Colchicine-associated Ring Mitosis in Liver Biopsy and Their Clinical Implications

Abstract

Colchicine is an alkaloid with antimitotic activity used to treat a variety of medical conditions. Colchicine toxicity can result in multiorgan failure and death. In recent years, the histopathologic features of colchicine toxicity in various organs that is, gastrointestinal tract, kidneys, salivary glands, muscle, and skin have been described. However, the histopathologic manifestations of colchicine in the liver have not been reported. We present the case of a 54-year-old man with transfusion acquired chronic hepatitis C and longstanding gout managed with colchicine. A liver biopsy performed showed changes consistent with chronic hepatitis C along with many scattered mitoses arrested in metaphase in the hepatocytes that have been referred to as “ring” mitoses. The current liver biopsy was compared with the biopsy from 7 years ago, which appeared similar, however, ring mitoses were absent. Ring mitosis have been associated with colchicine-mediated tissue injury in various other sites, and their presence is felt to represent colchicine-induced liver injury in this case.