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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 40 Issue 6
Jun.  2024
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Article Contents

Pathological diagnosis of cholestatic liver disease

DOI: 10.12449/JCH240605
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  • Corresponding author: ZHANG Jiping, zjp-zhang@163.com(ORCID: 0009-0000-4878-4607)
  • Received Date: 2024-04-02
  • Accepted Date: 2024-05-14
  • Published Date: 2024-06-25
  • Cholestatic liver disease (CLD) is a group of liver diseases caused by various reasons, such as abnormal bile metabolism, blocked outflow, and bile duct injury, and the major causes of CLD include drugs, poisons, immunity, genetics, obstruction, infection, and tumor. Cholestasis is a common pathological change in CLD; however, the site, histopathology, and ultrastructure of cholestasis due to different etiologies are relatively specific. According to the etiology, this article elaborates on the pathological characteristics of CLD such as autoimmune cholangitis, inherited metabolic liver disease, and large bile duct disease and introduces the differential diagnosis of other types of CLD, in order to improve the understanding of CLD pathology and facilitate accurate diagnosis and treatment.

     

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  • [1]
    JOHNSON CA, GISSEN P, SERGI C. Molecular pathology and genetics of congenital hepatorenal fibrocystic syndromes[J]. J Med Genet, 2003, 40( 5): 311- 319. DOI: 10.1136/jmg.40.5.311.
    [2]
    ESTRADAS J, PASCUAL-RAMOS V, MARTÍNEZ B, et al. Autoimmune hepatitis with giant-cell transformation[J]. Ann Hepatol, 2009, 8( 1): 68- 70.
    [3]
    SARCOGNATO S, SACCHI D, GRILLO F, et al. Autoimmune biliary diseases: Primary biliary cholangitis and primary sclerosing cholangitis[J]. Pathologica, 2021, 113( 3): 170- 184. DOI: 10.32074/1591-951X-245.
    [4]
    ZEN Y, HUBSCHER SG, NAKANUMA Y. Bile duct diseases. BurtAD, FerrellLD, HübscherSG, eds. MacSween’s pathology of the liver[M]. 7th ed. Philadelphia, PA: Elsevier, 2018: 515.
    [5]
    TAKAHASHI T, MIURA T, NAKAMURA J, et al. Plasma cells and the chronic nonsuppurative destructive cholangitis of primary biliary cirrhosis[J]. Hepatology, 2012, 55( 3): 846- 855. DOI: 10.1002/hep.24757.
    [6]
    CAREY EJ, ALI AH, LINDOR KD. Primary biliary cirrhosis[J]. Lancet, 2015, 386: 1565- 1575. DOI: 10.1016/S0140-6736(15)00154-3.
    [7]
    KARLSEN TH, FOLSERAAS T, THORBURN D, et al. Primary sclerosing cholangitis-a comprehensive review[J]. J Hepatol, 2017, 67( 6): 1298- 1323. DOI: 10.1016/j.jhep.2017.07.022.
    [8]
    HIRSCHFIELD GM, KARLSEN TH, LINDOR KD, et al. Primary sclerosing cholangitis[J]. Lancet, 2013, 382( 9904): 1587- 1599. DOI: 10.1016/S0140-6736(13)60096-3.
    [9]
    PORTMANN B, ZEN Y. Inflammatory disease of the bile ducts-cholangiopathies: Liver biopsy challenge and clinicopathological correlation[J]. Histopathology, 2012, 60( 2): 236- 248. DOI: 10.1111/j.1365-2559.2011.03853.x.
    [10]
    COLLING R, VERRILL C, FRYER E, et al. Bile duct basement membrane thickening in primary sclerosing cholangitis[J]. Histopathology, 2016, 68( 6): 819- 824. DOI: 10.1111/his.12857.
    [11]
    FIEL MI, SIMA HR, AZARIAN A, et al. A morphometric study of the hepatic arterioles in end-stage primary sclerosing cholangitis[J]. Virchows Arch, 2015, 466( 2): 143- 149. DOI: 10.1007/s00428-014-1680-9.
    [12]
    CARRASCO-AVINO G, SCHIANO TD, WARD SC, et al. Primary sclerosing cholangitis: Detailed histologic assessment and integration using bioinformatics highlights arterial fibrointimal hyperplasia as a novel feature[J]. Am J Clin Pathol, 2015, 143( 4): 505- 513. DOI: 10.1309/AJCPVKFVIPRBXQR2.
    [13]
    NAKAZAWA T, NAITOH I, HAYASHI K, et al. Diagnostic criteria for IgG4-related sclerosing cholangitis based on cholangiographic classification[J]. J Gastroenterol, 2012, 47( 1): 79- 87. DOI: 10.1007/s00535-011-0465-z.
    [14]
    ZHANG JP, HOU XT, YIN ZC, et al. Gilbert syndrome: Clinicopathological and genetic analyses of 29 cases[J]. Chin J Diagn Pathol, 2018, 25( 2): 85- 89. DOI: 10.3969/j.issn.1007-8096.2018.02.002.

