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Liver Biopsy

1 forms  
  1. StudyEvent: ODM
    1. Liver Biopsy
Administrative data
Description

Administrative data

Site
Description

Site

Data type

text

Subject
Description

Subject

Data type

text

Visit Name
Description

Visit Name

Data type

text

Status
Description

Status

Data type

text

Document Number
Description

Document Number

Data type

text

Liver Biopsy pt 1
Description

Liver Biopsy pt 1

Date of Liver Biopsy
Description

complete a separate form for each liver biopsy performed

Data type

date

Approximate size of liver biopsy
Description

Approximate size of liver biopsy

Data type

float

Measurement units
  • mm
mm
A. Final Diagnosis
Description

check all that apply

Data type

text

If Other, specify
Description

If Other, specify

Data type

text

B. Liver Architecture
Description

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Data type

text

If Other, specify
Description

If Other, specify

Data type

text

C. Description of Liver Cells or Hepatocytes
Description

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Data type

text

If Other, specify
Description

If Other, specify

Data type

text

D. Liver Cell or Hepatocyte Inclusions or Vacuoles
Description

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Data type

text

If Other, specify
Description

If Other, specify

Data type

text

E. Hepatocyte or Liver Cell Nuclear Abnormalities
Description

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Data type

text

If Other, specify
Description

If Other, specify

Data type

text

F. Liver or Lobular Infiltrates
Description

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Data type

text

If Other, specify
Description

If Other, specify

Data type

text

If Other, specify
Description

If Other, specify

G. Portal Tract Inflammation
Description

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Data type

text

If Other, specify
Description

If Other, specify

Data type

text

H. Bile Ducts
Description

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Data type

text

If Other, specify
Description

If Other, specify

Data type

text

I. Portal Veins
Description

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Data type

text

If Other, specify
Description

If Other, specify

Data type

text

J. Liver Infections
Description

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Data type

text

If Other, specify
Description

If Other, specify

Data type

text

K. Parasites or Ova
Description

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Data type

text

If Other, specify
Description

If Other, specify

Data type

text

Liver Biopsy pt 3
Description

Liver Biopsy pt 3

L. Histologic Staining or Additional Studies Obtained
Description

Check all that apply

Data type

text

If Other, specify
Description

If Other, specify

Data type

text

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Similar models

Liver Biopsy

1 forms
  1. StudyEvent: ODM
    1. Liver Biopsy
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative data
Site
Item
Site
text
Subject
Item
Subject
text
Item
Visit Name
text
Visit Name
Code List
Visit Name
CL Item
Liver Biopsy (1)
Status
Item
Status
text
Document Number
Item
Document Number
text
Item Group
Liver Biopsy pt 1
Date of Liver Biopsy
Item
Date of Liver Biopsy
date
Approximate size of liver biopsy
Item
Approximate size of liver biopsy
float
