Hepatic histology

In primary biliary cirrhosis there are four stages of increasing histological severity:

• stage I - characterized by portal inflammation with or without florid bile duct lesions
  • shrunken and necrotic biliary epithelial cells
  • granulomata centred on small intrahepatic bile ducts
  • inflammation remains confined to the portal triads
  • primarily a lymphocytic infiltrate
• stage II- interface hepatitis
  • many portal triads are scarred
  • inflammation spills over into liver parenchyma
  • bile ducts may become tortuous with lumenal obliteration
• stage III:
  • scarring results in portal triads being linked by fibrous septa
• stage IV:
  • frank cirrhosis

Reference:

• (1) Lindor KD et al. Primary biliary cirrhosis. Hepatology. 2009;50(1):291-308