Cholestasis

 

Epidemiology:

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Common sites:

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Gross features:

    • cirrhosis in end-stage

 

Histologic features:

    • portal tracts:
      • Bile ductular proliferation (most consistent feature)
      • Bile duct distension
      • Edema
      • Bile pigment retention
      • Neutrophilic inflammation eventually
        • Mild
        • Restricted to cholestatic areas
      • Fibrosis eventually
    • Hepatocyte changes in focal areas of cholestasis:
      • enlargement of hepatocytes
      • dilated canalicular spaces (bile plugs)
      • apoptotic cells present
      • bile pigment within hepatocytes
      • fine, foamy reticular cytoplasm (feathery degeneration)
      • increase in nuclear size and number
      • a few mitoses
    • Enlarged Kupffer cells with bile pigment
    • Bile lakes
    • Bile infarcts sometimes:
      • Substantial areas of hepatocellular degeneration or death
      • Pale or bile-stained hepatocytes
      • Discrete rounded cells like macrophages
      • Bile
      • Fibrin often abundant
    • Liver-cell plates remain mostly intact

 

Immunophenotype:

Marker:

Sensitivity:

Specificity:

 PAS (Kupffer cells)

 

 

 

Molecular features:

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Other features:

    • pruritis
    • skin xanthomas

 

References:

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