Item
A. Final Diagnosis
text
A. Final Diagnosis
Code List
A. Final Diagnosis
CL Item
Normal (1)
CL Item
Acute Hepatitis (2)
CL Item
Chronic Hepatitis (3)
CL Item
Cholestatic Hepatitis (4)
CL Item
Drug-induced cholestasis (5)
CL Item
Acute viral hepatitis (6)
CL Item
Chronic viral hepatitis (7)
CL Item
Drug-induced hepatitis (8)
CL Item
Autoimmune hepatitis (9)
CL Item
Bridging necrosis (10)
CL Item
Submassive hepatic necrosis (11)
CL Item
Massive hepatic necrosis (12)
CL Item
Steatosis - microvesicular (13)
CL Item
Steatosis - macrovesicular (14)
CL Item
Steatosis - mixed (15)
CL Item
Non-alcoholic steatohepatitis (16)
CL Item
Alcoholic hepatitis (17)
CL Item
Hepatic granulomas (18)
CL Item
Sarcoidosis (19)
CL Item
Fibrosis (20)
CL Item
Cirrhosis (21)
CL Item
Primary biliary cirrhosis (22)
CL Item
Primary sclerosing cholangitis (23)
CL Item
Autoimmune overlap syndrome (24)
CL Item
Hemochromatosis (25)
CL Item
Alpha - 1 - antitrypsin deficiency (26)
CL Item
Wilson's disease (27)
CL Item
Veno-occlusive disease (28)
CL Item
Budd-Chiari syndrome (29)
CL Item
Neoplasia (30)
CL Item
Other (31)
If Other, specify
Item
If Other, specify
text
Item
B. Liver Architecture
text
B. Liver Architecture
Code List
B. Liver Architecture
CL Item
Normal (1)
CL Item
Bridging fibrosis (2)
CL Item
Diffuse fibrosis (3)
CL Item
Nodular regenerative hyperplasia (4)
CL Item
Congenital hepatic fibrosis (5)
CL Item
Cirrhosis (6)
CL Item
Centrilobular congestion (7)
CL Item
Endophlebitis (8)
CL Item
Veno-Occlusive disease (9)
CL Item
Canalicular cholestatis (10)
CL Item
Apoptosis (11)
CL Item
Focal ( or spotty or mild) hepatocellular necrosis  (12)
CL Item
Interface hepatitis (periportal hepatitis or piecemeal necrosis) (13)
CL Item
Ischaemic necrosis (14)
CL Item
Centrolobular (Zone 3) necrosis (15)
CL Item
Focal coagulative necrosis (16)
CL Item
Centrolobular (Zone 3) coagulative necrosis (17)
CL Item
Bridging hepatocellular necrosis (18)
CL Item
Massive or panlobular hepatocellular necrosis (19)
CL Item
Dycplasia (20)
CL Item
Neoplasia (21)
CL Item
Other (22)
If Other, specify
Item
If Other, specify
text
Item
C. Description of Liver Cells or Hepatocytes
text
C. Description of Liver Cells or Hepatocytes
Code List
C. Description of Liver Cells or Hepatocytes
CL Item
Normal (1)
CL Item
Ballooning (2)
CL Item
Acidophilic (3)
CL Item
Pseudoxanthomatous (4)
CL Item
Multinucleated giant hepatocytes (5)
CL Item
Other (6)
If Other, specify
Item
If Other, specify
text
Item
D. Liver Cell or Hepatocyte Inclusions or Vacuoles
text
D. Liver Cell or Hepatocyte Inclusions or Vacuoles
Code List
D. Liver Cell or Hepatocyte Inclusions or Vacuoles
CL Item
No inclusions (1)
CL Item
Macrovesicular steatosis (2)
CL Item
Microvesicular ateatosis (3)
CL Item
Bile accumulation (4)
CL Item
Diastase - resistant, Pas-positive cytoplasmic inclusion (5)
CL Item
Alphy-1-Antitrypsin inclusions (6)
CL Item
Megamitochondria (7)
CL Item
Mallory bodies (8)
CL Item
"Ground Glass" inclusions (9)
CL Item
Lipofuchsin pigment (10)
CL Item
Hemosiderin Granules (11)
CL Item
Orcein-Positive Cytoplasmin Granules (12)
CL Item
Protoporphyrin Crystals (Birefringent under polarised light) (13)
CL Item
Uroporphyrin crystals (Red fluorescence under ultraviolet light) (14)
CL Item
Other (15)
If Other, specify
Item
If Other, specify
text
Item
E. Hepatocyte or Liver Cell Nuclear Abnormalities
text
E. Hepatocyte or Liver Cell Nuclear Abnormalities
Code List
