Microscopic Description -- Hepatitis C



Part 1:

Part 1 consists of a native hepatectomy specimen. The normal hepatic architecture is replaced by well-developed cirrhosis of mixed macronodular and micronodular patterns. The fibrous septa are wide and contain a mild lymphocytic infiltrate focally enriched by eosiniphils, occasionally in nodular aggregates. Cholangiolar proliferation is seen, but the native bile ducts are intact. Minimal piecemeal necrosis is seen. The cirrhotic nodules demonstrate mild hepatocellular swelling, Kupffer cell hypertrophy, oncocytic hepatocellular metaplasia, moderate macrovesicular steatosis which does not show a particular predilection in the distribution and moderate microvesicular steatosis. Extensive Mallory's hyaline deposition in the central and periportal distribution is appreciated. Marked hepatocanalicular cholestasis, mild mixed sinusoidal inflammation and mild hepatocellular iron deposition are present. No ground- glass cells are seen. Large cell dysplasia and focal low grade small cell dysplasia are appreciated, but no evidence of malignancy is seen. Section 1C, from the medium segment of the left lobe contains an infarcted nodule. Again, no evidence of malignancy of invasion is appreciated, but however, this will be further evaluated (deeper levels to follow). In section 1D (superficial hilum), the peribiliary glands show mild inflammatory atypia; no architectural or cytologic abnormality is appreciated. The hepatic vein resection margins are unremarkable. The PASD stain demonstrates heavy background, but it is negative for Alpha-1 antitrypsin globules.

Part 2:

Part 2 is labeled post-perfusion liver biopsy and consists of a needle core of liver parenchyma. More than seven portal tracts are recognized, which are essentially unremarkable. Throughout the lobules, there is mild hepatocellular swelling, Kupffer cell hypertrophy, focal central vein fibrosis, mild macrovesicular steatosis with focal fat correlations and moderate microvesicular steatosis. Mild sinusoidal neutrophilia is appreciated. No necrosis or viral inclusions are seen.

Final Diagnoses


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