Liver and intrahepatic bile ducts - nontumor
General
Normal histology
Copyright: 2002-2020, PathologyOutlines.com, Inc.
PubMed Search: Liver histology[title] normal[title]
General
Normal histology
Author: Komal Arora, M.D.
Topic Completed: 1 April 2012
Minor changes: 16 March 2020
Copyright: 2002-2020, PathologyOutlines.com, Inc.
PubMed Search: Liver histology[title] normal[title]
Table of Contents
Definition / general | Acini | Bile canaliculi | Bile ducts (intrahepatic) | Bile ductules | Central veins | Hepatocytes | Kupffer cells | Limiting plate | Lobules | Portal triad / portal tract | Reticulum | Sinusoids | Stellate cellsCite this page: Arora K. Normal histology. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/livernormalhistology.html. Accessed May 30th, 2020.
Definition / general
- Size of structures varies according to closeness to hepatic hilum
Acini
Definition / general
Diagrams / tables
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- Hemodynamic model of hepatic microanatomy that explains centrilobular necrosis
- Is a concept, not an identifiable microscopic structure; triangular (spherical) area
- Base is terminal twigs of hepatic artery and portal vein
Diagrams / tables
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Acini
Bile canaliculi
Definition / general
Microscopic (histologic) images
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Electron microscopy images
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- Drain bile from hepatocytes to portal space
- 1 - 2 micron wide areas between neighboring hepatocytes, formed by grooves in plasma membranes and separated from vascular space by tight junctions
- Intracellular actin and myosin filaments surrounding the canaliculi, propel secreted biliary fluid along canaliculi into canals of Hering, the terminal tributaries of the bile duct system (low cuboidal epithelium), to interlobular bile ducts (more robust cuboidal epithelium)
- Connected to bile ducts by cholangioles (bile ductules), usually not visible unless distended by bile
- Highlighted by CEA which stains biliary glycoprotein I in canalicular membrane (cross reacting substance)
Microscopic (histologic) images
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Bile canaliculi between hepatocytes
Silver stain shows network of canaliculi radiating away from central vein of lobule
Electron microscopy images
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Bile canaliculi (BC), MV=microvilli
Bile ducts (intrahepatic)
Definition / general
Microscopic (histologic) description
Microscopic (histologic) images
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Positive stains
- Develop from primitive hepatocytes of periportal limiting plate
Microscopic (histologic) description
- Cuboidal cells with mildly basophilic cytoplasm and single nuclei
Microscopic (histologic) images
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Normal bile ducts
Positive stains
Bile ductules
Definition / general
Microscopic (histologic) description
Microscopic (histologic) images
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Positive stains
- Also called ductular cells, cholangioles
- Converge from hepatic lobule onto portal tract and connect bile canaliculi to the interlobular bile ducts
- Represent the most proximal portion of the bile drainage pathway with a cholangiocyte lining
- Usually not seen in normal liver
- Proliferate in pathologic conditions and can differentiate into hepatocytes to repopulate a destroyed liver
Microscopic (histologic) description
- Small ovoid cells lying singly at periphery of portal tract or as strings within the lobule; not accompanied by artery
Microscopic (histologic) images
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Bile ductules due to chronic hepatitis C
Positive stains
Central veins
Definition / general
Microscopic (histologic) images
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- Also called terminal hepatic venules (NOT terminal hepatic vein)
- Found at center of hepatic lobule
- Smallest component of venous outflow tract, merge to form hepatic veins, then empty into inferior vena cava
Microscopic (histologic) images
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Single vein at center of lobule
Hepatocytes
Definition / general
Microscopic (histologic) images
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Positive stains
Electron microscopy images
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- Polygonal cells 25 - 30 microns, arranged in three dimensional plates that radiate away from central vein towards portal tracts
- Two cells thick in children ages 0 - 5 years; one cell thick at age 5 years or more
- Lined by sinusoids on two sides in which blood flows from portal space to central vein
- Also have biliary and lateral surfaces (for attachment to adjacent hepatocytes)
- Cells are uniform with abundant granular and eosinophilic cytoplasm with scattered fat vacuoles, glycogen and lipofuscin (prominent in centrilobular hepatocytes, increases with age); have central round to oval nuclei but nuclei may be pleomorphic and multiple (all mononuclear at birth, 10% binuclear at 8 years, 15% at 15 years, 25% in adults)
- Hepatocytes are continuously renewed with proliferation near portal space and death near central vein at 50 - 300 days
