Pathology
⏱ ~3-min readAceMark Guide
What this topic is really about
Chronic hepatitis B infection leads to a 'ground-glass' hepatocyte appearance due to the massive accumulation of hepatitis B surface antigen (HBsAg) within the endoplasmic reticulum. In contrast, alpha-1 antitrypsin deficiency presents with PAS-positive, diastase-resistant periportal globules rather than a diffuse ground-glass cytoplasm.
Ischemic injury in solid organs such as kidney and pancreas leads to coagulative necrosis, where protein denaturation preserves tissue architecture for several days. Liquefactive necrosis occurs in the brain, caseous necrosis is typical of tuberculosis, and fat necrosis is seen in adipose tissue following enzymatic digestion.
See the mechanism
Extrahepatic biliary obstruction blocks bile flow, leading to dilated bile ducts on imaging and a backup of conjugated bilirubin into the bloodstream. A diagram for this topic isn't available yet — the worked example below walks the same reasoning step by step.
An exam-style question, fully explained
A 45-year-old presents with cough and a hilar lymphadenopathy. Biopsy shows non-caseating granulomas. Most likely diagnosis:
- Identify what the question tests: A 45-year-old presents with cough and a hilar lymphadenopathy..
- Sarcoidosis is classically characterized by non-caseating granulomas and bilateral hilar lymphadenopathy in patients presenting with cough or dyspnea.
- In contrast, tuberculosis typically presents with caseating (necrotizing) granulomas containing central necrosis, rather than the non-caseating type seen here.
Traps the examiner sets
- Patients with diabetic ketoacidosis may initially present with high glucose levels, but the condition is characterized by the production of ketones, not the presence of high glucose.
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