Contributed by Anthony Demetris, M.D.
PATIENT HISTORY:
The patient is a elderly female who presented with mild fatigue, aching and arthritis with elevated serum ferritin 758 ng/ml. Total iron 125 ug/dl (35-150), iron binding capacity 217 ug/dl (260-445), % saturation 58 (18-50). No hepatomegaly or history of hematological disease.
Final Diagnosis (Case 96)
PART 1:LIVER, NEEDLE BIOPSY -
- MARKED (3-4 ON A SCALE OF 0-4) PREDOMINANTLY HEPATOCELLULAR IRON DEPOSITION, MOST CONSISTENT WITH HEREDITARY HEMOCHROMATOSIS (see microscopic description).
- MILD TO MODERATE PORTAL FIBROSIS WITH MILD ARCHITECTURAL DISTORTION.
- MILD CHRONIC PORTAL TRACT INFLAMMATION WITH LOW GRADE INTERFACE ACTIVITY (see microscopic description).
(1 H&E, 1 Iron), The specimen consists of a fragmented needle core biopsy of liver. The normal lobular architecture is mildly to moderately distorted in some areas by mild to moderate portal fibrosis, a mild ductular reaction, and a mild predominantly mononuclear inflammatory cell infiltrate. Neither florid duct lesions nor ductopenia are seen. There is mild interface activity in most of the triads.
Previous Biopsies on this Patient:
None
TPIS Related Resources:
Liver transplant topics
Hepatic Iron index calculator
Gross Description - Case 96
Two (2) consult slides and one (1) consult block.
Microscopic Description - Case 96
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