Fibrosis & Cirrhosis
Cirrhosis
Pathology
A key ingredient is fibrosis, whose development and extent
depends upon the interplay of many factors. The progression of fibrosis
to cirrhosis similarly depends upon the extent of injury, the presence
of continuing damage, and the liver's reaction to these agents.
Thus the lesion of cirrhosis is not static, and the features seen
depend upon the activity and stage of the disease involved. Classification
of pathology in cirrhosis may indicate the prominent features found
in any one specimen but does not provide etiologic information nor
a complete morphologic description of the pathology.
The common classification of the histopathology in cirrhosis: Micronodular
cirrhosis is characterized by thin, regular bands of connective
tissue and by small nodules (up to 1 cm in diameter) that vary little
in size. Typically, terminal hepatic venules or portal tracts are
difficult to identify. Macronodular cirrhosis is characterized by
nodules that vary in size (up to 5 cm in diameter), are often multinodular,
and contain portal tracts and terminal hepatic venules. Broad fibrous
bands of varying thickness surround the nodules. Collapse of the
normal liver architecture is suggested by the concentration of portal
tracts within the fibrous scars. Mixed cirrhosis (incomplete septal
cirrhosis) combines elements of micro- and macronodular cirrhosis.
Regeneration within the nodules is less conspicuous, and hepatic
venules and portal tracts are seen more often.
Source:The Merck Manual
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