    张继平, 侯晓涛, 尹自长, 等. Gilbert综合征29例临床病理及基因分析[J]. 诊断病理学杂志, 2018, 25( 2): 85- 89. DOI: 10.3969/j.issn.1007-8096.2018.02.002.
    [15]
    ATAOLLAHI M, DEHGHANI SM, ANBARDAR MH, et al. Liver histologic changes in children with type 1 of Crigler-Najjar syndrome[J]. Arkh Patol, 2021, 83( 5): 27- 30. DOI: 10.17116/patol20218305127.
    [16]
    FATA CR, GILLIS LA, PACHECO MC. Liver fibrosis associated with crigler-najjar syndrome in a compound heterozygote: A case report[J]. Pediatr Dev Pathol, 2017, 20( 6): 522- 525. DOI: 10.1177/1093526617697059.
    [17]
    WU ZB. Ultramicro-pathological diagnostics[M]. Shanghai: Shanghai Scientific& Technical Publishers, 2003.

    武忠弼. 超微病理诊断学[M]. 上海: 上海科学技术出版社, 2003.
    [18]
    LI LT, WANG JS. Advances in the study of progressive familial intrahepatic cholestasis[J]. Infect Dis Inf, 2019, 32( 2): 162- 165. DOI: 10.3969/j.issn.1007-8134.2019.02.017.

    李丽婷, 王建设. 进行性家族性肝内胆汁淤积症研究进展[J]. 传染病信息, 2019, 32( 2): 162- 165. DOI: 10.3969/j.issn.1007-8134.2019.02.017.
    [19]
    WENG YH, XIONG QF, LIU DX, et al. Clinical and pathological features of progressive familial intrahepatic cholestasis type 3[J]. J Clin Hepatol, 2022, 38( 1): 154- 159. DOI: 10.3969/j.issn.1001-5256.2022.01.024.

    翁宇航, 熊清芳, 刘杜先, 等. 进行性家族性肝内胆汁淤积症3型临床病理特征分析[J]. 临床肝胆病杂志, 2022, 38( 1): 154- 159. DOI: 10.3969/j.issn.1001-5256.2022.01.024.
    [20]
    QIU YL, GONG JY, FENG JY, et al. Defects in myosin VB are associated with a spectrum of previously undiagnosed low γ-glutamyltransferase cholestasis[J]. Hepatology, 2017, 65( 5): 1655- 1669. DOI: 10.1002/hep.29020.
    [21]
    GOMEZ-OSPINA N, POTTER CJ, XIAO R, et al. Mutations in the nuclear bile acid receptor FXR cause progressive familial intrahepatic cholestasis[J]. Nat Commun, 2016, 7: 10713. DOI: 10.1038/ncomms10713.
    [22]
    HALAWI A, IBRAHIM N, BITAR R. Triggers of benign recurrent intrahepatic cholestasis and its pathophysiology: A review of literature[J]. Acta Gastroenterol Belg, 2021, 84( 3): 477- 486. DOI: 10.51821/84.3.013.
    [23]
    GUINDI M. Wilson disease[J]. Semin Diagn Pathol, 2019, 36( 6): 415- 422. DOI: 10.1053/j.semdp.2019.07.008.
    [24]
    FANNI D, GUIDO M, GEROSA C, et al. Liver changes in Wilson’s disease: The full spectrum. A report of 127 biopsies from 43 patients[J]. Eur Rev Med Pharmacol Sci, 2021, 25( 12): 4336- 4344. DOI: 10.26355/eurrev_202106_26142.
    [25]
    ZHAO XY, HE ZY, LIU LW, et al. Comparative study of pathological characteristics of 45 patients with primary and secondary hemochromatosis[J]. Infect Dis Inf, 2019, 32( 2): 127- 131. DOI: 10.3969/j.issn.1007-8134.2019.02.007.

