This is a case-based course focused on adult medical liver biopsies encountered in Surgical Pathology practices. The course is designed for academic and community- based general surgical pathologists and pathologists-in-training. Approach to diagnosis during evaluation of liver biopsies will be utilized based on recognition of patterns of liver injury; utilization of special stains and immunohistochemistry will be highlighted. Following recognition of the patterns of injury, the development of differential diagnoses and relevant considerations for discussion with the submitting clinical colleagues will be discussed in order to ultimately derive a diagnosis. Updates in pertinent etiopathogenesis and treatment options will be mentioned when relevant.

The primary patterns and diagnostic lesions and their differentials discussed include autoimmune liver diseases, cholestatic liver diseases, vascular diseases affecting the liver, lesions in biopsies for "cirrhosis", lesions encountered in liver transplant patients and patients following bone marrow or other organ transplants, common drug induced liver injury, iron overload and liver biopsy in the AIDS/HIV patient.

All participants will have access to view the representative histological images on the USCAP website prior to the meeting, and a syllabus reviewing the diagnostic features discussed; with references will be distributed at the meeting. After the meeting, all participants will receive web access to the PowerPoint presentation given at the USCAP Annual Meeting along with the text portion of the text portion of the syllabus.

Following attendance of the course, the participants should be able to: 1) identify various patterns of liver injury in needle biopsies; 2) formulate relevant differential diagnoses from the patterns identified; 3) understand possible limitations of histologic evaluation and need for clinical correlations; 4) understand uses and value of various special stains in liver biopsy evaluation.

(LAST SCHEDULED PRESENTATION) This course may be used for CME credits or SAM credits.