My wife (48 yrs old, white, 5'4", 190 lbs, non-drinker, non-smoker, no drug use) recently had a liver biopsy with the following results. Could you please tell me lay-men's terms what this means and what my wife has to look forward to; prognosis and treatment. Thank you very much.
Sections reveal three disrupted needle biopsy core fragments of distorted, chronically inflamed hepatic tissue. Moderate fatty change is noted thoughout. Most portal triads are expanded by mixed chronic inflammatory cells and scattered neutrophils, the latter associated with proliferating bile ducts. Small number of eosinophils are also included in the infiltrate. Trichrome stain reveals moderate to severe portal fibrosis with focal portal-central and portal-portal bridging (stage 3 in a recently proposed four part staging scheme for steatohepatitis). Inflammatory infiltrates spill into the lobules where they are associated with occasional necrotic hepatocytes and ballooning degeneration of hepatocytes. The overall appearances are those of active steatohepatitis. They suggest a differential diagnosis including nonalcoholic steatohepatitis, alcoholic hepatitis,k and ascending cholangitis.
Microscopic Diagnosis: Steatohepatitis with moderate to severe portal fibrosis.