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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]] | |||