Skip to main content
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1978 May;31(5):395–414. doi: 10.1136/jcp.31.5.395

The morphology of cirrhosis. Recommendations on definition, nomenclature, and classification by a working group sponsored by the World Health Organization.

P P Anthony, K G Ishak, N C Nayak, H E Poulsen, P J Scheuer, L H Sobin
PMCID: PMC1145292  PMID: 649765

Abstract

This memorandum provides guidelines on the definition, nomenclature, and classification of cirrhosis, chronic hepatitis, and hepatic fibrosis. These are considered according to morphological characteristics and aetiology. It is hoped that this system will serve as a standard for diagnostic, research, and epidemiological purposes. The relationship of cirrhosis to liver cell carcinoma is briefly discussed and the possible morphological markers of an increased risk of malignancy are defined.

Full text

PDF
395

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anthony P. P., Vogel C. L., Barker L. F. Liver cell dysplasia: a premalignant condition. J Clin Pathol. 1973 Mar;26(3):217–223. [PMC free article] [PubMed] [Google Scholar]
  2. Baggenstoss A. H. Morphological features: their usefulness is the diagnosis, prognosis, and management of cirrhosis. Clin Gastroenterol. 1975 May;4(2):227–246. [PubMed] [Google Scholar]
  3. Farber E. Hyperplastic areas, hyperplastic nodules, and hyperbasophilic areas as putative precursor lesions. Cancer Res. 1976 Jul;36(7 Pt 2):2532–2533. [PubMed] [Google Scholar]
  4. GALL E. A. Posthepatitic, postnecrotic, and nutritional cirrhosis: a pathologic analysis. Am J Pathol. 1960 Mar;36:241–271. [PMC free article] [PubMed] [Google Scholar]
  5. GALL E. A. Primary and metastatic carcinoma of the liver. Relationship to hepatic cirrhosis. Arch Pathol. 1960 Aug;70:226–232. [PubMed] [Google Scholar]
  6. Galambos J. T. Classification of cirrhosis. Am J Gastroenterol. 1975 Dec;64(6):437–451. [PubMed] [Google Scholar]
  7. Galambos J. T. Natural history of alcoholic hepatitis. 3. Histological changes. Gastroenterology. 1972 Dec;63(6):1026–1035. [PubMed] [Google Scholar]
  8. Gedigk P., Müller R., Bechtelsheimer H. Morphology of liver damage among polyvinyl chloride production workers. A report of 51 cases. Ann N Y Acad Sci. 1975 Jan 31;246:278–285. doi: 10.1111/j.1749-6632.1975.tb51103.x. [DOI] [PubMed] [Google Scholar]
  9. Goldstein G. B., Lam K. C., Mistilis S. P. Drug-induced active chronic hepatitis. Am J Dig Dis. 1973 Mar;18(3):177–184. doi: 10.1007/BF01071970. [DOI] [PubMed] [Google Scholar]
  10. Gudat F., Bianchi L., Sonnabend W., Thiel G., Aenishaenslin W., Stalder G. A. Pattern of core and surface expression in liver tissue reflects state of specific immune response in hepatitis B. Lab Invest. 1975 Jan;32(1):1–9. [PubMed] [Google Scholar]
  11. Higginson J. The geographical pathology of liver disease in man. Gastroenterology. 1969 Nov;57(5):587–598. [PubMed] [Google Scholar]
  12. Hodgson H. J., Davies D. R., Thompson R. P. Congenital hepatic fibrosis. J Clin Pathol. 1976 Jan;29(1):11–16. doi: 10.1136/jcp.29.1.11. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Horvath E., Kovacs K., Ross R. C. Subcellular features of alcoholic liver lesion: alcoholic hyalin. J Pathol. 1973 Jul;110(3):245–250. doi: 10.1002/path.1711100307. [DOI] [PubMed] [Google Scholar]
  14. Ishak K. G. Light microscopic morphology of viral hepatitis. Am J Clin Pathol. 1976 May;65(5 Suppl):787–827. [PubMed] [Google Scholar]
  15. Kent G., Gay S., Inouye T., Bahu R., Minick O. T., Popper H. Vitamin A-containing lipocytes and formation of type III collagen in liver injury. Proc Natl Acad Sci U S A. 1976 Oct;73(10):3719–3722. doi: 10.1073/pnas.73.10.3719. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Lee F. I. Cirrhosis and hepatoma in alcoholics. Gut. 1966 Feb;7(1):77–85. doi: 10.1136/gut.7.1.77. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. MacSween R. N., Scott A. R. Hepatic cirrhosis: a clinico-pathological review of 520 cases. J Clin Pathol. 1973 Dec;26(12):936–942. doi: 10.1136/jcp.26.12.936. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Morris J. S., Schmid M., Newman S., Scheuer P. J., Sherlock S. Arsenic and noncirrhotic portal hypertension. Gastroenterology. 1974 Jan;66(1):86–94. [PubMed] [Google Scholar]
