Hepatic fibrosis - Female, 52 - Tissue image [5250730010648641]

This is the histopathological image of LIVER AND INTRAHEPATIC BILE DUCTS tissue sample obtained in Medical University Gdańsk and deposited in ZMDL-GUMED. The sample image was taken using: Pannoramic 250 3DHistech slide scanner (20x magnification) and saved to DICOM format. The detailed information about the patient, sample, and diagnosis are as follows: Patient:Age: 52Clinical description: Liver cirrhosis.Gender: FemaleDiagnosis:Classification: ICD-10_10-20Classification code: Chapter XI - Diseases of the digestive systemDiagnosis: Hepatic fibrosisResult of the histopathological examination: (Liver oligobiopsy in 2 sections, including 1 partially fragmented.)
More than half of the portal spaces are significantly or very significantly dilated, contain an abundant and very abundant number of mononuclear inflammatory cells, mainly lymphocytic, with an admixture of not very numerous eosinophils, separating fairly well from the lobule borderline; the remaining portal spaces were usually slightly widened. Within the most dilated portal spaces, lymph nodes forming, quite numerous HPCs-line cells differentiating into hepatocytes, and bile duct proliferation (well shown in IHC staining for CK7 and CK19) are visible; the basement membrane of some bile ducts is focally crossed by individual lymphocytic cells.
In the examined biopsy there are features of marked intensified periportal fibrosis with formation of incomplete fibrous bridges, and not too numerous but quite thick fibrous bridges of the portal-portal type and a single portal-central type bridge; there are also minor foci of intramedullary fibrosis.
In fever, not too many hepatocytes are found, showing the features of: cytoplasmic degeneration or intracellular bile stagnation, or glycogenic degeneration of the testes.
The microscopic image of the examined biopsy shows progressive fibrosis of the organ (without cirrhosis).
However, taking into account the morphological and clinical picture and the results of laboratory tests [positive anti-mitochondrial antibodies (AMA) in the blood serum], the onset of primary cirrhosis (PBC) cannot be ruled out.
IHC: SMA - numerous activated hepatic stellate cells;
Turnbull's blue (for the presence of Fe ++) - negative.Sample:Material: FFPECollecting method: Surgical specimenTopography: DIGESTIVE ORGANSOrgan: LIVER AND INTRAHEPATIC BILE DUCTSTissue: LiverType of staining: positive/IHCStaining: Not applicableAntibody: CK 19Technology:Equipment: Pannoramic 250 3DHistechLens: 20xOrganization:Source: Medical University Gdańsk