Histological analyses of trucut liver biopsies from patients with noncirrhotic portal fibrosis and extra-hepatic portal vein obstruction
- 1 January 2021
- journal article
- research article
- Published by Medknow in Indian Journal of Pathology and Microbiology
- Vol. 64 (5), 127-135
- https://doi.org/10.4103/ijpm.ijpm_387_20
Abstract
Background: Both noncirrhotic portal fibrosis (NCPF) and extrahepatic portal venous obstruction (EHPVO) are important causes of noncirrhotic portal hypertension (PH) in the Asian region. In this study, we analyzed the histopathological changes of liver needle-core biopsies from patients with NCPF and EHPVO. Patients and Methods: The patients were diagnosed as per the Asia Pacific Association for the Study of Liver (APASL) criteria. Minimum adequacy criteria for liver core biopsies were defined, and finally, 69 liver biopsies from patients with NCPF and 100 liver biopsies from patients with EHPVO were analyzed. All histological parameters were predefined, and three experienced pathologists analyzed the biopsies after reaching consensus. Institute ethics committee clearance was taken. Results: Although some histological features were overlapping, phlebosclerosis of intra-hepatic branches of the portal vein (PV), periportal aberrant vascular channels, remnant portal tracts, and hepatic fibrosis beyond the portal tracts without the formation of complete hepatic nodules (P < 0.001 for all) were common histological characteristics of NCPF on core-needle liver biopsies; while maintained lobular architecture, nonspecific dilatation of PV branches, absence of intra-hepatic PV phlebosclerosis, aberrant vascular channels, and significant fibrosis were characteristics of EHPVO. Conclusions: Despite the considerable histological overlap between NCPF and EHPVO, careful histological evaluation, supplemented by clinical features, radiological and biochemical findings can help in making a conclusive diagnosis. Patients with NCPF and EHPVO with clinical jaundice show transaminitis, high serum alkaline phosphatase level, more variceal bleed, and histological evidences of nodular regenerative hyperplasia.Keywords
This publication has 32 references indexed in Scilit:
- Etiology and long-term outcome of extrahepatic portal vein obstruction in childrenWorld Journal of Gastroenterology, 2010
- Coagulation status modulates murine hepatic fibrogenesis: implications for the development of novel therapiesJournal of Thrombosis and Haemostasis, 2008
- Noncirrhotic portal fibrosis/idiopathic portal hypertension: APASL recommendations for diagnosis and treatmentHepatology International, 2007
- Systemic and pulmonary hemodynamics in patients with non-cirrhotic portal fibrosis (NCPF) is similar to compensated cirrhosisHepatology International, 2007
- Histological grading and staging of chronic hepatitisJournal of Hepatology, 1995
- Efficacy of endoscopic sclerotherapy on long‐term management of oesophageal varices: A comparative study of results in patients with cirrhosis of the liver, non‐cirrhotic portal fibrosis (NCPF) and extrahepatic portal venous obstruction (EHO)*Journal of Gastroenterology and Hepatology, 1991
- Comparative efficacy of emergency endoscopic sclerotherapy for active variceal bleeding due to cirrhosis of the liver, non‐cirrhotic portal fibrosis and extrahepatic portal venous obstructionJournal of Gastroenterology and Hepatology, 1990
- Obliterative portal venopathy: A comparative study of 184 cases of extrahepatic portal obstruction and 469 cases of idiopathic portal hypertensionJournal of Gastroenterology and Hepatology, 1986
- Liver pathology of idiopathic portal hypertension. Comparison with non‐cirrhotic portal fibrosis of India The Japan idiopathic portal hypertension study*,+Liver International, 1982
- Ultrastructure of the liver in non-cirrhotic portal fibrosis with portal hypertensionGut, 1970