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