Publication: The pathology of the atrophylhypertrophy complex (AHC) of the liver. A light microscopic and immunohistochemical study
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Date
1994
Authors
Lory, J. ; Schweizer, W. ; Blumgart, L.H. ; Zimmermann, Astrid
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Publisher
Murcia : F. Hernández
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DOI
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info:eu-repo/semantics/article
Description
Abstract
The term, atrophylhypertrophy complex
(AHC) of the liver, denotes a distinct combination of
hepatic atrophy and hypertrophy occurring in situations
of significant impairment of bile flow andlor portal or
hepatic venous blood flow. In the lobes or segments
concerned atrophy ensues, whereas areas not or less
involved develop compensatory hypertrophy, resulting in
a characteristic gross deformity of the organ and, in
some instances, in rotation of the liver around a virtual
hilar axis. As recognition and early detection of AHC
have a strong implication on the treatment of several
hepatobiliary diseases, adequate combined clinical,
radiological and histopathological strategies have to be
used in order to arrive at a correct diagnosis. The present
investigation was designed to analyze the morphology
of AHC in detail and to define lesion patterns having
the highest predictive value. For atrophy, the following
features were highly characteristic: 1) Advanced septal
fibrosis with or without nodular change of parenchyma;
2) Biliary piecemeal necrosis with formation of vascular
structures; 3) Ductular proliferations, frequently
extending into septa and involving the parenchyma;
4) Capillarization of sinusoids with type IV collagen
deposition in Disse's space; 5) Factor VIII-associated
antigen expression by sinusoidal endothelia; 6) a
seemingly paradoxical increase of proliferative activity
of hepatocytes as based on PCNA staining. The severity
of lesions in atrophy was related to the type of
underlying disease, in that the changes were clearly
more expressed in situations of longstanding obstruction
due to benign disease. Using a set of well-defined
morphological parameters, atrophy can be reproducibly
distinguished from hypertrophy in biopsy material from
AHC.
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