Primary biliary cholangitis - Revision history

Michael at 22:29, 9 October 2021

2021-10-09T22:29:50Z

← Older revision		Revision as of 22:29, 9 October 2021
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	'''Primary biliary cholangitis''', abbreviated '''PBC''', is a rare [[medical liver disease]].		'''Primary biliary cholangitis''', abbreviated '''PBC''', is a rare [[medical liver disease]].

	It was previously known as ''primary ciliary cirrhosis''.<ref name=pmid26416194>{{cite journal \|~~vauthors~~=Beuers U, Gershwin ME, Gish RG, Invernizzi P, Jones DE, Lindor K, Ma X, Mackay IR, Parés A, Tanaka A, Vierling JM, Poupon R \|title=Changing Nomenclature for PBC: From 'Cirrhosis' to 'Cholangitis' \|journal=Am J Gastroenterol \|volume=110 \|issue=11 \|pages=1536–8 \|date=November 2015 \|pmid=26416194 \|pmc=4679751 \|doi=10.1038/ajg.2015.312 \|url=}}</ref>		It was previously known as ''primary ciliary cirrhosis''.<ref name=pmid26416194>{{cite journal \|authors=Beuers U, Gershwin ME, Gish RG, Invernizzi P, Jones DE, Lindor K, Ma X, Mackay IR, Parés A, Tanaka A, Vierling JM, Poupon R \|title=Changing Nomenclature for PBC: From 'Cirrhosis' to 'Cholangitis' \|journal=Am J Gastroenterol \|volume=110 \|issue=11 \|pages=1536–8 \|date=November 2015 \|pmid=26416194 \|pmc=4679751 \|doi=10.1038/ajg.2015.312 \|url=}}</ref>

	==General==		==General==

Michael: tweak

2021-09-30T20:53:30Z

tweak

← Older revision		Revision as of 20:53, 30 September 2021
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	\| Image = Primary_biliary_cirrhosis_intermed_mag.jpg		\| Image = Primary_biliary_cirrhosis_intermed_mag.jpg
	\| Width =		\| Width =
	\| Caption = Primary biliary ~~cirrhosis~~. [[H&E stain]].		\| Caption = Primary biliary cholangitis. [[H&E stain]].
			\| Synonyms = primary biliary cirrhosis (obsolete term)
	\| Micro = "florid duct lesion": intraepithelial lymphocytes - in bile duct, bile duct epithelial cells with eosinophilic cytoplasm; plasma cells; +/-[[granulomas]] (close to bile duct); +/-"garland" cirrhosis -- has irregular border		\| Micro = "florid duct lesion": intraepithelial lymphocytes - in bile duct, bile duct epithelial cells with eosinophilic cytoplasm; plasma cells; +/-[[granulomas]] (close to bile duct); +/-"garland" cirrhosis -- has irregular border
	\| Subtypes =		\| Subtypes =

Michael: rename article

2021-09-30T20:52:13Z

rename article

← Older revision		Revision as of 20:52, 30 September 2021
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	\| ClinDDx =		\| ClinDDx =
	}}		}}
	'''Primary biliary ~~cirrhosis~~''', abbreviated '''PBC''', is a rare [[medical liver disease]].		'''Primary biliary cholangitis''', abbreviated '''PBC''', is a rare [[medical liver disease]].

			It was previously known as ''primary ciliary cirrhosis''.<ref name=pmid26416194>{{cite journal \|vauthors=Beuers U, Gershwin ME, Gish RG, Invernizzi P, Jones DE, Lindor K, Ma X, Mackay IR, Parés A, Tanaka A, Vierling JM, Poupon R \|title=Changing Nomenclature for PBC: From 'Cirrhosis' to 'Cholangitis' \|journal=Am J Gastroenterol \|volume=110 \|issue=11 \|pages=1536–8 \|date=November 2015 \|pmid=26416194 \|pmc=4679751 \|doi=10.1038/ajg.2015.312 \|url=}}</ref>

	==General==		==General==

Michael: Michael moved page Primary biliary cirrhosis to Primary biliary cholangitis: the disease was renamed

2021-09-30T20:50:49Z

Michael moved page Primary biliary cirrhosis to Primary biliary cholangitis: the disease was renamed

← Older revision	Revision as of 20:50, 30 September 2021
(No difference)

