Liver and intrahepatic bile ducts-nontumor

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Liver and intrahepatic bile ducts-nontumor

Biliary tract disease

Cholestasis

Reviewers: Komal Arora, M.D. (see Reviewers page)
Revised: 9 May 2012, last major update May 2012
Copyright: (c) 2004-2012, PathologyOutlines.com, Inc.

General
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● Bile stagnation due to hepatocellular dysfunction, intra- or extrahepatic biliary obstruction
● Other causes: pregnancy (World J Gastroenterol 2009;15:2049), benign familial recurrent cholestasis, medications (Hepatology 2011;53:1377), postoperative, sepsis, amiodarone (Arch Pathol Lab Med 1999;123:251); rarely malaria falciparum (Arab J Gastroenterol 2012;13:35)
● Symptoms: pruritis (due to bile acid deposition in skin), skin xanthomas (due to hyperlipidemia); may cause deficiencies of fat soluble vitamins A, D, E, K
● Laboratory: elevated serum alkaline phosphatase (present in bile duct epithelium and hepatocyte canalicular membrane), elevated serum bilirubin

Micro description
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● Bile pigment within hepatic parenchyma (green-brown bile plugs), also within Kupffer cells, foamy degeneration of hepatocytes, bile duct proliferation (proliferation of epithelial cells and looping/reduplication of ducts), concretions, periportal neutrophils
● Late - bile lakes, portal tract fibrosis

Micro images
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Cholestasis

End of Liver and intrahepatic bile ducts-nontumor > Biliary tract disease > Cholestasis

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