Account-creators
179
edits
Difference between revisions of "Primary biliary cholangitis"
Jump to navigation
Jump to search
Primary biliary cholangitis (view source)
Revision as of 16:31, 25 October 2016
, 16:31, 25 October 2016→Images: added case with cirrhosis
(→Images: Added a case & adjusted matters for old cases with minor edits) |
(→Images: added case with cirrhosis) |
||
| Line 126: | Line 126: | ||
|} | |} | ||
Primary biliary cirrhosis with bridging fibrosis. Acini & lobules distorted by inflammation (Row 1 Left 40X) Loose granuloma in triad without duct (Row 1 Right 200X) Well-formed granuloma (Row 2 Left 200X) Piecemeal necrosis, PAS without diastase (Row 2 Right 200X) Damaged bile duct, PAS with diastase (Row 3 Left 400X) Bridging fibrosis, trichrome (Row 3 Right,200X) | Primary biliary cirrhosis with bridging fibrosis. Acini & lobules distorted by inflammation (Row 1 Left 40X) Loose granuloma in triad without duct (Row 1 Right 200X) Well-formed granuloma (Row 2 Left 200X) Piecemeal necrosis, PAS without diastase (Row 2 Right 200X) Damaged bile duct, PAS with diastase (Row 3 Left 400X) Bridging fibrosis, trichrome (Row 3 Right,200X) | ||
{| | |||
[[File:1 PBC 5 680x512px.tif|Stage 4 PBC.]] | |||
[[File:2 PBC 5 680x512px.tif| Stage 4 PBC.]] | |||
<br> | |||
[[File:3 PBC 5 680x512px.tif| Stage 4 PBC.]] | |||
[[File:4 PBC 5 680x512px.tif| Stage 4 PBC.]] | |||
<br> | |||
[[File:5 PBC 5 680x512px.tif| Stage 4 PBC.]] | |||
[[File:6 PBC 5 680x512px.tif| Stage 4 PBC.]] | |||
|} | |||
Primary biliary cirrhosis with Metavir stage 4 fibrosis (extensive fibrosis/cirrhosis). The patient was AMA positive and ANA negative. A. Inflamed tracts and bridges are intensely inflamed, with odd appearing edges of hepatocytes (arrows), suggestive of a jig saw pattern [40x]. B. Trichrome shows thin fibrous bands bounding regenerative isles (arrows) [Trichrome, 100X]. C. Reticulin shows two cell thick cords and cords lacking orientation, documenting regeneration; black lines about single cells document piecemeal necrosis [100X]. D. Lymphocytes, plasma cells, and macrophages, show piecemeal necrosis, surrounding hepatocytes (cyan arrows), as well as spreading into the lobule (green arrows), with aggregates reflecting spotty necrosis (black arrow). [400X]. E. PAS with diastase highlights a proliferated bile ductule (arrows) with epithelial damage [400X]. F. PAS with diastase shows an arteriole (green arrow) at great distance from an isolated bile ductule at the periphery of the triad (cyan arrow), consistent with loss of bile duct; neutrophils (black arrows) do not prove ascending cholangitis [400X]. | |||
===Staging PBC=== | ===Staging PBC=== | ||