Hepatic fibrosis - Female, 52 - Tissue image [525073001064761]

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/HCStaining: Masson TrichromeAntibody: Not applicableTechnology:Equipment: Pannoramic 250 3DHistechLens: 20xOrganization:Source: Medical University Gdańsk

本数据集为格但斯克医科大学获取并存入ZMDL-GUMED的肝脏及肝内胆管组织样本的组织病理学图像。该样本图像采用Pannoramic 250 3DHistech玻片扫描仪采集（放大倍数20倍），并以DICOM格式存储。

患者、样本及诊断详情如下：
患者：年龄52岁，女性，临床诊断为肝硬化。
ICD-10分类编码为ICD-10_10-20，归属第十一章——消化系统疾病，最终病理诊断为肝纤维化。
组织病理学检查结果：（肝少组织活检标本共2份切片，其中1份部分碎裂）。
超过半数的门管区显著或极显著扩张，内含大量乃至极大量单核炎症细胞，以淋巴细胞为主，混有少量嗜酸性粒细胞，与肝小叶边界分界清晰；其余门管区多呈轻度扩张。在扩张最显著的门管区内，可见形成淋巴滤泡的、数量较多的肝祖细胞（Hepatic Progenitor Cells, HPCs）——可分化为肝细胞，以及胆管增生（经CK7和CK19免疫组化（Immunohistochemistry, IHC）染色可清晰显示）；部分胆管的基底膜可见单个淋巴细胞局灶性浸润。
本次活检标本可见明显的汇管周围纤维化加重，形成不完全纤维间隔，汇管区-汇管区型纤维间隔数量不多但较粗大，可见1个汇管区-中央静脉型纤维间隔；同时存在少量髓内纤维化灶。
本次活检标本中肝细胞数量不多，可见以下病变：细胞质变性、细胞内胆汁淤积，或肝细胞糖原变性（原文疑似笔误，原表述为“glycogenic degeneration of the testes”，结合上下文修正为肝细胞相关病变）。
活检镜下表现为肝脏进行性纤维化（无肝硬化表现）。
结合形态学特征、临床表型及实验室检查结果[血清抗线粒体抗体（anti-mitochondrial antibodies, AMA）阳性]，不能排除原发性胆汁性肝硬化（Primary Biliary Cholangitis, PBC）的可能。
免疫组化结果：SMA标记可见大量活化的肝星状细胞；
滕氏蓝染色（检测Fe++）：阴性。

样本详情：
样本材质：福尔马林固定石蜡包埋（Formalin-Fixed Paraffin-Embedded, FFPE）
采集方式：手术标本
解剖部位：消化系统器官
靶器官：肝脏及肝内胆管
组织类型：肝脏
染色类型：阳性/对照
染色方法：Masson三色染色
所用抗体：无适用抗体
技术与设备：Pannoramic 250 3DHistech
物镜倍数：20倍
机构来源：格但斯克医科大学