Was a non responder in 2003 Peg/Intron w/ribavirin, now doc wants me to try Telaprevir (triple therapy).
Here are my liver biopsy results. My hepatologist thinks I may have more fibrosis than the test shows, so he now wants to do a EGD. I thought the biopsy was the gold standard for diagnosing the liver. Let me know what you think.
Final Diagnosis After Microscopy:
Liver (Core Biopsy):
1) Mild Portal and interface necroinflammatory activity, predominantly lymphocytic with nodular lymphoid aggregates, and rare plasma cells and eosinophils
2) Minimal lobular necroinflammatory activity
3) Fibrous portal expansion with occasional periportal fibrosis, suggestion of rare bridging and early nodular regeneration
4) Less than 1% steatosis
5) Negative for malignancy or Mallory-denk bodies
COMMENT:
Approximately 15 portal tracts occupy this intact specimen. Trichrome, reticulin, and periodic acid-schiff stained sections with and without diastase support the morphologic impression. An iron-stained section appears negative for hemosiderosis. The cumulative findings are consistent with viral hepatitis C, grade 2-3, stage 2-3, according to criteria in Batts KP, Ludwig J. Am J Surg Pathol 1995; 19:1409-1417. Some portal tracts are nearly completely spared of necroinflammatory activity and have minimal fibrosis.
GROSS DESCRIPTION:
The specimen is received in formalin labeled with the patient’s identification and “1.” It consists of three tan-brown core biopsies ranging in size from 1 to 1.9 cm in length and all with an average diameter of 0.1 cm. The specimen is wrapped in filter paper and entirely submitted in cassette 1.
HISTOCHEMICAL STAINS:
Trichrome, reticulin, PAS, PAS plus diastase x1 – supportive
Iron x1 - negative