Mitchell: /* Images */ added case with cirrhosis

2016-10-25T16:31:38Z

Images: added case with cirrhosis

← Older revision		Revision as of 16:31, 25 October 2016
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	\|}		\|}
	Primary biliary cirrhosis with bridging fibrosis. Acini & lobules distorted by inflammation (Row 1 Left 40X) Loose granuloma in triad without duct (Row 1 Right 200X) Well-formed granuloma (Row 2 Left 200X) Piecemeal necrosis, PAS without diastase (Row 2 Right 200X) Damaged bile duct, PAS with diastase (Row 3 Left 400X) Bridging fibrosis, trichrome (Row 3 Right,200X)		Primary biliary cirrhosis with bridging fibrosis. Acini & lobules distorted by inflammation (Row 1 Left 40X) Loose granuloma in triad without duct (Row 1 Right 200X) Well-formed granuloma (Row 2 Left 200X) Piecemeal necrosis, PAS without diastase (Row 2 Right 200X) Damaged bile duct, PAS with diastase (Row 3 Left 400X) Bridging fibrosis, trichrome (Row 3 Right,200X)
			{\|
			[[File:1 PBC 5 680x512px.tif\|Stage 4 PBC.]]
			[[File:2 PBC 5 680x512px.tif\| Stage 4 PBC.]]
			<br>
			[[File:3 PBC 5 680x512px.tif\| Stage 4 PBC.]]
			[[File:4 PBC 5 680x512px.tif\| Stage 4 PBC.]]
			<br>
			[[File:5 PBC 5 680x512px.tif\| Stage 4 PBC.]]
			[[File:6 PBC 5 680x512px.tif\| Stage 4 PBC.]]
			\|}
			Primary biliary cirrhosis with Metavir stage 4 fibrosis (extensive fibrosis/cirrhosis). The patient was AMA positive and ANA negative. A. Inflamed tracts and bridges are intensely inflamed, with odd appearing edges of hepatocytes (arrows), suggestive of a jig saw pattern [40x]. B. Trichrome shows thin fibrous bands bounding regenerative isles (arrows) [Trichrome, 100X]. C. Reticulin shows two cell thick cords and cords lacking orientation, documenting regeneration; black lines about single cells document piecemeal necrosis [100X]. D. Lymphocytes, plasma cells, and macrophages, show piecemeal necrosis, surrounding hepatocytes (cyan arrows), as well as spreading into the lobule (green arrows), with aggregates reflecting spotty necrosis (black arrow). [400X]. E. PAS with diastase highlights a proliferated bile ductule (arrows) with epithelial damage [400X]. F. PAS with diastase shows an arteriole (green arrow) at great distance from an isolated bile ductule at the periphery of the triad (cyan arrow), consistent with loss of bile duct; neutrophils (black arrows) do not prove ascending cholangitis [400X].

	===Staging PBC===		===Staging PBC===

Mitchell: /* Images */ Added a case & adjusted matters for old cases with minor edits

2016-08-25T21:08:30Z

Images: Added a case & adjusted matters for old cases with minor edits

← Older revision		Revision as of 21:08, 25 August 2016
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	www:		www:
	*[http://www.gidesigns.net/images/MC-copper-flower-garland-L.jpg Garland - wreath of flowers (gidesigns.net)].		*[http://www.gidesigns.net/images/MC-copper-flower-garland-L.jpg Garland - wreath of flowers (gidesigns.net)].
			{\|
			[[File:1 PBC 4 680x512px.tif\|Inflamed triads [arrows] amid undisturbed hepatocytes (Row 1 Left 40X).]]
			[[File:2 PBC 4 680x512px.tif\|Granuloma in portal triad (Row 1 Right 400X).]]
			<br>
			[[File:3 PBC 4 680x512px.tif\|Florid duct lesion (Row 2 Left 400X).]]
			[[File:4 PBC 4 680x512px.tif\|Triad missing interlobular bile duct (Row 2 Right 400X).]]
			\|}
			Primary biliary cirrhosis. Inflamed triads [arrows] amid undisturbed hepatocytes (Row 1 Left 40X). Granuloma in portal triad (Row 1 Right 400X). Florid duct lesion (Row 2 Left 400X). Triad missing interlobular bile duct (Row 2 Right 400X).

