB- 2 mg/dl

• AST 350 U/L, ALT 380 U/L, ALP-102 U /L

• TP- 7.5 mg/dl, Alb-4.5 mg/dl

Case 9

• 24 yr primigravida in 34 th week

• Nausea, repeated vomiting 10 days

• Abd pain & Jaundice – 7 days

• O/E BP- 130/90 mm Hg

• TB- 5 mg/dl, DB- 4.5 mg/dl

• AST & ALT – Normal , ALP- Normal

• PT & APTT- prolonged

Case 10

• 55 year lady

• Burning sensation abdomen – 3 weeks

• O/E- Hepatomegaly +

• TB- 0.3 mg/dl.

• ALT-14 U/L, AST-17 U/L

• TP- 6.7gm/dl, Alb- 3.09 gm/dl, Glob- 3.6 gm/dl

• ALP- 233 u/l, GGT- 557 u/l

• HIV- Nonreactive

Case 11

• 79 year male

• Abd pain on & off – 3 years,

• Abd distension +

• TB- 0.4 mg/dl

• AST 21 IU/L, ALT -24 IU/L ,ALP-69 U/L

• TP -7.6 gm/dl, Alb 4.4gm/dl, Glob-3.2gm/dl

Case 12

• 7 month old female baby

• Abd distension

• Large lobulated hetrogenously enhancing mass

• AFP > 30,000 IU/ml

• Well circumscribed mass 9x9x8 cm

Case 13

• 32 year male

• Chronic renal disease on Treatment

• Hypertensive

• TP-6.3gm/dl, Alb 3.27gm/dl

• ALT 8 IU /L , AST 10 IU/L ,ALP102 U/L

• TB- 0.2mg/dl, DB-0.1mg/dl

• S creat-8.9 mg/dl

• HB-5.0 g/dl