Abstract
Primary sclerosing cholangitis was diagnosed radiologically in 16 of 681 patients (2.2%) with chronic ulcerative colitis in a follow up study at the gastroenterology unit in Oxford. On the basis of established histological criteria, the liver biopsy was considered diagnostic in only half of the cases. The histological findings in these cases were therefore reassessed to determine whether the accuracy of biopsy diagnosis could be improved. The most common specific histological feature was periductal concentric fibrosis of small interlobular bile ducts, even in the absence of inflammation. Other common features were bile ductular proliferation associated with diminution or absence of interlobular bile ducts. Degeneration of bile duct epithelium and diffuse infiltration of portal tracts by mononuclear cells and polymorphonuclear leucocytes were accompanying features. Piecemeal necrosis without rosette formation was found in about half the biopsies. When all these features were considered together a biopsy diagnosis of primary sclerosing cholangitis was established in 14 of 16 cases.
Full text
PDFImages in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Afroudakis A., Kaplowitz N. Liver histopathology in chronic common bile duct stenosis due to chronic alcoholic pancreatitis. Hepatology. 1981 Jan-Feb;1(1):65–72. doi: 10.1002/hep.1840010111. [DOI] [PubMed] [Google Scholar]
- Blackstone M. O., Nemchausky B. A. Cholangiographic abnormalities in ulcerative colitis associated pericholangitis which resemble sclerosing cholangitis. Am J Dig Dis. 1978 Jul;23(7):579–585. doi: 10.1007/BF01072591. [DOI] [PubMed] [Google Scholar]
- Chapman R. W., Arborgh B. A., Rhodes J. M., Summerfield J. A., Dick R., Scheuer P. J., Sherlock S. Primary sclerosing cholangitis: a review of its clinical features, cholangiography, and hepatic histology. Gut. 1980 Oct;21(10):870–877. doi: 10.1136/gut.21.10.870. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Eade M. N. Liver disease in ulcerative colitis. I. Analysis of operative liver biopsy in 138 consecutive patients having colectomy. Ann Intern Med. 1970 Apr;72(4):475–487. doi: 10.7326/0003-4819-72-4-475. [DOI] [PubMed] [Google Scholar]
- GALL E. A., DOBROGORSKI O. HEPATIC ALTERATIONS IN OBSTRUCTIVE JAUNDICE. Am J Clin Pathol. 1964 Feb;41:126–139. doi: 10.1093/ajcp/41.2.126. [DOI] [PubMed] [Google Scholar]
- KIMMELSTIEL P., LARGE H. L., Jr, VERNER H. D. Liver damage in ulcerative colitis. Am J Pathol. 1952 Mar-Apr;28(2):259–289. [PMC free article] [PubMed] [Google Scholar]
- Lefton H. B., Winkelman E. I. Endoscopic retrograde cholangiographic evaluation of sclerosing cholangitis. Cleve Clin Q. 1974 Fall;41(3):143–147. doi: 10.3949/ccjm.41.3.143. [DOI] [PubMed] [Google Scholar]
- Ludwig J., Barham S. S., LaRusso N. F., Elveback L. R., Wiesner R. H., McCall J. T. Morphologic features of chronic hepatitis associated with primary sclerosing cholangitis and chronic ulcerative colitis. Hepatology. 1981 Nov-Dec;1(6):632–640. doi: 10.1002/hep.1840010612. [DOI] [PubMed] [Google Scholar]
- Lupinetti M., Mehigan D., Cameron J. L. Hepatobiliary complications of ulcerative colitis. Am J Surg. 1980 Jan;139(1):113–118. doi: 10.1016/0002-9610(80)90239-1. [DOI] [PubMed] [Google Scholar]
- MISTILIS S. P. PERICHOLANGITIS AND ULCERATIVE COLITIS. I. PATHOLOGY, ETIOLOGY, AND PATHOGENESIS. Ann Intern Med. 1965 Jul;63:1–16. doi: 10.7326/0003-4819-63-1-1. [DOI] [PubMed] [Google Scholar]
- Morris J. S., Gallo G. A., Scheuer P. J., Sherlock S. Percutaneous liver biopsy in patients with large bile duct obstruction. Gastroenterology. 1975 Apr;68(4 Pt 1):750–754. [PubMed] [Google Scholar]
- Perrett A. D., Higgins G., Johnston H. H., Massarella G. R., Truelove S. C., Wright R. The liver in ulcerative colitis. Q J Med. 1971 Apr;40(158):211–238. doi: 10.1093/oxfordjournals.qjmed.a067266. [DOI] [PubMed] [Google Scholar]
- Poulsen H., Christoffersen P. Histological changes in liver biopsies from patients with surgical bile duct disorders. Acta Pathol Microbiol Scand A. 1970;78(5):571–579. doi: 10.1111/j.1699-0463.1970.tb02542.x. [DOI] [PubMed] [Google Scholar]
- SCHWARTZ S. I., DALE W. A. Primary sclerosing cholangitis; review and report of six cases. AMA Arch Surg. 1958 Sep;77(3):439–451. [PubMed] [Google Scholar]
- STAUFFER M. H., SAUER W. G., DEARING W. H., BAGGENSTOSS A. H. THE SPECTRUM OF CHOLESTATIC HEPATIC DISEASE. JAMA. 1965 Mar 8;191:829–837. doi: 10.1001/jama.1965.03080100047011. [DOI] [PubMed] [Google Scholar]
- Schrumpf E., Elgjo K., Fausa O., Gjone E., Kolmannskog F., Ritland S. Sclerosing cholangitis in ulcerative colitis. Scand J Gastroenterol. 1980;15(6):689–697. doi: 10.3109/00365528009181516. [DOI] [PubMed] [Google Scholar]
- Shepherd H. A., Selby W. S., Chapman R. W., Nolan D., Barbatis C., McGee J. O., Jewell D. P. Ulcerative colitis and persistent liver dysfunction. Q J Med. 1983 Autumn;52(208):503–513. [PubMed] [Google Scholar]
- Thorpe M. E., Scheuer P. J., Sherlock S. Primary sclerosing cholangitis, the biliary tree, and ulcerative colitis. Gut. 1967 Oct;8(5):435–448. doi: 10.1136/gut.8.5.435. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Warren K. W., Athanassiades S., Monge J. I. Primary sclerosing cholangitis. A study of forty-two cases. Am J Surg. 1966 Jan;111(1):23–38. doi: 10.1016/0002-9610(66)90339-4. [DOI] [PubMed] [Google Scholar]
- Wiesner R. H., LaRusso N. F. Clinicopathologic features of the syndrome of primary sclerosing cholangitis. Gastroenterology. 1980 Aug;79(2):200–206. [PubMed] [Google Scholar]