	{\|		{\|
	[[File:1 PBC 3 680x512px.tif\| Ill defined triads, inflamed lobule (40X).]]		[[File:1 PBC 3 680x512px.tif\| Ill defined triads, inflamed lobule (40X).]]
	[[File:2 PBC 3 680x512px.tif\| Triad without a bile duct. Macrophages & occasional lymphocytes without epithelioid cells needed for granuloma and space where bile duct likely once was [cyan arrowhead] (400X).]]		[[File:2 PBC 3 680x512px.tif\| Triad without a bile duct. Macrophages & occasional lymphocytes without epithelioid cells needed for granuloma and space where bile duct likely once was [cyan arrowhead] (400X).]]
			<br>
	[[File:3 PBC 3 680x512px.tif\| PAS without diastase shows triad lacking bile duct and piecemeal necrosis (200X).]]		[[File:3 PBC 3 680x512px.tif\| PAS without diastase shows triad lacking bile duct and piecemeal necrosis (200X).]]
			[[File:4 PBC 3 680x512px.tif\| PAS with diastase shows bile duct/proliferating bile ductules with epithelial injury and hepatocytes with ballooning degeneration (400X).]]
	<br>		<br>
	~~[[File:4 PBC 3 680x512px.tif\| PAS with diastase shows bile duct/proliferating bile ductules with epithelial injury and hepatocytes with ballooning degeneration (400X).]]~~
	[[File:5 PBC 3 680x512px.tif\| Trichrome shows space of Disse collagenization and periportal fibrosis without definite bridging (100X)..]]		[[File:5 PBC 3 680x512px.tif\| Trichrome shows space of Disse collagenization and periportal fibrosis without definite bridging (100X)..]]
	[[File:6 PBC 3 680x512px.tif\| Iron stain shows isolated focus of hepatocytes with cytoplasmic blue granules (200X)]]		[[File:6 PBC 3 680x512px.tif\| Iron stain shows isolated focus of hepatocytes with cytoplasmic blue granules (200X)]]
	\|}		\|}
	Primary biliary cirrhosis. AMA positive. Viral serology/ANA negative. No definite granulomas. Ill defined triads, inflamed lobule (TL 40X). Triad without a bile duct. Macrophages & occasional lymphocytes without epithelioid cells needed for granuloma and space where bile duct likely once was [cyan arrowhead] (TM 400X). PAS without diastase shows triad lacking bile duct and piecemeal necrosis (TR 200X). PAS with diastase shows bile duct/proliferating bile ductules with epithelial injury and hepatocytes with ballooning degeneration (BL 400X). Trichrome shows space of Disse collagenization and periportal fibrosis without definite bridging (BM 100X). Iron stain shows isolated focus of hepatocytes with cytoplasmic blue granules (BR 200X).		Primary biliary cirrhosis. AMA positive. Viral serology/ANA negative. No definite granulomas. Ill defined triads, inflamed lobule (Row 1 Left 40X). Triad without a bile duct. Macrophages & occasional lymphocytes without epithelioid cells needed for granuloma and space where bile duct likely once was [cyan arrowhead] (Row 1 Right 400X). PAS without diastase shows triad lacking bile duct and piecemeal necrosis (Row 2 Left 200X). PAS with diastase shows bile duct/proliferating bile ductules with epithelial injury and hepatocytes with ballooning degeneration (Row 2 Right 400X). Trichrome shows space of Disse collagenization and periportal fibrosis without definite bridging (Row 3 Left 100X). Iron stain shows isolated focus of hepatocytes with cytoplasmic blue granules (Row 3 Right 200X).

	{\|		{\|
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	[[File:4 PBC 2 680x512px.tif\|Trichrome of the same triad shows portal fibrosis (200X).]]		[[File:4 PBC 2 680x512px.tif\|Trichrome of the same triad shows portal fibrosis (200X).]]
	\|}		\|}
	Primary biliary cirrhosis. Two inflamed triads accompany acini with mild steatosis (UL 20X).		Primary biliary cirrhosis. Two inflamed triads accompany acini with mild steatosis (Row 1 Left 20X). A triad bears a poorly formed granuloma [yellow arrowhead]. A bile duct is also seen [red arrowhead] (Row 1 Right 200X). A triad lacks a bile duct (Row 2 Left 200X). Trichrome of the same triad shows portal fibrosis (Row 2 Right 200X).
	A triad bears a poorly formed granuloma [yellow arrowhead]. A bile duct is also seen [red arrowhead] (UR 200X). A triad lacks a bile duct (LL 200X). Trichrome of the same triad shows portal fibrosis (LR 200X).

