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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