- Mitotic figures are rare
Microscopic (histologic) images
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Hepatocytes
Positive stains
Electron microscopy images
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Various images
Kupffer cells
Definition / general
Microscopic (histologic) images
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Positive stains
- Attached to endothelium in space of Disse
- Phagocytic cells that are part of reticuloendothelial system; triangular or star shaped with bean shaped nuclei and clear to granular cytoplasm
- Proliferate and enlarge in response to hepatocyte damage
- Degrade hemoglobin to unconjugated bilirubin
- Contain ceroid pigment, PAS+ diastase resistant granules that represent degraded cellular debris
Microscopic (histologic) images
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Kupffer cells
PAS diastase
Positive stains
Limiting plate
Definition / general
Microscopic (histologic) images
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- Encircling ring around portal tracts formed by lamina propria of hepatocytes immediately abutting the portal tract
- Disrupted by inflammation with hepatocellular death (piecemeal necrosis)
Microscopic (histologic) images
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Normal portal tract with bile duct, hepatic arteriole, portal venule and clearly defined limiting plate (arrows)
Chronic hepatitis shows destruction of limiting plate by inflammatory cells extending from portal tract into periportal parenchyma with necrosis / apoptosis of hepatocytes
Lobules
Definition / general
Diagrams / tables
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Microscopic (histologic) images
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- Traditional model of hepatic microanatomy
- 1 - 2 mm hexagonal area with a central terminal hepatic venule (also called central vein) and 3 - 6 portal tracts at periphery
- Centrilobular zone surrounds central vein and periportal zone adjoins portal tract
- Zone 1 is closest to vascular supply / portal tract, zone 3 is closest to central vein, is called centrilobular area, is furthest from arterial blood and most prone to vascular insults
Diagrams / tables
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Diagrams
Microscopic (histologic) images
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Lobule with central vein
Portal vein dye injection highlights lobule and blood flow towards not visible central vein
Portal triad / portal tract
Definition / general
Diagrams / tables
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Microscopic (histologic) images
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- Contains intrahepatic bile ducts, branches of hepatic artery, branches of portal vein
- 70 - 80% of arteries are normally accompanied by bile ducts
- Normally contains small numbers of lymphocytes and macrophages and occasional mast cells and eosinophils
- No neutrophils or plasma cells normally
- Row of hepatocytes around portal tract is ductal plate (limiting plate), contains stem cells responsible for bile duct growth and development
- Bile ducts are lined by cuboidal epithelium
- Portal tracts are more fibrotic in subcapsular zone
Diagrams / tables
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Diagram
Microscopic (histologic) images
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Portal tract
Reticulum
Definition / general
Microscopic (histologic) images
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- Collagen fibers in space of Disse, stain black with silver impregnation, produced by Ito cells
- Forms supporting framework of hepatocytes
- If present, even necrotic liver can regenerate
- If damaged, liver heals with fibrosis and possibly cirrhosis
Microscopic (histologic) images
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Reticulin stain
Sinusoids
Definition / general
Microscopic (histologic) images
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Negative stains
Electron microscopy images
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- Interposed between hepatic plates, carry arterial / venous blood to terminal hepatic vein, lined by fenestrated and discontinuous endothelial cells and Kupffer cells, which demarcate an extrasinusoidal space of Disse into which hepatocyte microvilli protrude
- Endothelial cells lack a basement membrane and lack the endothelial markers of larger vessels
Microscopic (histologic) images
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Sinusoids
Endothelial cells of sinusoid (PAS diastase)
Negative stains
Electron microscopy images
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Sinusoids
Stellate cells
Definition / general
Microscopic (histologic) images
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Positive stains
- Also called Ito cells
- Fat containing hepatic stellate cells of mesenchymal origin in space of Disse
- Not normally seen on routine H&E sections
- Activated after injury and transformed into myofibroblasts with liver fibrosis and inflammation
- Store and metabolize vitamin A
- May become laden with fat in hypervitaminosis A
Microscopic (histologic) images
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Fat stain
Stellate cell (Ito cell) lipidosis
Positive stains