	{\|		{\|
	[[File:1 PBC - 1 - 40X 680x512px.tif\|Acini & lobules distorted by inflammation]]		[[File:1 PBC - 1 - 40X 680x512px.tif\|Acini & lobules distorted by inflammation]]
	[[File:2 PBC - 1 - 200X 680x512px.tif\|Loose granuloma in triad without duct]]		[[File:2 PBC - 1 - 200X 680x512px.tif\|Loose granuloma in triad without duct]]
			<br>
	[[File:3 PBC - 1 - 200X 680x512px.tif\|Well-formed granuloma]]		[[File:3 PBC - 1 - 200X 680x512px.tif\|Well-formed granuloma]]
			[[File:4 PBC - 1 -200X 680x512px.tif\|Piecemeal necrosis, PAS without diastase]]
	<br>		<br>
	~~[[File:4 PBC - 1 -200X 680x512px.tif\|Piecemeal necrosis, PAS without diastase]]~~
	[[File:5 PBC - 1 -400X 680x512px.tif\|Damaged bile duct, PAS with diastase]]		[[File:5 PBC - 1 -400X 680x512px.tif\|Damaged bile duct, PAS with diastase]]
	[[File:6 PBC - 1 -200X 680x512px.tif\|Bridging fibrosis, trichrome]]		[[File:6 PBC - 1 -200X 680x512px.tif\|Bridging fibrosis, trichrome]]
	\|}		\|}
	Primary biliary cirrhosis with bridging fibrosis. Acini & lobules distorted by inflammation (~~TL,~~40X) Loose granuloma in triad without duct (~~TM,~~200X) Well-formed granuloma (~~TR,~~200X) Piecemeal necrosis, PAS without diastase (~~BL,~~200X) Damaged bile duct, PAS with diastase (~~BM,~~400X) Bridging fibrosis, trichrome (BR,200X)		Primary biliary cirrhosis with bridging fibrosis. Acini & lobules distorted by inflammation (Row 1 Left 40X) Loose granuloma in triad without duct (Row 1 Right 200X) Well-formed granuloma (Row 2 Left 200X) Piecemeal necrosis, PAS without diastase (Row 2 Right 200X) Damaged bile duct, PAS with diastase (Row 3 Left 400X) Bridging fibrosis, trichrome (Row 3 Right,200X)

	===Staging PBC===		===Staging PBC===

Mitchell: /* Images */ added a case without definite granulomas

2016-07-29T17:01:12Z

Images: added a case without definite granulomas

← Older revision		Revision as of 17:01, 29 July 2016
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	www:		www:
	*[http://www.gidesigns.net/images/MC-copper-flower-garland-L.jpg Garland - wreath of flowers (gidesigns.net)].		*[http://www.gidesigns.net/images/MC-copper-flower-garland-L.jpg Garland - wreath of flowers (gidesigns.net)].
			{\|
			[[File:1 PBC 3 680x512px.tif\| Ill defined triads, inflamed lobule (40X).]]
			[[File:2 PBC 3 680x512px.tif\| Triad without a bile duct. Macrophages & occasional lymphocytes without epithelioid cells needed for granuloma and space where bile duct likely once was [cyan arrowhead] (400X).]]
			[[File:3 PBC 3 680x512px.tif\| PAS without diastase shows triad lacking bile duct and piecemeal necrosis (200X).]]
			<br>
			[[File:4 PBC 3 680x512px.tif\| PAS with diastase shows bile duct/proliferating bile ductules with epithelial injury and hepatocytes with ballooning degeneration (400X).]]
			[[File:5 PBC 3 680x512px.tif\| Trichrome shows space of Disse collagenization and periportal fibrosis without definite bridging (100X)..]]
			[[File:6 PBC 3 680x512px.tif\| Iron stain shows isolated focus of hepatocytes with cytoplasmic blue granules (200X)]]
			\|}
			Primary biliary cirrhosis. AMA positive. Viral serology/ANA negative. No definite granulomas. Ill defined triads, inflamed lobule (TL 40X). Triad without a bile duct. Macrophages & occasional lymphocytes without epithelioid cells needed for granuloma and space where bile duct likely once was [cyan arrowhead] (TM 400X). PAS without diastase shows triad lacking bile duct and piecemeal necrosis (TR 200X). PAS with diastase shows bile duct/proliferating bile ductules with epithelial injury and hepatocytes with ballooning degeneration (BL 400X). Trichrome shows space of Disse collagenization and periportal fibrosis without definite bridging (BM 100X). Iron stain shows isolated focus of hepatocytes with cytoplasmic blue granules (BR 200X).

