Chronic hepatobiliary diseases often present with overlapping clinical symptoms such as fatigue, pruritus, and elevated liver enzymes, making histopathological evaluation a critical component for definitive diagnosis. Match each hepatobiliary disorder with its most characteristic finding on liver biopsy.
- Primary biliary cholangitisFlorid duct lesion with granulomatous destruction of interlobular bile ducts
- Primary sclerosing cholangitisConcentric periductal fibrosis leading to bile duct obliteration
- Alpha-1 antitrypsin deficiencyPAS-positive, diastase-resistant intracytoplasmic globules in periportal hepatocytes
- Autoimmune hepatitisProminent lymphoplasmacytic infiltrate in the portal tracts with interface hepatitis
Answer
The correct matches are: Primary biliary cholangitis pairs with florid duct lesions and granulomatous destruction; Primary sclerosing cholangitis pairs with concentric periductal fibrosis; Alpha-1 antitrypsin deficiency pairs with PAS-positive, diastase-resistant globules; and Autoimmune hepatitis pairs with lymphoplasmacytic infiltrate and interface hepatitis.
Each of these chronic liver diseases has a distinct pathophysiology that is reflected in its histology. PBC is a granulomatous destruction of small ducts. PSC is a fibrosing disease of larger ducts. Alpha-1 antitrypsin deficiency is a storage disorder of misfolded proteins. Autoimmune hepatitis is an inflammatory condition characterized by plasma cells.
Step-by-Step Solution
Key Concept
Histopathological diagnosis of chronic hepatobiliary diseases