Curriculum for Specialty Certificate Examination in Gastroenterology

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Sunday 14 April 2013

primary biliary cirrhosis

The histologic images show a portal area with a collection of non-caseating granulomas, lymphocytes, and several small, residual bile ducts (top image). Also, a classic "florid duct lesion" is illustrated on the bottom image. The histologic findings are classic for primary biliary cirrhosis.

3 comments:

  1. A liver biopsy specimen obtained from a patient with newly diagnosed PBC would most likely show which of the following?

    1-Ground-glass appearance of hepatocytes
    2-Ductopenia and florid bile duct lesion
    3-Microvesicular fat and hyaline bodies
    4-Obliterative fibrosis cholangitis
    5-“Owl’s-eye” inclusions

    The initial lesion found on liver biopsy of a patient with PBC is damage to epithelial cells in the small bile ducts. The most important and only diagnostic clue in many cases is ductopenia (defined as the absence of interlobular bile ducts in >50% of the portal tract). The florid duct lesion, in which the epithelium of the interlobular and segmental bile ducts degenerates segmentally with formation of poorly defined, noncaseating, epithelioid granulomas, is nearly diagnostic of PBC, although this lesion is found in a relatively small proportion of patients, mainly those with early-stage disease.

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