Cirrhosis: Difference between revisions
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File:Histopathology of mild zone 3 steatosis without fibrosis (van Gieson).jpg|'''No fibrosis''', but mild zone 3 steatosis, in which collagen fibres (pink–red, arrow) are confined to portal tracts (P) (van Gieson's stain)ref name="BoydCain2020">{{cite journal|last1=Boyd|first1=Alexander|last2=Cain|first2=Owen|last3=Chauhan|first3=Abhishek|last4=Webb|first4=Gwilym James|title=Medical liver biopsy: background, indications, procedure and histopathology|journal=Frontline Gastroenterology|volume=11|issue=1|year=2020|pages=40–47|issn=2041-4137|doi=10.1136/flgastro-2018-101139}}<br>-"This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license"</ref> | File:Histopathology of mild zone 3 steatosis without fibrosis (van Gieson).jpg|'''No fibrosis''', but mild zone 3 steatosis, in which collagen fibres (pink–red, arrow) are confined to portal tracts (P) (van Gieson's stain)<ref name="BoydCain2020">{{cite journal|last1=Boyd|first1=Alexander|last2=Cain|first2=Owen|last3=Chauhan|first3=Abhishek|last4=Webb|first4=Gwilym James|title=Medical liver biopsy: background, indications, procedure and histopathology|journal=Frontline Gastroenterology|volume=11|issue=1|year=2020|pages=40–47|issn=2041-4137|doi=10.1136/flgastro-2018-101139}}<br>-"This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license"</ref> | ||
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"/> | ||
Revision as of 06:46, 20 December 2019
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]
- 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
.jpg)
- 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]](https://upload.wikimedia.org/wikipedia/commons/thumb/2/23/Histopathology_of_mild_zone_3_steatosis_without_fibrosis_%28van_Gieson%29.jpg/500px-Histopathology_of_mild_zone_3_steatosis_without_fibrosis_%28van_Gieson%29.jpg?utm_source=commons.wikimedia.org&utm_campaign=imageinfo&utm_content=thumbnail)
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]](https://upload.wikimedia.org/wikipedia/commons/thumb/a/af/Histopathology_of_steatohepatitis_with_mild_fibrosis_in_the_form_of_fibrous_expansion_%28van_Gieson%29.jpg/500px-Histopathology_of_steatohepatitis_with_mild_fibrosis_in_the_form_of_fibrous_expansion_%28van_Gieson%29.jpg?utm_source=commons.wikimedia.org&utm_campaign=imageinfo&utm_content=thumbnail)
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]](https://upload.wikimedia.org/wikipedia/commons/thumb/d/da/Histopathology_of_steatohepatitis_with_moderate_fibrosis%2C_with_thin_fibrous_bridges_%28van_Gieson%29.jpg/500px-Histopathology_of_steatohepatitis_with_moderate_fibrosis%2C_with_thin_fibrous_bridges_%28van_Gieson%29.jpg?utm_source=commons.wikimedia.org&utm_campaign=imageinfo&utm_content=thumbnail)
Histopathology of steatohepatitis with moderate fibrosis, with thin fibrous bridges (van Gieson's stain)[2] -
![Histopathology of steatohepatitis with established cirrhosis, with thick bands of fibrosis (van Gieson's stain)[2]](https://upload.wikimedia.org/wikipedia/commons/thumb/0/0d/Histopathology_of_steatohepatitis_with_established_cirrhosis%2C_with_thick_bands_of_fibrosis_%28van_Gieson%29.jpg/330px-Histopathology_of_steatohepatitis_with_established_cirrhosis%2C_with_thick_bands_of_fibrosis_%28van_Gieson%29.jpg?utm_source=commons.wikimedia.org&utm_campaign=imageinfo&utm_content=thumbnail)
Histopathology of steatohepatitis with established cirrhosis, with thick bands of fibrosis (van Gieson's stain)[2] -
Trichrome stain, showing cirrhosis as a nodular texture surrounded by fibrosis (wherein collagen is stained blue).
![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]](/File:Histopathology_of_mild_zone_3_steatosis_without_fibrosis_(van_Gieson).jpg)
![Histopathology of steatohepatitis with mild fibrosis in the form of fibrous expansion (van Gieson's stain)[2]](/File:Histopathology_of_steatohepatitis_with_mild_fibrosis_in_the_form_of_fibrous_expansion_(van_Gieson).jpg)
![Histopathology of steatohepatitis with moderate fibrosis, with thin fibrous bridges (van Gieson's stain)[2]](/File:Histopathology_of_steatohepatitis_with_moderate_fibrosis,_with_thin_fibrous_bridges_(van_Gieson).jpg)
![Histopathology of steatohepatitis with established cirrhosis, with thick bands of fibrosis (van Gieson's stain)[2]](/File:Histopathology_of_steatohepatitis_with_established_cirrhosis,_with_thick_bands_of_fibrosis_(van_Gieson).jpg)
_(5690946257).jpg)
Notes
- ↑ Micronodular or diffuse cirrhosis can be due to alcohol, hemochromatosis, hepatic venous outflow obstruction, chronic biliary obstruction, jejunoileal bypass, and Indian childhood cirrhosis.
- ↑ 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
- ↑ 1.0 1.1 Bashar Sharma; Savio John.. Hepatic Cirrhosis. StatPearls at the National Center for Biotechnology Information. Last Update: June 3, 2019.
- ↑ 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:. 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