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Contributed by Randall G. Lee, M.D.
Previous Biopsies on this Patient:
None
TPIS Related Resources:
Knodell Scoring
Liver Transplant Topics
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The liver biopsy demonstrates hepatic architecture distorted by irregular portal fibrosis with focal bridging fibrosis and early nodular formation. Cirrhosis has not developed, however. The portal tracts predominantly demonstrate dense ductular proliferation with a mixed inflammatory response including neutrophils and lymphocytes. Mild lymphocytic type piecemeal necrosis is identified. In occasional portal tracts, no definite intralobular bile duct is noted, whereas other tracts shows ducts with epithelial eosinophilia and focal lymphocytic infiltration. In addition, a medium-sized duct demonstrates a so-called florid duct lesion with duct rupture, adjacent inflammation including epithelioid histiocytes and eosinophils, and intraepithelial lymphocyte inflammation. These later duct changes are most helpful in establishing a diagnosis of primary biliary cirrhosis, and are consistent with the clinical setting and AMA positivity.
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