title: The role of the pathologist in diagnosing and grading biliary diseases.
abstract: Pathological features of primary biliary cirrhosis (PBC) are reviewed. Immune-mediated, non-suppurative cholangitis is the initial lesion and is followed by the gradual and extensive destruction of bile ducts and development of chronic cholestasis. Simultaneously, necro-inflammatory activities of the hepatic parenchyma and limiting plates of milder form develop not infrequently. Eventually, liver fibrosis and cirrhosis develop. A new system applicable to needle liver biopsies in which staging is evaluated using a combination of three factors (fibrosis, cholestasis, and bile duct loss) and necro-inflammatory activities of the bile duct and hepatic parenchyma are graded, is proposed. The clinical and therapeutic evaluation of PBC using this system is warranted.
authors.affiliation: Department of human pathology, Kanazawa University Graduate School of Medicine, Kanazawa 920-8640, Japan. pbcpsc@kenroku.kanazawa-u.ac.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Nakanuma
authors.forename: K
authors.initials: K
authors.lastname: Harada
mesh_terms: D018450:Disease Progression; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000145:classification* / Q000473:pathology*; D010338:Pathology, Clinical; D010819:Physician's Role; D012720:Severity of Illness Index