Contributed by Randall G. Lee, M.D.
PATIENT HISTORY:
Per referral patient history sheet, the patient is a 52-year-old asymptomatic male found to have elevated liver enzymes and positive anti-HCV. Review of outside material.

Final Diagnosis (Case 67)


LIVER, NEEDLE BIOPSY -
  1. CHRONIC HEPATITIS WITH MODERATE INFLAMMATORY ACTIVITY AND BRIDGING FIBROSIS.
  2. HISTOLOGIC FEATURES CONSISTENT WITH HEPATITIS C INFECTION.

COMMENT:
Although bridging fibrosis is present, the overall architecture is maintained and therefore definite cirrhosis is not yet present.

Previous Biopsies on this Patient:
None

TPIS Related Resources:
Liver Transplant Topics

Gross Description - Case 67


The specimen consists of four (4) consult slides. No surgical pathology report is received with the specimen.

Microscopic Description - Case 67


The liver biopsy shows intact hepatic architecture but there is fibrosis and expansion of the portal tracts with occasional portal based fibrous bridges. Early architectural distortion is present, but because normal lobular landmarks can be discerned, overt cirrhosis is not yet present. The portal regions contain a moderate mononuclear infiltrate associated with mild bile duct injury and occasional lymphoid aggregates. There is mild ductular proliferation in the background. Mild to moderate piecemeal necrosis is additionally seen. The lobules demonstrate a mild to moderate inflammatory infiltrate with a sinusoidal distribution. Occasional focal necroses acidophilic bodies are seen. Mild macrovesicular steatosis is focally present. No ground glass hepatocytes, viral inclusions, bile duct loss, cytoplasmic globules, pigment deposition, evidence, or chronic cholestasis are seen. Overall changes are consistent with chronic hepatitis C with moderate activity and bridging fibrosis.

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