Liver and intrahepatic bile ducts-nontumor
Biliary tract disease
Acute large duct obstruction
Reviewers: Komal Arora, M.D. (see Reviewers page)
Revised: 21 May 2012, last major update May 2012
Copyright: (c) 2004-2012, PathologyOutlines.com, Inc.
● Biopsies have decreased due to improved imaging
● Usually due to gallstones in common bile duct; also bile plugs or surgical ligation
● Associated with marked but transient increase in ALT/AST
● Without treatment, may progress to portal fibrosis and biliary cirrhosis with loss of bile ducts
● Note: cholestasis and ductular proliferation are non-specific changes
● Early - centrilobular canalicular cholestasis with edema of portal tracts, proliferation of small bile ductules (CK7+) without lumina at periphery of portal tract and neutrophils outside of the ducts, bile stasis in hepatocytes and canaliculi
● Late - bile accumulation within ducts and ductules and possibly bile lakes (very specific); feathery degeneration of hepatocytes adjacent to areas of cholestasis, foamy and bile-containing Kupffer cells; may develop portal-portal bridging fibrosis and ultimately cirrhosis with a jigsaw-like pattern
● Lobule is not affected since injury occurs via portal tracts
● Sepsis (neutrophils present within lobules as well as portal areas), drug reaction, treated liver transplant rejection, hyperalimentation toxicity
● J Clin Pathol 1994;47:457
End of Liver and intrahepatic bile ducts-nontumor > Biliary tract disease > Acute large duct obstruction
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