Skip to main content
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1985 Sep;38(9):1013–1020. doi: 10.1136/jcp.38.9.1013

Structural aspects of the liver in patients with biliary disease and portal hypertension.

K Weinbren, N S Hadjis, L H Blumgart
PMCID: PMC499351  PMID: 4044871

Abstract

Structural changes were examined in liver tissue from 28 patients with chronic bile duct obstruction in whom portal hypertension was diagnosed. Extrahepatic portal occlusion was found in three patients and cirrhosis of the liver in two. In the remaining 23 patients diffuse hepatocyte hyperplasia and portal fibrosis were observed, but a normal spatial relation between portal tracts and hepatic venous radicles was, for the most part, retained. Liver tissue was also examined from a group of 76 patients with chronic bile duct obstruction in whom there was no indication of portal hypertension but some evidence of hepatocyte hyperplasia and fibrosis. Both these features were much less extensive than the changes seen in the group of patients ostensibly suffering from portal hypertension. The findings suggest that the combination of portal hypertension and chronic bile duct obstruction may not imply the unremitting, progressive, and irreversible changes that accompany cirrhosis because the normal vascular relations are retained. In the light of increasing experimental and clinical evidence of the resorption of collagen and the remodelling of hepatic plates it seems that the structural abnormalities in duct obstruction may substantially regress.

