Histological analyses of trucut liver biopsies from patients with noncirrhotic portal fibrosis and extra-hepatic portal vein obstruction

Background: Both noncirrhotic portal fibrosis (NCPF) and extrahepatic portal venous obstruction (EHPVO) are important causes of noncirrhotic portal hypertension (PH) in the Asian region. In this study, we analyzed the histopathological changes of liver needle-core biopsies from patients with NCPF an...

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Autores principales:	Archana George Vallonthaiel, Vandana Baloda, Lavleen Singh, Rajni Yadav, Ragini Kilambi, Sudha Battu, Vishnubhatla Sreenivas, Sujoy Pal, Subrat K Acharya, Siddhartha DattaGupta, Shalimar, Prasenjit Das
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer Medknow Publications 2021
Materias:	extra-hepatic portal vein obstruction histology noncirrhotic portal fibrosis portal hypertension portal vein Pathology RB1-214 Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/f6702fe8a3284562a29b13482babbdb3
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spelling	oai:doaj.org-article:f6702fe8a3284562a29b13482babbdb32021-12-02T19:23:04ZHistological analyses of trucut liver biopsies from patients with noncirrhotic portal fibrosis and extra-hepatic portal vein obstruction0377-492910.4103/IJPM.IJPM_387_20https://doaj.org/article/f6702fe8a3284562a29b13482babbdb32021-01-01T00:00:00Zhttp://www.ijpmonline.org/article.asp?issn=0377-4929;year=2021;volume=64;issue=5;spage=127;epage=135;aulast=Vallonthaielhttps://doaj.org/toc/0377-4929Background: Both noncirrhotic portal fibrosis (NCPF) and extrahepatic portal venous obstruction (EHPVO) are important causes of noncirrhotic portal hypertension (PH) in the Asian region. In this study, we analyzed the histopathological changes of liver needle-core biopsies from patients with NCPF and EHPVO. Patients and Methods: The patients were diagnosed as per the Asia Pacific Association for the Study of Liver (APASL) criteria. Minimum adequacy criteria for liver core biopsies were defined, and finally, 69 liver biopsies from patients with NCPF and 100 liver biopsies from patients with EHPVO were analyzed. All histological parameters were predefined, and three experienced pathologists analyzed the biopsies after reaching consensus. Institute ethics committee clearance was taken. Results: Although some histological features were overlapping, phlebosclerosis of intra-hepatic branches of the portal vein (PV), periportal aberrant vascular channels, remnant portal tracts, and hepatic fibrosis beyond the portal tracts without the formation of complete hepatic nodules (P < 0.001 for all) were common histological characteristics of NCPF on core-needle liver biopsies; while maintained lobular architecture, nonspecific dilatation of PV branches, absence of intra-hepatic PV phlebosclerosis, aberrant vascular channels, and significant fibrosis were characteristics of EHPVO. Conclusions: Despite the considerable histological overlap between NCPF and EHPVO, careful histological evaluation, supplemented by clinical features, radiological and biochemical findings can help in making a conclusive diagnosis. Patients with NCPF and EHPVO with clinical jaundice show transaminitis, high serum alkaline phosphatase level, more variceal bleed, and histological evidences of nodular regenerative hyperplasia.Archana George VallonthaielVandana BalodaLavleen SinghRajni YadavRagini KilambiSudha BattuVishnubhatla SreenivasSujoy PalSubrat K AcharyaSiddhartha DattaGuptaShalimarPrasenjit DasWolters Kluwer Medknow Publicationsarticleextra-hepatic portal vein obstructionhistologynoncirrhotic portal fibrosisportal hypertensionportal veinPathologyRB1-214MicrobiologyQR1-502ENIndian Journal of Pathology and Microbiology, Vol 64, Iss 5, Pp 127-135 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	extra-hepatic portal vein obstruction histology noncirrhotic portal fibrosis portal hypertension portal vein Pathology RB1-214 Microbiology QR1-502
