Liver Biopsy - Pathalogy report

[thaiduong]

I just had a biopsy on 30 March 2004 and the results are back (please see the report below).  Please help me to make sense out of this report and what is my liver cuurent status based on the biopsy report. I'm trying to do some findings/reserach prior to seeing my doctor.

Thanks
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Pathology Report -- Liver Biopsy

MICROCOSPIC FINDINGS:

The sections reveal multiple needle like fragments of liver parenchyma showing some preservation of the architecture, there is some mild fatty infiltration which is patchy. The parenchyma shows an occasional focus of individual liver cell drop out but no balloon generation or councilman bodies are seen. There is no bile stasis. A rare nucleus shows glycogenation. The portal areas show some expansion, chronic inflammation and some break in the limiting plate with a few inflammatory cells spilling
into the adjacent lobule. An occasional bile duct radicle is identified. No marked increase in fibrosis or bridging is identified.

Special stains with trichrome show some portal fibrosis but no distinct bridging or cirrhosis noted.

DIAGNOSTICS:

NEEDLE BIOPSY OF LIVER SHOWING PORTAL TRIADITIS, MINIMAL FATTY INFILTRATION AND CHRONIC HEPATITIS, COMPATIBLE WITH HEPATITIS-C INFECTION

NO BRIDGING FIBROSIS OR CIRRHOSIS NOTED.

THE SEVERITY INDEX IS SCORE AT 8 OUT OF A SCORE OF 28
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[Kevin Pho, MD]

There are a variety of scores that are used to grade the severity of a liver biopsy - so I cannot comment on this particular one that is used.

Liver histology is useful for predicting the stage and prognosis of the disease. Patients with cirrhosis should undergo periodic screening for hepatocellular carcinoma, and upper endoscopy to evaluate for varices.

Once treatment has started, the baseline liver histology can assist in decisions regarding medication adjustment in patients who experience adverse effects. As an example, the threshold to discontinue therapy may be relatively high in patients who have advanced histologic features.

A liver biopsy can establish the presence of concomitant diseases (such as hemochromatosis, alcoholic hepatitis, and hepatic sarcoidosis), and the degree to which these conditions contribute to the liver disease.

A biopsy itself does not determine who receives treatment for hepatitis C.  Your present biopsy findings are relatively non-specific - but reassuring in that there was no evidence of cirrhosis.  This suggests that there has not been any permanent liver damage.

As a general rule, patients who are considered for treatment should have histologic and virologic evidence of chronic infection (ie, HCV RNA detectable in serum) and an elevated serum ALT.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

Bibliography:
Chopra.  Treatment of chronic hepatitis C virus infection: Recommendations.  UptoDate, 2004.

[surgeon]

the description is fairly non-descript; there aren't dramatic abnormalities. The inflammation is compatible with (meaning it might be due to) hepaptitis C, but there aren't signs of severe damage. It has to be understood in the context of your overall situation, information about which isn't provided. Your doctors ought to be able to put it in context.

[julocks]

A related discussion, liver biospy was started.