A 22-year-old woman from Albania has a congenital anemia requiring multiple transfusions of RBCs for many years. On physical examination, her skin has a bronze color. Liver function tests show reduced serum albumin. Which of the following findings would most likely appear in a liver biopsy specimen?
Each unit of blood contains about 250 mg of iron. The body has no mechanism for getting rid of excess iron. About 10 to 20 mg of iron per day is lost with normal desquamation of epithelia; menstruating women lose slightly more. Any excess iron becomes storage iron, or hemosiderin. Over time, hemosiderosis involves more and more tissues of the body, particularly the liver, but also skin. Initially, hemosiderin deposits are found in Kupffer cells and other mononuclear phagocytes in the bone marrow, spleen, and lymph nodes. With great excess of iron, liver cells also accumulate iron. Amyloid is an abnormal protein derived from a variety of precursors, such as immunoglobulin light chains. Bilirubin, a breakdown product of blood, can be excreted in the bile so that a person does not become jaundiced. Glycogen storage diseases are inherited and present in childhood. Steatosis usually occurs with ingestion of hepatotoxins, such as alcohol.
Amyloid in portal triads
Bilirubin in canaliculi
Glycogen in hepatocyte
Hemosiderin in hepatocytes
Cellular Pathology