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正常的肝的外部表面
This is the external surface of a normal liver. The color is brown and the surface is smooth. A normal liver is about 1200 to 1600 grams.
這是一個正常的肝的表面。顏色是棕色的,表面是光滑的。一個正常的肝是大約重1200到1600 公克。
正常的肝的剖面
The cut surface of a normal liver has a brown color. Near the hilum here, note the portal vein carrying the blood to the liver branches at center left with accompanying hepatic artery and bile ducts. At the lower right is a branch of hepatic vein draining blood from the liver to the inferior vena cava.
一個正常的肝的剖面是棕色的。靠近核心的部分,可看到將血液導向肝臟的門靜脈伴隨著肝動脈和膽道往左分支。在右下方可看到一支肝靜脈將血液流向下腔靜脈。
肝被把histologically分成lobules
Liver is divided histologically into lobules. The center of the lobule is the central vein. At the periphery of the lobule are the portal triads. Functionally, the liver can be divided into three zones, based upon oxygen supply. Zone 1 encircles the portal tracts where the oxygenated blood from hepatic arteries enters. Zone 3 is located around central veins, where oxygenation is poor. Zone 2 is located in between.
在組織學上,肝臟可被分為不同的區塊。區塊的中心是中央靜脈。在區塊的周遭則是肝動脈、肝靜脈及膽道。就含氧量而言,肝可被分為3 個區域。第1 區域環繞著來自肝動脈被氧化的血的入口道。第3 區域位於中央靜脈的周圍含氧量低的地方。第2 區域則位於第1與第3區域之間。
含脂肪的變態
This liver is slightly enlarged and has a pale yellow appearance, seen both on the capsule and cut surface. This uniform change is consistent with fatty metamorphosis (fatty change).
此肝臟略顯腫大,且在其表面及切面均偏黃。這種表裡相同的改變和脂肪變性的病變是一致的。
酒精中毒
This is the histological appearance of hepatic fatty change. The lipid accumulates in the hepatocytes in vacuoles, which have a clear appearance with H&E staining. The most common cause of fatty change in developed nations is alcoholism. In developing nations, kwashiorkor in children is another cause. Diabetes mellitus, obesity, and severe gastrointestinal malabsorption are additional causes.
這是肝脂肪變性在組織上的變化。這些脂肪累積於肝細胞的液胞中,經H&E染色後呈透明狀。在已開發國家中,造成肝臟脂肪變性最普遍的原因是酗酒(酒精中毒)。在開發國家中,兒童的夸休可爾症(營養缺乏症之一)是另一個原因。糖尿病,肥胖症和嚴重的腸胃吸收不良也是一些其他的因素。
類脂空泡
This picture shows the lipid vacuoles within the hepatocytes. Alcohol, the most common cause of fatty change in liver, is a hepatotoxin that interferes with mitochondrial and microsomal functions in hepatocytes. This interference leads to the disruption of lipoprotein transport and/or fatty acid accumulation, which in turn causes an accumulation of lipids in the liver.
此圖顯示肝細胞中含脂肪的液胞。誠如前述,酒精是造成肝脂肪變性最普遍的原因,是一種肝毒素,會干擾肝細胞中腺粒體及微粒體的功能。這種干擾會導致破壞脂蛋白的運輸並累積脂肪酸,並造成肝臟內脂肪的累積。
肝硬變
Ongoing liver damage due to hepatocyte necrosis followed by fibrosis and hepatocyte regeneration results in cirrhosis. This produces a nodular, firm liver. The nodules seen here are larger than 3 mm and, hence, this is an example of "macronodular" cirrhosis.
肝細胞壞死及隨後的纖維化和肝細胞再生因而導致的持續性肝損壞會造成肝硬化。這就形成一個堅硬且含有結節的肝臟。在此看見的結節大於3毫米,因此這個例子屬於大結節性的肝硬化。
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