Contributed by Randall G. Lee, M.D.
PATIENT HISTORY:

PATIENT HISTORY: Per referral report, the patient is a 47 year-old female with diabetes (insulin dependent) and elevated LFTs. Review of outside material.


Final Diagnosis (Case 44)

LIVER, NEEDLE BIOPSY -
  1. HISTOLOGIC CHANGES OF NODULAR REGENERATIVE HYPERPLASIA.
  2. PORTAL FIBROSIS AND GLYCOGENATED HEPATOCYTE NUCLEI.

Comment:
Nodular regenerative hyperplasia is a histologic reaction pattern associated with a wide variety of conditions, including rheumatoid arthritis, myeloproliferative diseases, and use of several drugs (including corticosteroids), as well as settings such as bone marrow and renal transplantation, diabetes mellitus, and early in chronic biliary disorders. The glycogenated nuclei noted in this specimen are consistent with the history of diabetes mellitus.

Previous Biopsies on this Patient:
None

TPIS Related Resources:
Liver Transplant Topics


Gross Description - Case 44

The specimen consists of five (5) consult slides without an accompanying surgical pathology reports.


Microscopic Description - Case 44

The liver biopsy shows overall maintainance of lobular architecture, but nodular hyperplasia of the parenchyma is noted, as is mild portal fibrosis. The nodular hyperplasia is characterized by thickening, particularly of periportal, hepatic cell plates with impingement and compression of adjoining areas. Cirrhosis is not present, and there is no significant inflammatory infiltration. Numerous hepatocytes show glycogenated nuclei consistent with the patient's history of diabetes mellitus. No ground glass cells, cytoplasmic globules, viral inclusions, steatosis or steatohepatitis, or pigment


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