    赵新颜, 何志颖, 刘立伟, 等. 45例原发性与继发性血色病临床病理特点对比研究[J]. 传染病信息, 2019, 32( 2): 127- 131. DOI: 10.3969/j.issn.1007-8134.2019.02.007.
    [26]
    MIYAMOTO R, JUN SD, OTA K, et al. Neonatal intrahepatic cholestasis caused by citrin deficiency with no hepatic steatosis: A case report[J]. BMC Pediatr, 2021, 21( 1): 237. DOI: 10.1186/s12887-021-02717-w.
    [27]
    ZHANG JP, CHENG YB, ZHOU XJ, et al. Neonatal intrahepatic cholestasis caused by citrin deficiency: A clinicopathological analysis of two cases[J]. Chin J Diagn Pathol, 2018, 25( 4): 261- 265. DOI: 10.3969/j.issn.1007-8096.2018.04.006.

    张继平, 程艳波, 周晓军, 等. Citrin缺陷导致的新生儿肝内胆汁淤积症2例临床病理观察[J]. 诊断病理学杂志, 2018, 25( 4): 261- 265. DOI: 10.3969/j.issn.1007-8096.2018.04.006.
    [28]
    FABRIS L, MILANI C, FIOROTTO R, et al. Dysregulation of the Scribble/YAP/β-catenin axis sustains the fibroinflammatory response in a PKHD1-/- mouse model of congenital hepatic fibrosis[J]. FASEB J, 2022, 36( 6): e22364. DOI: 10.1096/fj.202101924R.
    [29]
    SAXENA R. Practical hepatic pathology: A diagnostic approach[M]. 2nd Ed. Philadelphia: Elsevier, 2018.
    [30]
    DESMET VJ. Congenital diseases of intrahepatic bile ducts: Variations on the theme“ductal plate malformation”[J]. Hepatology, 1992, 16( 4): 1069- 1083. DOI: 10.1002/hep.1840160434.
    [31]
    CHEN IY, WHITNEY-MILLER CL, LIAO XY. Congenital hepatic fibrosis and its mimics: A clinicopathologic study of 19 cases at a single institution[J]. Diagn Pathol, 2021, 16( 1): 81. DOI: 10.1186/s13000-021-01142-y.
    [32]
    GILBERT MA, BAUER RC, RAJAGOPALAN R, et al. Alagille syndrome mutation update: Comprehensive overview of JAG1 and NOTCH2 mutation frequencies and insight into missense variant classification[J]. Hum Mutat, 2019, 40( 12): 2197- 2220. DOI: 10.1002/humu.23879.
    [33]
    WU LN, SUN LY, ZHU ZJ, et al. Clinical and histological characteristics of patients with Alagille syndrome[J]. Chin Hepatol, 2023, 28( 3): 351- 354, 363. DOI: 10.14000/j.cnki.issn.1008-1704.2023.03.018.

    武丽娜, 孙丽莹, 朱志军, 等. Alagille综合征的临床及病理特征分析[J]. 肝脏, 2023, 28( 3): 351- 354, 363. DOI: 10.14000/j.cnki.issn.1008-1704.2023.03.018.
    [34]
    CASANOVA-GONZÁLEZ MJ, TRAPERO-MARUGÁN M, JONES EA, et al. Liver disease and erythropoietic protoporphyria: A concise review[J]. World J Gastroenterol, 2010, 16( 36): 4526- 4531. DOI: 10.3748/wjg.v16.i36.4526.
    [35]
    ANSTEY AV, HIFT RJ. Liver disease in erythropoietic protoporphyria: Insights and implications for management[J]. Gut, 2007, 56( 7): 1009- 1018. DOI: 10.1136/gut.2006.097576.
    [36]
    MACDONALD DM, GERMAIN D, PERROT H. The histopathology and ultrastructure of liver disease in erythropoietic protoporphyria[J]. Br J Dermatol, 1981, 104( 1): 7- 17. DOI: 10.1111/j.1365-2133.1981.tb01705.x.
    [37]
    VIJ M, RELA M. Biliary atresia: Pathology, etiology and pathogenesis[J]. Future Sci OA, 2020, 6( 5): FSO466. DOI: 10.2144/fsoa-2019-0153.
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