Full text

PDF
1013

Images in this article

Selected References

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

  1. Adson M. A., Wychulis A. R. Portal hypertension in secondary biliary cirrhosis. Arch Surg. 1968 Apr;96(4):604–612. doi: 10.1001/archsurg.1968.01330220120020. [DOI] [PubMed] [Google Scholar]
  2. Anthony P. P., Ishak K. G., Nayak N. C., Poulsen H. E., Scheuer P. J., Sobin L. H. The morphology of cirrhosis. Recommendations on definition, nomenclature, and classification by a working group sponsored by the World Health Organization. J Clin Pathol. 1978 May;31(5):395–414. doi: 10.1136/jcp.31.5.395. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. BUNTON G. L., CAMERON R. REGENERATION OF LIVER AFTER BILIARY CIRRHOSIS. Ann N Y Acad Sci. 1963 Dec 30;111:412–421. doi: 10.1111/j.1749-6632.1963.tb36981.x. [DOI] [PubMed] [Google Scholar]
  4. CAMERON R., BUNTON G. L. Congenital biliary atresia. Br Med J. 1960 Oct 29;2(5208):1253–1257. doi: 10.1136/bmj.2.5208.1253. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. COLE W. H., IRENEUS C., Jr, REYNOLDS J. T. Strictures of the common bile duct; studies in 122 cases. Ann Surg. 1955 Oct;142(4):537-50; discussion, 550-1. doi: 10.1097/00000658-195510000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. DOEHLERT C. A., Jr, BAGGENSTOSS A. H., CAIN J. C. Obstructive biliary cirrhosis and alcoholic cirrhosis; comparison of clinical and pathologic features. Am J Clin Pathol. 1955 Aug;25(8):902–914. doi: 10.1093/ajcp/25.8.902. [DOI] [PubMed] [Google Scholar]
  7. ELIAS H. A re-examination of the structure of the mammalian liver; parenchymal architecture. Am J Anat. 1949 Mar;84(2):311–333. doi: 10.1002/aja.1000840206. [DOI] [PubMed] [Google Scholar]
  8. KELTY R. H., BAGGENSTOSS A. H., BUTT H. R. The relation of the regenerated liver nodule to the vascular bed in cirrhosis. Gastroenterology. 1950 Jun;15(2):285–295. [PubMed] [Google Scholar]
  9. Kershenobich D., Uribe M., Suárez G. I., Mata J. M., Pérez-Tamayo R., Rojkind M. Treatment of cirrhosis with colchicine. A double-blind randomized trial. Gastroenterology. 1979 Sep;77(3):532–536. [PubMed] [Google Scholar]
  10. MORGAN J. D., HARTROFT W. S. Juvenile liver. Age at which one-cell-thick plates predominate in the human liver. Arch Pathol. 1961 Jan;71:86–88. [PubMed] [Google Scholar]
  11. Nimni M. E., Gerth N., Bavetta L. A. Reversibility of a pencillamine induced defect in collagen aggregation. Nature. 1967 Mar 4;213(5079):921–922. doi: 10.1038/213921a0. [DOI] [PubMed] [Google Scholar]
  12. PARKER R. G. Occlusion of the hepatic veins in man. Medicine (Baltimore) 1959 Dec;38:369–402. doi: 10.1097/00005792-195912000-00002. [DOI] [PubMed] [Google Scholar]
  13. Peters R. L. Viral hepatitis: a pathologic spectrum. Am J Med Sci. 1975 Jul-Aug;270(1):17–31. doi: 10.1097/00000441-197507000-00004. [DOI] [PubMed] [Google Scholar]
  14. Popper H., Orr W. Current concepts in cirrhosis. Scand J Gastroenterol Suppl. 1970;6:203–222. [PubMed] [Google Scholar]
  15. Popper H. Pathologic aspects of cirrhosis. A review. Am J Pathol. 1977 Apr;87(1):228–264. [PMC free article] [PubMed] [Google Scholar]
  16. RAPPAPORT A. M., BOROWY Z. J., LOUGHEED W. M., LOTTO W. N. Subdivision of hexagonal liver lobules into a structural and functional unit; role in hepatic physiology and pathology. Anat Rec. 1954 May;119(1):11–33. doi: 10.1002/ar.1091190103. [DOI] [PubMed] [Google Scholar]
  17. Reynolds T. B., Ito S., Iwatsuki S. Measurement of portal pressure and its clinical application. Am J Med. 1970 Nov;49:649–657. doi: 10.1016/s0002-9343(70)80131-0. [DOI] [PubMed] [Google Scholar]
  18. Rojkind M., Dunn M. A. Hepatic fibrosis. Gastroenterology. 1979 Apr;76(4):849–863. [PubMed] [Google Scholar]
  19. Rojkind M., Kershenobich D. Effect of colchicine on collagen, albumin and transferrin synthesis by cirrhotic rat liver slices. Biochim Biophys Acta. 1975 Feb 10;378(3):415–423. doi: 10.1016/0005-2787(75)90186-0. [DOI] [PubMed] [Google Scholar]
  20. 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]
  21. SCOBIE B. A., SUMMERSKILL W. H. HEPATIC CIRRHOSIS SECONDARY TO OBSTRUCTION OF THE BILIARY SYSTEM. Am J Dig Dis. 1965 Feb;10:135–146. doi: 10.1007/BF02236664. [DOI] [PubMed] [Google Scholar]
  22. Sedgwick C. E., Poulantzas J. K., Kune G. A. Management of portal hypertension secondary to bile duct strictures: review of 18 cases with splenorenal shunt. Ann Surg. 1966 Jun;163(6):949–953. doi: 10.1097/00000658-196606000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Stromeyer F. W., Ishak K. G. Nodular transformation (nodular "regenerative" hyperplasia) of the liver. A clinicopathologic study of 30 cases. Hum Pathol. 1981 Jan;12(1):60–71. doi: 10.1016/s0046-8177(81)80242-0. [DOI] [PubMed] [Google Scholar]
  24. Thaler M. M., Gellis S. S. Studies in neonatal hepatitis and biliary atresia. 3. Progression and regression of cirrhosis in biliary atresia. Am J Dis Child. 1968 Sep;116(3):271–279. doi: 10.1001/archpedi.1968.02100020273007. [DOI] [PubMed] [Google Scholar]
  25. WEINBREN K. The effect of bile duct obstruction on regeneration of the rat's liver. Br J Exp Pathol. 1953 Jun;34(3):280–289. [PMC free article] [PubMed] [Google Scholar]

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

RESOURCES