Morphologic features of chronic hepatitis associated with primary sclerosing cholangitis and chronic ulcerative colitis

Journal Article · · Hepatology (N.Y.); (United States)

DOI:https://doi.org/10.1002/hep.1840010612· OSTI ID:5175173

Ludwig, J; Barham, S S; LaRusso, N F; Elveback, L R; Wiesner, R H; McCall, J T

Histologic, ultrastructural, chemical, and statistical methods were used to study liver biopsy and autopsy specimens from 43 patients who had primary sclerosing cholangitis (PSC), with or without chronic ulcerative colitis (CUC), and from 19 patients who had CUC without PSC. In all study groups, essentially the same abnormalities were found in the hepatic parenchyma outside the major bile ducts, although nondiagnostic tissue samples were observed also. Specimens from patients with extrahepatic PSC were indistinguishable from those patients with combined extra- and intrahepatic PSC. Common findings included periductal fibrosis and inflammation, portal edema and fibrosis, focal proliferation of bile ducts and ductules, focal bile duct obliteration and loss of bile ducts, copper deposition, and cholestasis. Proliferation of bile ducts in some portal tracts and obliteration or absence of bile duct in others were the most characteristic changes. In most specimens, inflammatory changes appeared mild, yet biliary cirrhosis had developed in 34% of the patients. Specimens from patients with PSC, with or without CUC, more often contained bile and strikingly increased stainable copper (Grades 2 and 3) than did specimens from patients with CUC without PSC. Hepatic copper contents, measured by atomic absorption spectrophotometry, also were higher in specimens from patients with PSC. Study of PCS specimens by transmission electron microscopy and by energy-dispersive X-ray microanalysis revealed that most copper was sequestered in lipolysosomes. The recognition of strikingly similar morphologic features in many liver specimens from patients with either PSC or CUC or both suggests that the causes of these conditions are closely related.

• Research Organization: Department of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota
• OSTI ID: 5175173
• Journal Information: Hepatology (N.Y.); (United States), Journal Name: Hepatology (N.Y.); (United States) Vol. 1:6; ISSN HEPAD
• Country of Publication: United States
• Language: English

Related Subjects

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CHEMISTRY
400103 -- Radiometric & Radiochemical Procedures-- (-1987)
550900* -- Pathology
59 BASIC BIOLOGICAL SCIENCES
ABSORPTION SPECTROSCOPY
AUTOPSY
BILIARY TRACT
BIOPSY
BODY
CHEMICAL ANALYSIS
COPPER
DIAGNOSTIC TECHNIQUES
DIGESTIVE SYSTEM
DIGESTIVE SYSTEM DISEASES
DISEASES
ELECTRON MICROSCOPY
ELEMENTS
FIBROSIS
GASTROINTESTINAL TRACT
GLANDS
HEPATITIS
HISTOLOGY
INFLAMMATION
INTESTINES
LARGE INTESTINE
LIVER
METALS
MICROSCOPY
MORPHOLOGICAL CHANGES
NONDESTRUCTIVE ANALYSIS
ORGANS
PATHOLOGICAL CHANGES
PATHOLOGY
PATIENTS
SPECTROSCOPY
SYMPTOMS
TRANSITION ELEMENTS
TRANSMISSION ELECTRON MICROSCOPY
ULCERS
X-RAY EMISSION ANALYSIS