Difference between revisions of "Cirrhosis"
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# | '''Cirrhosis''' is end stage [[liver fibrosis|fibrosis]] of the [[liver]]. | ||
==General== | |||
*Cirrhosis ''is'' stage 4 (Laennec). | |||
Etiology: | |||
*Perisinusoidal fibrosis may suggest congestive hepatopathy.<ref>OA. September 15, 2009.</ref> | |||
*In NAFLD portal-to-portal fibrosis (septal/bridging fibrosis) tends to be more common than perivenular fibrosis.<ref name=pmid14991537>Pathologic features associated with fibrosis in nonalcoholic fatty liver disease. Gramlich T, Kleiner DE, McCullough AJ, Matteoni CA, Boparai N, Younossi ZM. Hum Pathol. 2004 Feb;35(2):196-9. PMID 14991537.</ref> | |||
*The etiology of late stage fibrosis (cirrhosis), may be impossible to determine. | |||
Prognosis: | |||
*The classic teaching is that cirrhosis is irreversible; however, there is increasing evidence that it regresses.<ref name=pmid11079009>{{Cite journal | last1 = Wanless | first1 = IR. | last2 = Nakashima | first2 = E. | last3 = Sherman | first3 = M. | title = Regression of human cirrhosis. Morphologic features and the genesis of incomplete septal cirrhosis. | journal = Arch Pathol Lab Med | volume = 124 | issue = 11 | pages = 1599-607 | month = Nov | year = 2000 | doi = 10.1043/0003-9985(2000)1241599:ROHC2.0.CO;2 | PMID = 11079009 }}</ref><ref name=pmid21286337>{{Cite journal | last1 = Kim | first1 = SU. | last2 = Park | first2 = JY. | last3 = Kim | first3 = do Y. | last4 = Ahn | first4 = SH. | last5 = Choi | first5 = EH. | last6 = Seok | first6 = JY. | last7 = Lee | first7 = JM. | last8 = Park | first8 = YN. | last9 = Chon | first9 = CY. | title = Non-invasive assessment of changes in liver fibrosis via liver stiffness measurement in patients with chronic hepatitis B: impact of antiviral treatment on fibrosis regression. | journal = Hepatol Int | volume = 4 | issue = 4 | pages = 673-80 | month = | year = 2010 | doi = 10.1007/s12072-010-9201-7 | PMID = 21286337 }}</ref><ref name=pmid24304452>{{Cite journal | last1 = Casado | first1 = JL. | last2 = Quereda | first2 = C. | last3 = Moreno | first3 = A. | last4 = Pérez-Elías | first4 = MJ. | last5 = Martí-Belda | first5 = P. | last6 = Moreno | first6 = S. | title = Regression of liver fibrosis is progressive after sustained virological response to HCV therapy in patients with hepatitis C and HIV coinfection. | journal = J Viral Hepat | volume = 20 | issue = 12 | pages = 829-37 | month = Dec | year = 2013 | doi = 10.1111/jvh.12108 | PMID = 24304452 }}</ref> | |||
Special types: | |||
*Garland cirrhosis ([[AKA]] holly leaf cirrhosis) - see ''[[primary biliary cirrhosis]]''. | |||
==Gross== | |||
Cirrhosis can be divided (in gross pathology) into: | |||
*Micronodular cirrhosis - classically due to [[alcohol]]. | |||
**Uniform, diffuse. | |||
*Macronodular cirrhosis - classically due to viral hepatitis. | |||
**Irregular. | |||
===Images=== | |||
*[http://www.meddean.luc.edu/lumen/MedEd/orfpath/cirhosis.htm Cirrhosis - macronodular & micronodular (meddean.luc.edu)]. | |||
==Microscopic== | |||
Formal Robbins definitions (all three required) is:<ref name=Ref_PCPBoD8_439>{{Ref PCPBoD8|439}}</ref> | |||
#Bridging fibrosis. | |||
#Nodule formation. | |||
#Disruption of the hepatic architecture. | |||
===Images=== | |||
<gallery> | |||
Image:Cirrhosis_high_mag.jpg | Cirrhotic liver - trichrome stain. (WC/Nephron) | |||
</gallery> | |||
==See also== | |||
*[[Medical liver pathology]]. | |||
==References== | |||
{{Reflist|1}} | |||
[[Category:Diagnosis]] | |||
[[Category:Liver pathology]] | |||
Latest revision as of 04:12, 11 June 2016
Cirrhosis is end stage fibrosis of the liver.
General
- Cirrhosis is stage 4 (Laennec).
Etiology:
- Perisinusoidal fibrosis may suggest congestive hepatopathy.[1]
- In NAFLD portal-to-portal fibrosis (septal/bridging fibrosis) tends to be more common than perivenular fibrosis.[2]
- The etiology of late stage fibrosis (cirrhosis), may be impossible to determine.
Prognosis:
- The classic teaching is that cirrhosis is irreversible; however, there is increasing evidence that it regresses.[3][4][5]
Special types:
- Garland cirrhosis (AKA holly leaf cirrhosis) - see primary biliary cirrhosis.
Gross
Cirrhosis can be divided (in gross pathology) into:
- Micronodular cirrhosis - classically due to alcohol.
- Uniform, diffuse.
- Macronodular cirrhosis - classically due to viral hepatitis.
- Irregular.
Images
Microscopic
Formal Robbins definitions (all three required) is:[6]
- Bridging fibrosis.
- Nodule formation.
- Disruption of the hepatic architecture.
Images
Cirrhotic liver - trichrome stain. (WC/Nephron)
See also
References
- ↑ OA. September 15, 2009.
- ↑ Pathologic features associated with fibrosis in nonalcoholic fatty liver disease. Gramlich T, Kleiner DE, McCullough AJ, Matteoni CA, Boparai N, Younossi ZM. Hum Pathol. 2004 Feb;35(2):196-9. PMID 14991537.
- ↑ Wanless, IR.; Nakashima, E.; Sherman, M. (Nov 2000). "Regression of human cirrhosis. Morphologic features and the genesis of incomplete septal cirrhosis.". Arch Pathol Lab Med 124 (11): 1599-607. doi:10.1043/0003-9985(2000)1241599:ROHC2.0.CO;2. PMID 11079009.
- ↑ Kim, SU.; Park, JY.; Kim, do Y.; Ahn, SH.; Choi, EH.; Seok, JY.; Lee, JM.; Park, YN. et al. (2010). "Non-invasive assessment of changes in liver fibrosis via liver stiffness measurement in patients with chronic hepatitis B: impact of antiviral treatment on fibrosis regression.". Hepatol Int 4 (4): 673-80. doi:10.1007/s12072-010-9201-7. PMID 21286337.
- ↑ Casado, JL.; Quereda, C.; Moreno, A.; Pérez-Elías, MJ.; Martí-Belda, P.; Moreno, S. (Dec 2013). "Regression of liver fibrosis is progressive after sustained virological response to HCV therapy in patients with hepatitis C and HIV coinfection.". J Viral Hepat 20 (12): 829-37. doi:10.1111/jvh.12108. PMID 24304452.
- ↑ Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 439. ISBN 978-1416054542.