title: Revisiting the topic of histochemically detectable copper in various liver diseases with special focus on venous outflow impairment.
abstract: We surveyed histochemically detectable copper in various liver diseases with emphasis on chronic biliary disease (CBD) and venous outflow impairment. Using rhodanine, we graded copper accumulation in 298 liver specimens: venous outflow impairment (n = 64), CBD (n = 123), Wilson disease (WD) (n = 12), chronic hepatitis C (n = 32), steatohepatitis (n = 28), sarcoidosis (n = 15), cholestatic hepatitis (n = 12), and acute large bile duct obstruction (n = 12). Copper was detected in 39% of specimens; all had chronic liver disease. Copper increased with increasing fibrosis. CBD accumulated copper more frequently than other chronic diseases (except WD), both in early (61% vs 3%) and late (94% vs 59%) stages and in larger amounts. Rhodanine was positive in 73% of livers with CBD, 20% with sarcoidosis, 9% with chronic hepatitis C, and 7% with steatohepatitis. Copper was detected in 14% of chronic venous outflow impairment specimens; with 1 exception, stainable copper was absent in early stages but detected in 38% of cirrhotic livers. In conclusion, rhodanine helps differentiate CBD from other conditions, including venous outflow impairment; in the absence of advanced fibrosis, rhodanine positivity strongly favors CBD. In contrast, rhodanine positivity is nonspecific in cirrhosis, but the absence of copper in that setting excludes CBD.
authors.affiliation: Division of Anatomic Pathology, Rochester, MN 55905, USA. Mounajjed.Taofic@mayo.edu
authors.forename: Taofic
authors.initials: T
authors.lastname: Mounajjed
authors.forename: Amy S
authors.initials: AS
authors.lastname: Oxentenko
authors.forename: Hina
authors.initials: H
authors.lastname: Qureshi
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Smyrk
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D001660:Biliary Tract Diseases / Q000175:diagnosis / Q000378:metabolism*; D002908:Chronic Disease; D003300:Copper / Q000378:metabolism*; D003937:Diagnosis, Differential; D005260:Female; D006503:Hepatic Veins / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D008107:Liver Diseases / Q000175:diagnosis / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000378:metabolism*; D012039:Regional Blood Flow; D012236:Rhodanine / Q000737:chemistry; D013194:Staining and Labeling / Q000379:methods; D055815:Young Adult
chemical_list: D003300:Copper; D012236:Rhodanine