Q. Kindly interpret my liver biopsy report and confirm if I have cirrhosis.

Answered by
Dr. Ujjal Kanti Ray
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Dec 21, 2020

Hello doctor,

Please interpret the liver biopsy report shown below. Kindly explain the what stage of fibrosis and confirm whether cirrhosis is present or not.

Pathological diagnosis:

A. Liver parenchyma biopsy:

Steatohepatitis with perisinusoidal and periportal fibrosis.

Note:

The biopsy shows preservation of the architecture.

Trichrome and reticulin stains highlight foci of perisinusoidal and periportal fibrosis.

The portal tracts show patchy chronic inflammation composed predominantly of small lymphocytes.

Interface activity is not identified.

The interlobular bile ducts are intact without injury.

The lobular parenchyma is notable for 30% macrovesicular steatosis.

Rare hepatocytes show ballooning degeneration with mallory hyaline inclusions.

There are scattered foci of inflammatory activity throughout the parenchyma.

Cholestasis is not seen.

The hepatic vasculature is unremarkable.

The iron stain shows trace storage iron.

PAS stain after diastase digestion is negative for diagnostic cytoplasmic inclusions.

Clinical data:

Patient is a 48-year-old male with fatty liver and elevated LFTs presents for liver.

Parenchymal biopsy.

Operation: none provided.

Operative findings: none provided.

Clinical diagnosis: fatty liver.

Tissue submitted:

A/1. Liver parenchyma biopsy.

Gross description:

Part A is received in formalin, labeled with the patient's name, Liver parenchyma biopsy and consists of 4 tan-brown cylindrical soft tissue fragments (ranging from 0.3-1.7 cm in length by 0.1 cm diameter) which are submitted in toto. A1: 4 fragments

#

Hello,

Welcome to icliniq.com.

The most common cause of periportal and perisinusoidal fibrosis with chronic inflammatory cell infiltration is due to steatohepatitis in both alcoholic and non-alcoholic. However, chances are very high in alcoholics. Periportal fibrosis can occur due to Schistosoma mansoni residing at some pocket in the middle east. Your report does not suggest frank portal cirrhosis. LFT (liver function test) will indicate the functional condition of the liver. If it responds to the treatment, reversal is possible; otherwise, it may lead to frank portal cirrhosis.

Thank you doctor,

Does the report provide enough details to determine the stage of fibrosis, i.e., F1, F2, F3, etc.? Also, is Schistosoma mansoni the only cause? How would a person who never traveled abroad get this condition?

#

Hello,

Welcome back to icliniq.com.

I told Schistosoma mansoni can cause this type of condition without knowing your tour habits. If you were never out of your country, then this possibility is ruled out. Often this is a common question to the pathologists to assess the staging and prognosis of the patient. It is very difficult to stage fibrosis. Moreover, clinical data and lab reports are important. So far, with the information given in the report, there is no portal invasion of fibrosis and no interlobular bridging of fibrosis. F1 to F4 staging is normally done to assess the stage of cirrhosis.

In my opinion, your diagnosis is not cirrhosis. It is liver inflammation due to fatty changes and chronic inflammation of the liver. Alcohol consumption in excess is an important cause. You did not mention that. So far, fibrosis is concerned, it is from 0 to 1. Do not get panic. Give up Alcohol if you are used to it. You are obese and need to reduce your weight a lot.

I hope this helps.


Was this answer helpful?

 | 

Related Questions:
How to cure hepatitis C viral disease?

We approached another doctor, who requested us to get back with the following test results: hepatitis C viral (HCV RNA) quantitative real-time PCR - 2744422 IU/mL, linear reporting range of the assay is 43 to 69 X 10 (7...   Read full

Can you see the attached CBC report, and let me know if there is anything serious ?

.. gone through your wife's reports (attachment removed to protect patient identity). The report shows schistocytes, which are fragmented RBC (red blood cell), commonly seen in hemolytic anemia. So, to rule out hemolysis, serum LDH (lactate dehydr...   Read full

Please suggest me a suitable therapy for lower back pain.

Get tested for hepatitis B and C, autoimmune liver markers and probably a liver biopsy ...   Read full

Also Read Answers From:

Comprehensive Medical Second Opinion.Submit your Case

Related Questions & Answers


Please help me interpret my reports.

Query: Hello doctor, I am a 23 year old female. I am bulimic for the past nine years and also suffering from anxiety and depression for the past five years. I like to drink alcohol a lot. I recently had a checkup and I have attached my test reports for your reference. I am just taking vitamin supplements...  Read Full »

Kindly help me interpret my liver USG report.

Query: Hello doctor, Four months before, I was diagnosed with fatty liver, slightly elevated fasting sugar and the level of total cholesterol. My current medications are tablet Viboliv 500 daily two times in a restricted diet and Nexpro RD. I had consumed spicy foods rarely. In the last four months, I l...  Read Full »

Hemoglobin, RBC, and WBC are going down rapidly. What can be the reason?

Query: Hello doctor, My husband's hemoglobin is 3.7 g/dL, but the hemoglobin level was 5 g/dL when we checked it two days back. His RBC and WBC are also going down. What can be the reason?  Read Full »

Also Read


I am suffering from dry and scaly scalp. Is that scalp psoriasis?
Hello doctor, I am suffering from dry, scaly patches on the scalp for the last six to eight months. Since childhood, I h...  Read more»
Birth Control Methods - Facts, and Types
Devices or treatments done to prevent unwanted pregnancy are called birth control methods.In this article, I am going to...  Read more»
Crohn's Disease
Crohn's disease causes inflammation of the digestive tract, which results in symptoms like severe diarrhea, stomach pain...  Read more»

Ask your health query to a doctor online?

Ask a Pathologist Now

* guaranteed answer within 4 hours.

Disclaimer: All health Q&As published on this website are not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.