Help with diagnosis please!!

[mednunu]

Hi! I'm on my third year of med school and we need to determine what is wrong with this liver based on this biopsies. I've been researching for weeks now and can't seem to find anything like this. Have you ever seen anything like this? If so, can you please help me? Thank you!!!

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[icpshootyz]

Clear cut case of FAIDS. No question.

 

[AZpath]

FAIDS ? Spell that one out for us old timers.

 

[deleted314957]

Clear cut case of FAIDS. No question.

Feline AIDS?? Looks like hi grade, hi stage hepatitis, likely viral but with the same old diff of drug/autoimmune/etc. But I don't know what the hell else FAIDS could
stand for and have no idea what it looks like in a cat.

 

[icpshootyz]

J/K, I was referring to feline AIDS. I'm not keen on helping people do their homework for them.

 

[hoeround]

probably autoimmune hepatitis, but can't be for sure w/o clinical history. female? ANA? ASM? LKM? IgG elevated?

 

[mednunu]

probably autoimmune hepatitis, but can't be for sure w/o clinical history. female? ANA? ASM? LKM? IgG elevated?

Feline AIDS?? Looks like hi grade, hi stage hepatitis, likely viral but with the same old diff of drug/autoimmune/etc. But I don't know what the hell else FAIDS could
stand for and have no idea what it looks like in a cat.

Thank you very much for answering It's not autoimmune because all ANA, LKM, ASM are negative, it can't be any viral hepatitis because all results came negative, there is an hypergammaglobulinemia but the professor didn't give any more information on which Ig is/are elevated. It is a 33 yo male and according to the information the professor gave us it can't be toxic either because he didn't eat or consume any substance or drug. The symptoms we're given are acute hepatitis, jaundice and ashtenia.

J/K, I was referring to feline AIDS. I'm not keen on helping people do their homework for them.

Thank you for the misguided answer, I wouldn't have thought of looking it up because I just don't care at all about my education and learning. I just thought someone could have seen something similar because there's nothing on any book like Robbins or Sherlocks and maybe someone could have seen something in their medical practice.

 

[coroner]

I've been researching for weeks now and can't seem to find anything like this.

Weeks...? Exactly how long are they giving your class to figure this out?

probably autoimmune hepatitis, but can't be for sure w/o clinical history. female? ANA? ASM? LKM? IgG elevated?

Hoeround, third post in ten years...Where've you been?

 

[mednunu]

Weeks...? Exactly how long are they giving your class to figure this out?

We've had 2 months since they gave us the material, but every group had to work on 2 different cases. Ours were an autoimmune hepatitis and this one.

 

[Path or bust]

Hi! I'm on my third year of med school and we need to determine what is wrong with this liver based on this biopsies. I've been researching for weeks now and can't seem to find anything like this. Have you ever seen anything like this? If so, can you please help me? Thank you!!!

I really haven't seen alot of exciting liver since residency. My best guess based on the info and having thrown out autoimmune hepatitis and viral hepatitis....acute cellular rejection.

Picture 1 shows mixed portal inflammation consisting of mixed lymphocytes, plasma cells and eosinophils. Picture 2 shows trichrome stain with apparent fibrosis which is likely not all fibrosis but collapse of the reticulin meshwork from hepatocellular damage. Picture 3 shows cytoplasmic eosinophilia, cytoplasmic vacuolization, apoptosis and the upper left shows a capillary thrombosis and endotheliitis. Picture 4 shows really nice endotheliitis of the vein and the lifting of the endothelial cell layer. It also shows the cytoplasmic vacuolization. Picture 5 shows more endotheliitis, bile duct damage and some lymphocytic cholangitis (which would make you think of PSC).

2 of the 3 following features are needed for acute cellular rejection. Bile duct damage, subendothelial inflammation (endotheliitis), mixed portal inflammation.

 

[yaah]

If this is your third year of med school typically the diagnoses you need to consider are "Cirrhosis" and "Hepatitis" and "cancer." Don't get too cute about it.

 

[octopusprime]

If this is your third year of med school typically the diagnoses you need to consider are "Cirrhosis" and "Hepatitis" and "cancer." Don't get too cute about it.

agree.