Contributed by Randall G. Lee, M.D.
PATIENT HISTORY:
Per referral letter, the patient is an elderly male. At the time of surgery, the surgeon thought the liver looked cirrhotic. Review of outside material.

Final Diagnosis (Case 88)

LIVER, WEDGE BIOPSY -
  1. MIXED MACRONODULAR AND MICRONODULAR CIRRHOSIS WITH MILD INFLAMMATORY ACTIVITY AND FOCI OF FLORID, BUT REACTIVE, DUCTULAR PROLIFERATION.
  2. NO SPECIFIC ETIOLOGIC CLUES IDENTIFIED.

Previous Biopsies on this Patient:
None

TPIS Related Resources:
Liver Transplant Topics

Gross Description - Case 88

The specimen consists of seven (7) consult slides. No surgical pathology report is received with the specimen.

Microscopic Description - Case 88

The wedge biopsy of liver consists largely of subcapsular parenchyma, which makes conclusions about the architecture somewhat tenuous. Nonetheless, advanced cirrhosis appears to be present, as manifest by totally deranged architecture with parenchymal nodules bounded by irregular zones of fibrosis. There is mild inflammatory activity in terms of intranodular and interface inflammation. In addition, zones of dense ductular proliferation are prominent. These demonstrate mild nuclear atypia, but overall the changes are reactive in nature. We find such zones in some 5-10% of explanted cirrhotic livers, and often they correspond to areas in which hepatic venules have been occluded and led to parenchymal collapse. No ground-glass hepatocytes, viral inclusions, cytoplasmic globules, iron deposition, bile duct loss, or changes of steatohepatitis are seen.

Please mail comments, corrections or suggestions to the TPIS administration at the UPMC.