Tag Archives: Liver

April 2022—Don’t be afraid of livers. Maryam K. Pezhouh, MD, offered that advice in a CAP21 presentation on autoimmune hepatitis, primary biliary cholangitis, and overlap syndrome, part of a session on common queries in liver pathology. “You don’t need to know everything when you’re looking at the liver,” said Dr. Pezhouh, associate clinical professor of pathology at the University of California, San Diego. “But you need to know what your clinician and your patient are asking.”

March 2020—For pathologists, a first look at nonalcoholic fatty liver disease can be jarring. Purva Gopal, MD, has seen her share of initial biopsies on patients whose “livers are already cirrhotic,” she says. So has Cynthia Guy, MD, professor, Department of Pathology, and chief of the liver and GI surgical pathology section, Duke University Health System. It’s not a good look, obviously, so it’s one she’s doing her best to share with clinical colleagues. At her institution, pathologists have built a strong connection with the hepatologists and gastroenterologists, she says, and NAFLD is part of the regular show-and-tell.

January 2020—When looking at a liver biopsy, always suspect there might be drug-induced liver injury. “But then try hard to prove there isn’t. It’s always a diagnosis of exclusion and pattern evaluation,” says David E. Kleiner, MD, PhD, reference pathologist for the Drug-Induced Liver Injury Network. In that role, he pieces together clues that point to a drug having injured a liver—or not. Drug-induced liver injury is rare, and few pathologists see it. “The incidence is between one in 100,000 and one in a million, depending on what survey you read,” Dr. Kleiner says.

May 2018—It didn’t take long for Heather Stevenson-Lerner, MD, PhD, to grasp one key fact about the liver biopsy cases she was seeing at the University of Texas Medical Branch, Galveston: They were often complicated. UTMB sees plenty of challenging liver cases of its own, says Dr. Stevenson-Lerner, assistant professor of medicine and liver and transplantation pathologist, Department of Pathology.

April 2017—In a presentation at CAP16 on common patterns of liver injury, Robert M. Najarian, MD, called drug-induced liver injury the great mimicker in liver pathology. “When in doubt, rule drugs out,” he said, including herbal agents, supplements, and over-the-counter agents.

March 2017—Keep eyes wide open to everything and describe everything because there might be a number of different factors playing into a patient’s disease. That was the reminder Robert M. Najarian, MD, opened with last fall in his CAP16 presentation on common patterns of liver injury.