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Pathology of the liver

Lefkowitch, Jay H. MD

Current Opinion in Gastroenterology: May 1999 - Volume 15 - Issue 3 - p 192-199

Among the topics of recent investigation in liver pathology were an examination of normal portal tract structures in needle liver biopsies, computer reconstructions of the intrahepatic biliary tree, identification of oval cells (presumed progeny of hepatic stem cells) in a variety of biliary and nonbiliary diseases and tumors, the features and pathogenesis of nonalcoholic steatohepatitis, and further characterization of proliferating bile ductules. A morphometric study of portal structures in normal needle liver biopsies found that approximately one third in a given specimen may not show a portal vein and that a bile duct may not be seen in 7%. Apoptosis is a critical mechanism for the death of hepatocytes in viral hepatitis and also in endothelial injury in the cold perfusion–warm reperfusion sequence in liver transplantation. The results of two studies examining the relationship of steatosis to chronic hepatitis C virus infection in native and transplanted livers suggest that fatty change is a specific virus-mediated lesion. In the field of hepatic neoplasia, liver cell dysplasia (large cell change), long thought to be a premalignant lesion, was hypothesized to represent abnormal hepatocyte polyploidization.

College of Physicians and Surgeons of Columbia University, New York, New York, USA

Correspondence to J.H. Lefkowitch, College of Physicians and Surgeons of Columbia University, Department of Pathology, 630 West 168th Street, New York, NY 10032, USA

© 1999 Lippincott Williams & Wilkins, Inc.