Neil Theise, M.D., Beth Israel Medical Center, New York NY; and Romil Saxena, M.D., FRCPath, Indiana University Medical Center, Indianapolis IN.
Recently instituted grading and staging guidelines for chronic liver diseases, some of which may now be considered epidemic in scope, as well as terminologic changes in hepatopathology require clarification for the general practicing pathologist. The main objective of this course is to critically review the most recent updates in nomenclature, grading, and staging for the most common liver diseases. Topics to be covered in detail include:
|1.|| Grading and staging of chronic hepatitis, in particular of hepatitis C, as well as of mixed viral infections (e.g. HCV/HBV, HCV/HIV, HBV/HDV), with attention to utility of immunohistochemical testing and relationship to treatment and diagnosis;|
|2.|| Grading and staging for non-alcoholic fatty liver disease and definitions of “steatohepatitis” and “steatofibrosis”;|
|3.|| Recognition of compound disease occurrence, in particular fatty liver disease and chronic hepatitis C, and overlap syndromes of primary biliary cirrhosis and autoimmune hepatitis;|
|4.|| Diagnostic criteria for genetic hemochromatosis in light of available genetic testing mutations;|
|5.|| Rationale for terminology changes regarding “ductular reactions” in diverse acute and chronic liver disease;|
|6.|| Diagnostic criteria for small/early hepatocellular carcinoma and malignancy-associated hepatocellular lesions (e.g. dysplastic nodules and foci, large and small cell change).|
The course is intended to be a practical overview to update diagnostic pathologists already in practice as well as residents and fellows still in training.
Upon completion of the course, participants should be able to: grade and stage the most common diseases found in liver biopsy specimens; recognize common overlap disease categories and understand the clinical implications of such recognition; use the most up to date nomenclature for clear communication with hepatology/gastroenterology colleagues.
Participants will receive a CD of powerpoint presentations used in the course, inclusive of photomicrographs of all lesions reviewed and a handout.