Liver Biopsies: Anatomy and Histological Considerations (by LabCE)

1.5 P.A.C.E. contact hour(s)

(based on 212 customer ratings)

Author: Brooke Eguia, BS, MS, HT(ASCP), HTL(ASCP)
Reviewer: Carla Shoffeitt, MSM, HT(ASCP)

Course provided by LabCE.

The goal of this continuing education course is to provide essential knowledge to histology professionals regarding the structure and function of a liver biopsy received in the pathology laboratory. This course explores common diseases and provides information regarding how a liver biopsy assists the pathologist and clinician in diagnosing these diseases. Upon completion of this course, the histotechnologist will have a greater understanding of optimal histotechniques used to create slides that are adequate for diagnosis, develop a foundational knowledge about the anatomy of a liver biopsy (as well as common diseases), and also identify artifacts, special stains, and pigments that are specific to liver biopsies that may be used to assist in diagnosis.

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Included In These Course Packages

Continuing Education Credits

P.A.C.E.® Contact Hours (acceptable for AMT, ASCP, and state recertification): 1.5 hour(s)
Course number 578-041-20, approved through 5/31/2022
Course number 20-778092, approved through 9/1/2022

Objectives

  • Identify tissue and cellular components of a liver biopsy.
  • Describe characteristic histologic features observed in liver biopsies with common liver diseases.
  • Define common special stain applications performed on liver biopsies and list the diseases that the stains assist in identifying.
  • Explain critical factors that contribute to optimal technical preparation of liver biopsies.
  • Identify different pigments that can be seen in liver biopsies.

Customer Ratings

(based on 212 customer ratings)

Course Outline

  • Introduction
      • Introduction
  • Tissue Identification
      • Connective Tissue
      • Connective Tissue: Type I Collagen
      • Connective Tissue: Type III Collagen
      • Hepatocytes: Liver Epithelial Cells
      • Kupffer Cells and other Sinusoidal Cells
  • Normal Histology
      • Lobular Organization: Portal Tracts and Central Veins
      • Portal Tracts: Bile Ducts
      • Portal Tracts: Arterioles
      • Portal Tracts: Portal Vein
      • Parenchyma: The "Lobule"
      • Parenchyma: Sinusoids
  • Technical Preparation
      • Fixative
      • Rapid Tissue Processing: Transplant Patients
      • Biopsy Cycle Tissue Processing
      • Cassetting: Sponge versus Wrapping
  • Microtomy
      • Artifacts
      • Section Thickness
      • Step Sections
  • Disease
      • Benign Inflammatory Metabolic Disease
      • Benign Inflammatory Metabolic Disease: Non-Alcoholic Steatohepatitis (NASH)
      • Benign Inflammatory Metabolic Disease: Hemochromotosis and Hemosiderosis
      • Benign Inflammatory Metabolic Disease: Wilson's Disease
      • Benign Inflammatory Metabolic Disease: Amyloidosis
      • Alcoholic Liver Disease
      • Hepatitis: Viral A, B, and C
      • Hepatitis B Core Antigen (HBcAg) and Hepatitis B Surface Antigen (HBsAg) Double Stain in Liver.
      • Hepatitis: Other Common Viruses
      • Granulomatous Hepatitis
      • Granulomatous Hepatitis: Fungal Infections
      • Hepatitis: Drug Induced
      • Transplant Induced: Rejection
      • Transplant Induced: Graft Versus Host Disease (GVHD)
      • Advanced and End Stage Liver Disease (Cirrhosis)
      • Tumors: Benign
      • Tumors: Malignant
      • Malignant Tumors: Metastatic
      • Malignant Tumors: Primary
  • Stains
      • Trichrome
      • Reticulin
      • Rhodanine
      • Prussian Blue
      • Oil Red O
      • Immunohistochemistry (IHC) and Immunoperoxidase (IP)
  • Pigments
      • Exogenous Pigments
      • Endogenous Pigments
  • References
      • References

Additional Information

Level of instruction: Basic to intermediate
 
Intended audience:  Clinical laboratory histotechnologists, histotechnicians, and other medical laboratory personnel who have an interest in this subject matter. This course is also appropriate for histology and clinical laboratory science students, pathology residents, and practicing pathologists.  
 
Author information: Brooke Eguia, BS, MS, HT(ASCP), HTL(ASCP) is the Pathology Technical Supervisor at Fairview Southdale Hospital in Edina, Minnesota. She graduated from St. Cloud State University with a Bachelor of Science degree in general biology and from Capella University with a Master of Science in Human Service with a specialization in Health Care Administration. During her time as an undergraduate, Brooke's interests and studies focused on histologic techniques and gross anatomic dissection. Her senior year, she co-authored for aquatic toxicology research that Aquaculture published in January 2009. Acting as a primary health career mentor to high school students, Brooke satisfied her desire for training and teaching histotechnicians and also worked as adjunct faculty at Rasmussen College, as a Medical Assistant laboratory techniques instructor. Most recently, she has focused on proctoring histology students in clinical/classroom progress and exam preparation.
 
Reviewer information: Carla J. Shoffeitt, MSM, HT(ASCP) is the Manager of the Pathology Department of Emory St. Joseph’s Hospital of Emory Healthcare in Atlanta, Georgia. She holds a Master of Science Degree in Healthcare Management as well as a Bachelor of Science degree in Biology from Troy University, Troy, Alabama. She is certified as a Histotechnician and has 25 years of experience in the field of Histology.

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Course provided by LabCE.
A liver biopsy section demonstrating several forms of artifact such as chatter,</br> folds, and sponge artifact.


A liver biopsy section stained with Congo Red demonstrating amyloid


A liver biopsy stained by Masson's Trichrome demonstrating normal tissue</br> architecture and favorable tissue cassetting.


A liver biopsy stained with Gordon & Sweets reticulin stain demonstrating abnormal</br> reticulin collapse, as well as abnormal arrangement of hepatocytes.


A liver biopsy stained with Gordon & Sweets reticulin stain demonstrating normal reticulin architecture, 40X magnification.


A liver biopsy stained with Prussian blue demonstrating ferric iron in a patient</br> with hemochromatosis.


A Masson's trichrome stained liver biopsy demonstrating an increase in type I</br> collagen in a patient with bridging portal fibrosis.



 
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