liver biopsy results

[cam4930]

Liver biopsy conducted on 9/17/2010. I am curious about what the report says. Thanks

------ report -------------
FINAL PATHOLOGIC DIAGNOSIS
Liver, Core Biopsy Specimen:
Portions of Benign Hepatic Parenchyma Showing Histologic Changes Consistent with Chronic Hepatitis, Clinically Chronic Hepatitis B per Corrected Clinical History,
with Minimal Necroinflammatory Activity (Grade 0 to 1 Inflammation)
and No Significant Fibrosis Seen (Stage 0 Fibrosis).

COMMENT: Sections of the liver core biopsy specimen reveal a generous sample for evaluation consisting of multiple cores of benign hepatic parenchyma with an intact lobular architecture. Steatosis is not present. The central veins are unremarkable. Within the portal tracts, there are lymphoid aggregates seen and an isolated focus of interface change is identified. Within the lobule, a tiny focus of spotty necrosis is present. Granulomata are not identified. There is no evidence of a chronic cholangiopathy nor is bile duct
proliferation seen. Stainable iron is not evident on special stain. Reticulin and trichrome stains show a normal connective tissue architecture, without evidence of hepatic fibrosis or cirrhosis. There is no evidence of malignancy present.

Final Comment: The histologic findings are interpreted as a minimal degree of chronic hepatitis
(grade 0 to 1 of 4) with no significant fibrosis (stage 0 of 4) compatible with the clinical history of chronic hepatitis B (per corrected clinical history).

Addendum Comment: Immunohistochemical stain is performed for hepatitis B surface antigen. No immunoreactivity is detected in the biopsy specimen.

[cam4930]

I just ask my doctor. He basically said it is possible for serum HBsAg+ patients showing intrahepatic HBsAg-.

Studies show that the pattern of intrahepatic HBsAg and HBcAg distributions correlated with the stage of liver damage. See

http://synapse.koreamed.org/Synapse/Data/PDFData/0159GNL/gnl-2-166.pdf

Another research says the intrahepatic HBsAg predicts the treatment response of interferon+adv. It sounds to me that intrahepatic HBsAg correlated with serum HBsAg, since serum HBsAg is considered a predictor marker of interferon treatment response. See http://www.kenes.com/easl2010/Posters/Abstract914.htm

Another research found that there is >80% serum HBsAg positive patients showing intrahepatic HBsAg positive.

[cam4930]

I found out that it is possible that immunohistochemical stain is less sensitive than radioimmunology test in serum. That would imply that the intrahepatic hbsag quantity is low. Without hbsag quantitative tests (not available in US), I may be able to draw a conclusion that my hbsag quantitative should be low enough to make immunohistochemical stain insensitive. This is just a guess. I will discuss with my doctor when I can get a hold of him.

[cam4930]

I checked online info. It seems to me that immunohistochemical stain of biopsy sample is more accurate way to confirm hbv infection. Very strange that hbsag was not detected in my case. S it possible that they have messed up the sample? I need to rethink the validity of this report.

[stef2011]

you have a perfectly healthy liver more than everage population with fat/meat diets, it was possible to avoid a therapy with tnf and wait for the new interferon lamda to be available, in cases like yours nucs are not very indicated and immune modulator would have been a better try to eradicate hbv

the only result of tnf treatment is liver cancer prevention since your hbvdna was not very low