Biopsy Results

[mrigg1]

Need questions answered. According to results my biopsy contained suboptimal hepatic parenchyma with three portal tracts with focal (only one portal tract) mild lymphocytic inflammatory infiltrate without interface activity. Bile ducts and portal vessels are unremarkable. There is no evidence of micro or macro vesicular steatosis. No significabt cholestasis is present in perisinusoidal areas. One apoptotic hepatocyte was seen. An iron stain demonstrates absence of iron. D-PAS stain demonstrates no cytoplasmic inclusions and absence of Mallory bodies.There is focal pericellular fibrosis on trichromatic stain.

Diagnosis-Mild/Portal inflammation

Negative for steatosis,intrahepatic iron deposition or fibrosis and malignancy.

Should I be worried since biopsy was suboptimal/inadequate with only three portal tracts. Could it miss fibrosis somewhere else in the liver.

[Ter74]

Hello. I am new on this board and have found others to be very helpful. I will preface this with as I do have a nursing degree and have researched a lot on the Liver, that of course it's opinion. The one thing that I had never seen nor heard of was the apoptic hepatocyte. I looked into that under the NIH ( National Institute of Health ) and found that it is a reason for inflammation. I'm going to copy and paste a section as I don't want to misinterpret it to you and I am currently battling a Hepatic Encephalopathy flare up.

Apoptosis is a process of programmed cell death. Apoptotic cells are characterized by energy-dependent biochemical mechanisms and obvious morphological changes [1, 2]. These features include membrane blebbing, cell shrinkage, nuclear chromatin condensation, and chromosomal DNA fragmentation. The apoptotic process deletes single cell or small clusters of cells without inflammatory response [3]. Apoptotic cells die in a controlled and regulated fashion. This makes apoptosis distinct from other uncontrolled modes of cell death such as necrosis, necroptosis, autophagy, and cornification [4]. Uncontrolled cell death leads to cell lysis, inflammatory response, and serious health problems [5]. Apoptosis is associated with multiple pathophysiological functions. During the embryological stage of mammals, apoptosis is important for the normal development of organs [6]. In adults, apoptosis regulates physiological processes (e.g., removing aged cells) and maintains tissue homeostasis [7]. Dysfunction or dysregulation of the apoptotic program is implicated in a variety of congenital anomalies and pathological conditions such as tumorigenesis, autoimmune diseases, neurodegenerative disorders, and others.

The way I interpret it is that you have to get a handle on that as if the cell death continues it progresses your liver impairment. I think your the interpretation of your results seem positive and that they will get control of the apoptic hepatocyte issue the inflammation will stop. It's a very positive biopsy as it shows no micro nor macro steatosis. I myself would ask more about the cell death and how to stop that from any more inflammation that could eventually lead to steatosis and on.

Hope this is of some help. Good luck. Please keep in touch.