spellingShingle	extra-hepatic portal vein obstruction histology noncirrhotic portal fibrosis portal hypertension portal vein Pathology RB1-214 Microbiology QR1-502 Archana George Vallonthaiel Vandana Baloda Lavleen Singh Rajni Yadav Ragini Kilambi Sudha Battu Vishnubhatla Sreenivas Sujoy Pal Subrat K Acharya Siddhartha DattaGupta Shalimar Prasenjit Das Histological analyses of trucut liver biopsies from patients with noncirrhotic portal fibrosis and extra-hepatic portal vein obstruction
description	Background: Both noncirrhotic portal fibrosis (NCPF) and extrahepatic portal venous obstruction (EHPVO) are important causes of noncirrhotic portal hypertension (PH) in the Asian region. In this study, we analyzed the histopathological changes of liver needle-core biopsies from patients with NCPF and EHPVO. Patients and Methods: The patients were diagnosed as per the Asia Pacific Association for the Study of Liver (APASL) criteria. Minimum adequacy criteria for liver core biopsies were defined, and finally, 69 liver biopsies from patients with NCPF and 100 liver biopsies from patients with EHPVO were analyzed. All histological parameters were predefined, and three experienced pathologists analyzed the biopsies after reaching consensus. Institute ethics committee clearance was taken. Results: Although some histological features were overlapping, phlebosclerosis of intra-hepatic branches of the portal vein (PV), periportal aberrant vascular channels, remnant portal tracts, and hepatic fibrosis beyond the portal tracts without the formation of complete hepatic nodules (P < 0.001 for all) were common histological characteristics of NCPF on core-needle liver biopsies; while maintained lobular architecture, nonspecific dilatation of PV branches, absence of intra-hepatic PV phlebosclerosis, aberrant vascular channels, and significant fibrosis were characteristics of EHPVO. Conclusions: Despite the considerable histological overlap between NCPF and EHPVO, careful histological evaluation, supplemented by clinical features, radiological and biochemical findings can help in making a conclusive diagnosis. Patients with NCPF and EHPVO with clinical jaundice show transaminitis, high serum alkaline phosphatase level, more variceal bleed, and histological evidences of nodular regenerative hyperplasia.
format	article
author	Archana George Vallonthaiel Vandana Baloda Lavleen Singh Rajni Yadav Ragini Kilambi Sudha Battu Vishnubhatla Sreenivas Sujoy Pal Subrat K Acharya Siddhartha DattaGupta Shalimar Prasenjit Das
author_facet	Archana George Vallonthaiel Vandana Baloda Lavleen Singh Rajni Yadav Ragini Kilambi Sudha Battu Vishnubhatla Sreenivas Sujoy Pal Subrat K Acharya Siddhartha DattaGupta Shalimar Prasenjit Das
author_sort	Archana George Vallonthaiel
title	Histological analyses of trucut liver biopsies from patients with noncirrhotic portal fibrosis and extra-hepatic portal vein obstruction
title_short	Histological analyses of trucut liver biopsies from patients with noncirrhotic portal fibrosis and extra-hepatic portal vein obstruction
title_full	Histological analyses of trucut liver biopsies from patients with noncirrhotic portal fibrosis and extra-hepatic portal vein obstruction
title_fullStr	Histological analyses of trucut liver biopsies from patients with noncirrhotic portal fibrosis and extra-hepatic portal vein obstruction
title_full_unstemmed	Histological analyses of trucut liver biopsies from patients with noncirrhotic portal fibrosis and extra-hepatic portal vein obstruction
title_sort	histological analyses of trucut liver biopsies from patients with noncirrhotic portal fibrosis and extra-hepatic portal vein obstruction
publisher	Wolters Kluwer Medknow Publications
publishDate	2021
url	https://doaj.org/article/f6702fe8a3284562a29b13482babbdb3
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Histological analyses of trucut liver biopsies from patients with noncirrhotic portal fibrosis and extra-hepatic portal vein obstruction

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