Cirrhosis: Difference between revisions

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File:Histopathology of steatohepatitis with mild fibrosis in the form of fibrous expansion (van Gieson).jpg|Histopathology of steatohepatitis with '''mild fibrosis''' in the form of fibrous expansion (van Gieson's stain)<ref name="BoydCain2020"/>
File:Histopathology of steatohepatitis with mild fibrosis in the form of fibrous expansion (van Gieson).jpg|Histopathology of steatohepatitis with '''mild fibrosis''' in the form of fibrous expansion (van Gieson's stain)<ref name="BoydCain2020"/>
File:Histopathology of steatohepatitis with moderate fibrosis, with thin fibrous bridges (van Gieson).jpg|Histopathology of steatohepatitis with '''moderate fibrosis''', with thin fibrous bridges (van Gieson's stain)<ref name="BoydCain2020"/>
File:Histopathology of steatohepatitis with moderate fibrosis, with thin fibrous bridges (van Gieson).jpg|Histopathology of steatohepatitis with '''moderate fibrosis''', with thin fibrous bridges (van Gieson's stain)<ref name="BoydCain2020"/>
File:Histopathology of moderate fibrosis.jpg|thumb|'''Moderate''' fibrosis, H&E stain.
File:Histopathology of moderate fibrosis.jpg|thumb|'''Moderate fibrosis''' (H&E stain).
File:Histopathology of steatohepatitis with established cirrhosis, with thick bands of fibrosis (van Gieson).jpg|Histopathology of steatohepatitis with '''established cirrhosis''', with thick bands of fibrosis (van Gieson's stain)<ref name="BoydCain2020"/>
File:Histopathology of steatohepatitis with established cirrhosis, with thick bands of fibrosis (van Gieson).jpg|Histopathology of steatohepatitis with '''established cirrhosis''', with thick bands of fibrosis (van Gieson's stain)<ref name="BoydCain2020"/>
File:Cirrhosis of the liver (trichrome stain) (5690946257).jpg|[[Trichrome stain]], showing cirrhosis as a nodular texture surrounded by fibrosis (wherein collagen is stained blue).
File:Cirrhosis of the liver (trichrome stain) (5690946257).jpg|[[Trichrome stain]], showing cirrhosis as a nodular texture surrounded by fibrosis (wherein collagen is stained blue).
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Revision as of 13:15, 21 May 2021

Author: Mikael Häggström [note 1]
Cirrhosis of the liver:

Gross processing

In autopsy, make consecutive liver slices, such as in the sagittal or coronal plane.

Gross examination

Cirrhosis is characterized by pale areas. Categorize into either of the following: (1) micronodular, (2) macronodular, or (3) mixed:[1]

File:Gross pathology of alcoholic liver cirrhosis.jpg
Micronodular cirrhosis, with diffuse areas of pallor.
  • Micronodular or diffuse cirrhosis (uniform nodules less than 3 mm in diameter).[notes 1]
  • Macronodular cirrhosis (irregular nodules with a variation greater than 3 mm in diameter).
  • Pale macronodules of cirrhosis
    Pale macronodules of cirrhosis
  • Mixed cirrhosis (when features of both micronodular and macronodular cirrhosis are present): Usually micronodular cirrhosis progresses into macronodular cirrhosis over time.

Microscopic evaluation

Components:[1]

  • Diagnosing cirrhosis. The diagnosis of cirrhosis by biopsy requires the presence of fibrosis and nodules.
  • Assessing the degree of inflammation (grade) and fibrosis (stage) of the disease.
  • No fibrosis, but mild zone 3 steatosis, in which collagen fibres (pink–red, arrow) are confined to portal tracts (P) (van Gieson's stain)[2]
    No fibrosis, but mild zone 3 steatosis, in which collagen fibres (pink–red, arrow) are confined to portal tracts (P) (van Gieson's stain)[2]
  • Histopathology of steatohepatitis with mild fibrosis in the form of fibrous expansion (van Gieson's stain)[2]
    Histopathology of steatohepatitis with mild fibrosis in the form of fibrous expansion (van Gieson's stain)[2]
  • Histopathology of steatohepatitis with moderate fibrosis, with thin fibrous bridges (van Gieson's stain)[2]
    Histopathology of steatohepatitis with moderate fibrosis, with thin fibrous bridges (van Gieson's stain)[2]
  • Error creating thumbnail:
    Moderate fibrosis (H&E stain).
  • Error creating thumbnail:
    Histopathology of steatohepatitis with established cirrhosis, with thick bands of fibrosis (van Gieson's stain)[2]
  • Error creating thumbnail:
    Trichrome stain, showing cirrhosis as a nodular texture surrounded by fibrosis (wherein collagen is stained blue).

Notes

  1. ↑ Micronodular or diffuse cirrhosis can be due to alcohol, hemochromatosis, hepatic venous outflow obstruction, chronic biliary obstruction, jejunoileal bypass, and Indian childhood cirrhosis.
  1. ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. ↑ 1.0 1.1 Bashar Sharma; Savio John.. Hepatic Cirrhosis. StatPearls at the National Center for Biotechnology Information. Last Update: June 3, 2019.
  2. ↑ 2.0 2.1 2.2 2.3 Boyd, Alexander; Cain, Owen; Chauhan, Abhishek; Webb, Gwilym James (2020). "Medical liver biopsy: background, indications, procedure and histopathology ". Frontline Gastroenterology 11 (1): 40–47. doi:10.1136/flgastro-2018-101139. ISSN 2041-4137. 
    -"This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license"

Image sources


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