Liver cirrhosis is an irreversible end-stage liver disease characterized by widespread fibrosis and regenerating nodules replacing normal liver parenchyma, appearing as a shrunken liver with multiple tiny nodules on both the outer surface and cut surface; it is classified into macronodular (>3mm nodules) and micronodular (<3mm nodules) types, with the most common causes being alcohol abuse (Laennec's cirrhosis) and chronic viral hepatitis B and C, and clinically presents with portal hypertension features including ascites, variceal bleeding, caput medusae, and hepatic encephalopathy.
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Pathology Gross Specimen: Liver Cirrhosis Explained | MBBS 2nd Year | NEET PG 2026 | PW MedEdAdded:
It's a clearcut diagnos of cerosis by looking at all the nodular structures.
Describe how we will be presenting it to an examiner. You might not be able to see all the notches and the loes here because so once we have established this is specimen of liver. So what do I do next? Hey guys, welcome back to one more specimen of gross pathology porters. And here it's a clearcut diagnose of cerosis by looking at all the nodular structures. Let's go and describe how we will be presenting it to an examiner.
Right? So this is actually not an entire liver. If you look it's a slice of a liver. You can see this outer aspect.
The only thing what we can appreciate in a slice of a liver to say it's liver is the shape because you might not be able to see all the notches and the loes here because since it's slice right on the back on the reverse side if you can look. Yes. Again you can see just the raw surface here. You'll not be able to appreciate any anatomical landmarks especially when it's a slice of a liver.
If an entire liver is given how to say it's a liver one obviously is the shape of the liver. Then the loes of the liver you can see the left and the right lobe and if there's any falsifant anything stuck there you can say according to that or the gallbladder force if you can appreciate on the below aspect of it that also might help us saying that it is most likely the liver. If it's a slice of the liver please go and stress more on the shape of the liver. Apart from that you might not be able to see any anatomical description or if you have a case tree presented along with the specimen that might help me to say okay it's most likely a liver sample.
Right? So once we have established this there's a specimen of liver. So what do I do next? So if you look at the size of the liver the first thing is since the specimen of liver for an adult liver there's definitely a shrunken liver. The part shrunken should be very much emphasis because you know that we are going to lead them to the diagnosis of cerosis. Cerosis has to be a shrunken liver. It has to be hard but we cannot palpate a jar mounted specimen. So shrunken liver should be there on the and on the outer surface you can see multiple tiny nodular structures.
Cerosis by definition is nothing but fibros of liver with regenerating nodules. Right? So the entire liver paranca is replaced by tiny tiny nodules of varying sizes. Varying sizes makes it important for us to lead to the right diagnosis. And even on the cut surface of the liver if you look if you carefully appreciate you can see multiple tiny nodules especially in the periphery. It's not only on the periphery it's actually in the center of the liver. Parent also it's more appreciated on the periphery. Right? So once you establish there's a case of a ceros of liver then comes your viva questions. So what all can happen in a viva with respect to cerosis. The first since a gross specimen obviously the diagnosis and the classification comes based on gross though not very much useful in the current scenario we divide cerosis into macronodular cerosis and micronodular cerosis. Quite a few of them will have a combination of macro and micronula cerosis. Macro we the definition is anything more than 3 millm. It's millimeter not centimeter.
more than 3 millimeter nodules we say it's macronautular and if it's less than 3 millm nodules we say it's micronodular do I need to read the table which cause macron micro I would honestly say no but do remember that one of the commonest cause which is alcoholic cerosis is a combination of both macro and microno cerosis and also has a name called as lenacerosis and one of the other thing like the common cause of cerosis being hepatitis B and hepit the chronic hepatitis post necrotic or post hepatitis are generally a macrona right these are two things which you have to number is cerosis reversible that could be a question definitely cerosis is an irreversible condition with respect to an undergraduate right so the cause of cerosis the leading cause being alcohol the next cause can be your hepatitis B and hepatitis C are the hepatitis virus rarely lead to cerosis most of them cause acute liver failure right apart from that you have lots of metabolic disorders like an hemocchromosis or an alpha onein deficiencies they also can lead up to cerosis but the chunk as we stated it's going to be your cerosis is going to be alcohol and your viral hepatitis. Fine. So how will a patient with cerosis present? Cerosis most of the time will present with portal hypertension. The classical features are assitis which is nothing but due to reduced alpine production by the liver and also the increased pressure due to portal hypertension and you'll have the vericial bleedings and all the protocs where you can see them in the esophagus you can see them in the bad area of the liver. Remember the amlus the capot medi the hemorrhoid spiles you can see classical photosmic anesmosis. Third, you might definitely see patients in terminal stage of hypatic enkaphyalopathy where the ammonia which is in the form of the form the gut bacteria has not been able to process by the liver. The toxin hits the brain and causes enkyopathy. So these are the classical precision of cerosis with portal hypertention. Right? These are things which can come in the exam. And do I need to document cerosis in microscopy? There's only one requirement to document cerosis when the patient is a candidate for a liver transplant.
Apart from that we not require to document zeros on a microscopy and ultra sonogram is more than enough and the needle which is useful for liver biopsies whom silver man made it. Right?
That's all regarding this uh sample and see you soon in the next video. Till then, bye-bye.
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