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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Liver Problems

Nature of Spaecimen:Liver (Needle) biopsy
Section Show a short core of liver parenchyma with overall preserved architecture containing 6 portal tracts . three of them are expanded due to fibrosis with periportal extension. patchy mild lymphmononuclear infiltrates and ductular reaction are seen. Lobules show scattered canalicular chholestatic with foramtion of cholestatic rosettes.Sinusoidal kupffer cells are hyperplastic and present in clusters with foamy cytoplasm and centrally placed small nuuclei.Foci of extramedullary erythorposiesis are seen.Special strains do not show any globules of alpha-1 antitrypsin, inscrease in stainable iron copper or copper binding protein.Prominent pericellular fibrosis with formation of micronodules are seen.There is no frank cirrhosis.
Mon, 4 Aug 2014
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Gastroenterologist, Surgical 's  Response
Hi,
How are you? Thanks for the very detailed histo-path report of the needle biopsy. But unfortunately it is very difficult to interpret the biopsy report without a clinical context. Please do let me know the clinical condition of the patient, esp his / her age and any symptoms, if any, they might be suffering from. What was the indication for the biopsy?
Just by looking at the biopsy report, I would guess its from a child (due to the extramedullary erythropoeisis). There appears to be changes due to bile duct blockage (cholestasis and ductular reaction) which seems to have been going on for a while (due to portal tract expansion and initiation of fibrosis). Although cirrhotic changes are not yet seen, I would say, whatever the condition of the patient now, he is on his way there. The three most common conditions causing cirrhosis in a child have been ruled out (hemochromatosis - increased iron, Wilson's - Increased copper and Alpha 1 anti-trypsin defeciency)

Please do let me know some clinical details regarding the patient so that I can advise you better.

Please do not hesitate to contact me for any further details required - rxsuresh@gmail.com
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Suggest Treatment For Liver Problems

Hi, How are you? Thanks for the very detailed histo-path report of the needle biopsy. But unfortunately it is very difficult to interpret the biopsy report without a clinical context. Please do let me know the clinical condition of the patient, esp his / her age and any symptoms, if any, they might be suffering from. What was the indication for the biopsy? Just by looking at the biopsy report, I would guess its from a child (due to the extramedullary erythropoeisis). There appears to be changes due to bile duct blockage (cholestasis and ductular reaction) which seems to have been going on for a while (due to portal tract expansion and initiation of fibrosis). Although cirrhotic changes are not yet seen, I would say, whatever the condition of the patient now, he is on his way there. The three most common conditions causing cirrhosis in a child have been ruled out (hemochromatosis - increased iron, Wilson s - Increased copper and Alpha 1 anti-trypsin defeciency) Please do let me know some clinical details regarding the patient so that I can advise you better. Please do not hesitate to contact me for any further details required - rxsuresh@gmail.com