I got my biopsy report from my doctor today and it says "abundant dark pigment in portal macrophages". It also mentions "minimal piecemeal necrosis". I know necrosis means cell death, so I'm hoping that since is says "minimal", this is a good thing. Yes, I know I should have read it while at the doctor's office, but the nurse was giving me my kit, and explaining all of the goodies inside, and of course, by the time I got to my car I couldn't remember half of what she said, so I didn't read my biopsy report till I got home.
I know ya'll are very informed about all this stuff so.....
I don’t have a clue what the dark pigmented region refers to; hopefully, someone else can remark on this. Is there any reference to a numerical expression, such as stage and grade? This can be useful tool; if not, perhaps your doctor can translate the results into a Metavir format; that is commonly used as a scale here in the U.S.
Janis and Friends has a decent section on interpreting biopsy results too:
Macrophages on your biopsy signify immune response. They go to the areas where inflammation happens and remove "the debris"--dead cells and other particles. This debris is what is seen as dark pigment. Sometimes, a lot of lymphocytes are seen too, because they are part of immune response as well.
This finding doesn't mean anything other than you have an inflammatory process in your liver-which is expected with hepatitis C. It is good that there was not much necrosis and fibrosis-these are really important findings that show how severe liver disease is.
Trying to take the needed data and enter it into a numerical score is delicate business; pathologists seem to argue over this quite a bit. And, there are several ways to categorize scoring; Knodell, Metavir, Ishak all differ in how they fit narrative reporting into numerical values.
Mild piecemeal necrosis is often grouped into stage one disease; but there are other criteria to consider, I believe. Best to consult with either your doctor, or try to contact the pathologist that generated the report and see if they’ll provide a fibrosis stage and grade of inflammation. Sometimes they seem to prefer to stay with narrative report only…
The most commonly used system and the one used in here most frequently seems to be the Metavir system; this utilizes a score that classifies fibrosis from F0 through F4, with F4 signifying cirrhosis.
Nice to see you’re moving right along with this whole process; you should hopefully have enough info at hand soon to arrive at a decision. Good luck with this, and keep us informed—
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