E. Hepatocyte or Liver Cell Nuclear Abnormalities
CL Item
None (1)
CL Item
Hepatocellular mitoses (2)
CL Item
Binucleated or multinucleated hepatocytes (3)
CL Item
CMV Inclusion bodies (4)
CL Item
HSV Inclusions (5)
CL Item
Varicella Inclusions (6)
CL Item
Other (7)
If Other, specify
Item
If Other, specify
text
Item
F. Liver or Lobular Infiltrates
text
F. Liver or Lobular Infiltrates
Code List
F. Liver or Lobular Infiltrates
CL Item
None (1)
CL Item
Eosinophils (2)
CL Item
Lymphocytes (3)
CL Item
Plasma cells (4)
CL Item
Neutrophils (5)
CL Item
Macrophages and proliferating Kupfer cells (6)
CL Item
Granulomas (7)
CL Item
Other (8)
If Other, specify
Item
If Other, specify
text
Item Group
If Other, specify
Item
G. Portal Tract Inflammation
text
G. Portal Tract Inflammation
Code List
G. Portal Tract Inflammation
CL Item
None (1)
CL Item
Eosinophils (2)
CL Item
Lymphoid aggregates and / or follicles (3)
CL Item
Plasma cells (4)
CL Item
Neutrophils (5)
CL Item
Histocytes and macrophages (6)
CL Item
Other (7)
If Other, specify
Item
If Other, specify
text
Item
H. Bile Ducts
text
H. Bile Ducts
Code List
H. Bile Ducts
CL Item
Normal (1)
CL Item
Proliferation of bile ducts (bile ductular reaction) (2)
CL Item
Dilation, degeneration or disruption of portal bile ducts (3)
CL Item
Paucity of bile ducts (4)
CL Item
Periductal fibrosis (5)
CL Item
Other (6)
If Other, specify
Item
If Other, specify
text
Item
I. Portal Veins
text
I. Portal Veins
Code List
I. Portal Veins
CL Item
Normal (1)
CL Item
Pyelophlebitis (2)
CL Item
Thrombosis, sclerosis or occlusion of portal vein (3)
CL Item
Neoplastic invasion of portal vein (4)
CL Item
Granulomatous compression of portal vein (5)
CL Item
Other (6)
If Other, specify
Item
If Other, specify
text
Item
J. Liver Infections
text
J. Liver Infections
Code List
J. Liver Infections
CL Item
Normal (1)
CL Item
Leishmaniasis Donovani (2)
CL Item
Plasmodium Falciparum (3)
CL Item
Toxoplasmosis (4)
CL Item
Cryptococcus Neoformans (5)
CL Item
Histoplasma Capsulatum (6)
CL Item
Mycobacterioum Tuberculosis (7)
CL Item
Other mycrobacterial Species (8)
CL Item
Other (9)
If Other, specify
Item
If Other, specify
text
Item
K. Parasites or Ova
text
K. Parasites or Ova
Code List
K. Parasites or Ova
CL Item
None (1)
CL Item
Schistosome and/or Ova (2)
CL Item
Ascaris and/or Ova (3)
CL Item
Toxocara and/or Ova (4)
CL Item
Echinococcus cysts (5)
CL Item
Hepatic Capillariasis worms and/or Ova (6)
CL Item
Other (7)
If Other, specify
Item
If Other, specify
text
Item Group
Liver Biopsy pt 3
Item
L. Histologic Staining or Additional Studies Obtained
text
L. Histologic Staining or Additional Studies Obtained
Code List
L. Histologic Staining or Additional Studies Obtained
CL Item
Haematoxylin and Eosin (or H&E) (1)
CL Item
Masson (2)
CL Item
Toluidine Blue or Giemsa (3)
CL Item
Prussian Blue (4)
CL Item
Periodic Acidic Schiff (PAS), with or without diastase (5)
CL Item
Oil Red O (6)
CL Item
Congo Red (7)
CL Item
Hall's Stain (8)
CL Item
Gridley's Stain (9)
CL Item
Rhodanine (Copper) (10)
CL Item
Rubeanic Acid (Copper) (11)
CL Item
Orcein, Aldehyde Fuchsin or Victoria Blue (12)
CL Item
Electron Microscopy (13)
CL Item
Hepatitis A Immunostains Positive (14)
CL Item
Hepatitis B Core Antigen or Hepatitis B Surface Antibody Immunostains Positive (15)
CL Item
Hepatitis D Immunostains (16)
CL Item
Other Immunostains (17)
CL Item
Other (18)
If Other, specify
Item
If Other, specify
text
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