  19. Murray-Lyon I. M., Ockenden B. G., Williams R. Congenital hepatic fibrosis--is it a single clinical entity? Gastroenterology. 1973 Apr;64(4):653–656. [PubMed] [Google Scholar]
  20. Nayak N. C., Ramalingaswami V. Indian childhood cirrhosis. Clin Gastroenterol. 1975 May;4(2):333–349. [PubMed] [Google Scholar]
  21. Peters R. L., Gay T., Reynolds T. B. Post-jejunoileal-bypass hepatic disease. Its similarity to alcoholic hepatic disease. Am J Clin Pathol. 1975 Mar;63(3):318–331. doi: 10.1093/ajcp/63.3.318. [DOI] [PubMed] [Google Scholar]
  22. Popper H., Kent G. Fibrosis in chronic liver disease. Clin Gastroenterol. 1975 May;4(2):315–332. [PubMed] [Google Scholar]
  23. Popper H. Pathologic aspects of cirrhosis. A review. Am J Pathol. 1977 Apr;87(1):228–264. [PMC free article] [PubMed] [Google Scholar]
  24. Popper H., Schaffner F. Chronic hepatitis: taxonomic, etiologic, and therapeutic problems. Prog Liver Dis. 1976;5:531–558. [PubMed] [Google Scholar]
  25. Popper H., Uenfriend S. Hepatic fibrosis. Correlation of biochemical and morphologic investigations. Am J Med. 1970 Nov;49:707–721. doi: 10.1016/s0002-9343(70)80135-8. [DOI] [PubMed] [Google Scholar]
  26. Poulsen H., Christoffersen P. Abnormal bile duct epithelium in chronic aggressive hepatitis and cirrhosis. A review of morphology and clinical, biochemical, and immunologic features. Hum Pathol. 1972 Jun;3(2):217–225. doi: 10.1016/s0046-8177(72)80075-3. [DOI] [PubMed] [Google Scholar]
  27. Powell L. W., Kerr J. F. The pathology of the liver in hemochromatosis. Pathobiol Annu. 1975;5:317–337. [PubMed] [Google Scholar]
  28. RUBIN E., KRUS S., POPPER H. Pathogenesis of postnecrotic cirrhosis in alcoholics. Arch Pathol. 1962 Apr;73:288–299. [PubMed] [Google Scholar]
  29. Ramalingaswami V., Nayak N. C. Liver disease in India. Prog Liver Dis. 1970;3:222–235. [PubMed] [Google Scholar]
  30. Rojkind M., Kershenobich D. Hepatic fibrosis. Prog Liver Dis. 1976;5:294–310. [PubMed] [Google Scholar]
  31. Rubin E., Lieber C. S. Relation of alcoholic liver injury to cirrhosis. Clin Gastroenterol. 1975 May;4(2):247–272. [PubMed] [Google Scholar]
  32. Rubin E., Popper H. The evolution of human cirrhosis deduced from observations in experimental animals. Medicine (Baltimore) 1967 Mar;46(2):163–183. doi: 10.1097/00005792-196703000-00009. [DOI] [PubMed] [Google Scholar]
  33. Sama S. K., Bhargava S., Nath N. G., Talwar J. R., Nayak N. C., Tandon B. N., Wig K. L. Noncirrhotic portal fibrosis. Am J Med. 1971 Aug;51(2):160–169. doi: 10.1016/0002-9343(71)90234-8. [DOI] [PubMed] [Google Scholar]
  34. Schaffner F. Primary biliary cirrhosis. Clin Gastroenterol. 1975 May;4(2):351–366. [PubMed] [Google Scholar]
  35. Scheuer P. J. Chronic hepatitis: a problem for the pathologist. Histopathology. 1977 Jan;1(1):5–19. doi: 10.1111/j.1365-2559.1977.tb01640.x. [DOI] [PubMed] [Google Scholar]
  36. Scheuer P. J. Liver biopsy in the diagnosis of cirrhosis. Gut. 1970 Mar;11(3):275–278. doi: 10.1136/gut.11.3.275. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Sharp H. L. The current status of alpha-1-antityrpsin, a protease inhibitor, in gastrointestinal disease. Gastroenterology. 1976 Apr;70(4):611–621. [PubMed] [Google Scholar]
  38. Sherlock S., Scheuer P. J. The presentation and diagnosis of 100 patients with primary biliary cirrhosis. N Engl J Med. 1973 Sep 27;289(13):674–678. doi: 10.1056/NEJM197309272891306. [DOI] [PubMed] [Google Scholar]
  39. Smetana H. F. Cirrhosis of the liver: principles of classification, histogenesis, and pathogenesis. Pathol Annu. 1972;7:107–144. [PubMed] [Google Scholar]
  40. Sternlieb I. Evolution of the hepatic lesion in Wilson's disease (hepatolenticular degeneration). Prog Liver Dis. 1972;4:511–525. [PubMed] [Google Scholar]
  41. Sternlieb I. The development of cirrhosis in Wilson's disease. Clin Gastroenterol. 1975 May;4(2):367–379. [PubMed] [Google Scholar]
  42. Van Waes L., Lieber C. S. Early perivenular sclerosis in alcoholic fatty liver: an index of progressive liver injury. Gastroenterology. 1977 Oct;73(4 Pt 1):646–650. [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES