Hepatobiliary pathology.
OBJECTIVE
Publications concerning liver histopathology in fatty liver disease and chronic hepatitis C, iron and copper overload, and liver transplantation from the past year have been surveyed to highlight useful concepts and diagnostic information.


RESULTS
Two microscopic forms of pediatric nonalcoholic steatohepatitis have been described: type 1 in which hepatocyte ballooning and/or pericellular fibrosis accompany the steatosis; and type 2 which has portal tract inflammation and/or fibrosis as the salient accompanying feature. In chronic hepatitis C, the ductular reaction appears to be a major factor associated with fibrosis. In patients transplanted for hepatitis C virus-related cirrhosis, immunostaining of post-transplant liver biopsies for alpha-smooth muscle actin (i.e. in activated hepatic stellate cells) may identify those individuals at risk for severe recurrence. Clinicopathological papers on several forms of non-HFE hemochromatosis were published and Wilson's disease was described in individuals of 60 years or more in age. Cholestasis in childhood was expertly reviewed and histopathologic precursor lesions of hepatocellular carcinoma were also examined in a comprehensive article.


CONCLUSIONS
Recent publications with impact on liver biopsy interpretation include a morphologic classification of nonalcoholic steatohepatitis in childhood, the differential diagnosis of childhood cholestasis and pathogenetic factors involved in fibrogenesis in chronic hepatitis C.
Lefkowitch
Jay H
JH
Department of Pathology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA. JHL3@columbia.edu
D000682:Amyloid / Q000378:metabolism; D001660:Biliary Tract Diseases / Q000276:immunology / Q000378:metabolism / Q000473:pathology*; D001706:Biopsy; D006801:Humans; D019190:Iron Overload / Q000378:metabolism; D007633:Keratins / Q000235:genetics; D008107:Liver Diseases / Q000276:immunology / Q000378:metabolism / Q000473:pathology*; D016031:Liver Transplantation; D008661:Metabolism, Inborn Errors / Q000473:pathology; D028361:Mitochondrial Diseases / Q000473:pathology; D009154:Mutation; D020675:Peroxisomes / Q000378:metabolism
D000682:Amyloid; D007633:Keratins