	{\|		{\|
	[[File:1 PBC 2 680x512px.tif\|Two inflamed triads accompany acini with mild steatosis (20X).]]		[[File:1 PBC 2 680x512px.tif\|Two inflamed triads accompany acini with mild steatosis (20X).]]
	[[File:2 PBC 2 680x512px.tif\|A triad bears a poorly formed granuloma [yellow arrowhead]. A bile duct is also seen [red arrowhead] (200X).]]		[[File:2 PBC 2 680x512px.tif\|A triad bears a poorly formed granuloma [yellow arrowhead]. A bile duct is also seen [red arrowhead] (200X).]]
			<br>
	[[File:3 PBC 2 680x512px.tif\|A triad lacks a bile duct (200X).]]		[[File:3 PBC 2 680x512px.tif\|A triad lacks a bile duct (200X).]]
	[[File:4 PBC 2 680x512px.tif\|Trichrome of the same triad shows portal fibrosis (200X).]]		[[File:4 PBC 2 680x512px.tif\|Trichrome of the same triad shows portal fibrosis (200X).]]
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	[[File:2 PBC - 1 - 200X 680x512px.tif\|Loose granuloma in triad without duct]]		[[File:2 PBC - 1 - 200X 680x512px.tif\|Loose granuloma in triad without duct]]
	[[File:3 PBC - 1 - 200X 680x512px.tif\|Well-formed granuloma]]		[[File:3 PBC - 1 - 200X 680x512px.tif\|Well-formed granuloma]]
			<br>
	[[File:4 PBC - 1 -200X 680x512px.tif\|Piecemeal necrosis, PAS without diastase]]		[[File:4 PBC - 1 -200X 680x512px.tif\|Piecemeal necrosis, PAS without diastase]]
	[[File:5 PBC - 1 -400X 680x512px.tif\|Damaged bile duct, PAS with diastase]]		[[File:5 PBC - 1 -400X 680x512px.tif\|Damaged bile duct, PAS with diastase]]
	[[File:6 PBC - 1 -200X 680x512px.tif\|Bridging fibrosis, trichrome]]		[[File:6 PBC - 1 -200X 680x512px.tif\|Bridging fibrosis, trichrome]]
	\|}		\|}
			Primary biliary cirrhosis with bridging fibrosis. Acini & lobules distorted by inflammation (TL,40X) Loose granuloma in triad without duct (TM,200X) Well-formed granuloma (TR,200X) Piecemeal necrosis, PAS without diastase (BL,200X) Damaged bile duct, PAS with diastase (BM,400X) Bridging fibrosis, trichrome (BR,200X)
	Primary biliary cirrhosis with bridging fibrosis. Acini & lobules distorted by inflammation (TL,40X) Loose granuloma in triad without duct (TR,200X) Well-formed granuloma (ML,200X) Piecemeal necrosis, PAS without diastase (MR,200X) Damaged bile duct, PAS with diastase (BL,400X) Bridging fibrosis, trichrome (BR,200X)

	===Staging PBC===		===Staging PBC===

Mitchell: /* Microscopic */ a second PBC case, this one much more typically hard to diagnose!

2016-07-12T19:18:12Z

Microscopic: a second PBC case, this one much more typically hard to diagnose!

← Older revision		Revision as of 19:18, 12 July 2016
Line 85:		Line 85:
	www:		www:
	*[http://www.gidesigns.net/images/MC-copper-flower-garland-L.jpg Garland - wreath of flowers (gidesigns.net)].		*[http://www.gidesigns.net/images/MC-copper-flower-garland-L.jpg Garland - wreath of flowers (gidesigns.net)].
			{\|
			[[File:1 PBC 2 680x512px.tif\|Two inflamed triads accompany acini with mild steatosis (20X).]]
			[[File:2 PBC 2 680x512px.tif\|A triad bears a poorly formed granuloma [yellow arrowhead]. A bile duct is also seen [red arrowhead] (200X).]]
			[[File:3 PBC 2 680x512px.tif\|A triad lacks a bile duct (200X).]]
			[[File:4 PBC 2 680x512px.tif\|Trichrome of the same triad shows portal fibrosis (200X).]]
			\|}
			Primary biliary cirrhosis. Two inflamed triads accompany acini with mild steatosis (UL 20X).
			A triad bears a poorly formed granuloma [yellow arrowhead]. A bile duct is also seen [red arrowhead] (UR 200X). A triad lacks a bile duct (LL 200X). Trichrome of the same triad shows portal fibrosis (LR 200X).

	{\|		{\|

Mitchell: /* Images */

2016-07-07T21:59:55Z

Images

← Older revision		Revision as of 21:59, 7 July 2016
Line 85:		Line 85:
	www:		www:
	*[http://www.gidesigns.net/images/MC-copper-flower-garland-L.jpg Garland - wreath of flowers (gidesigns.net)].		*[http://www.gidesigns.net/images/MC-copper-flower-garland-L.jpg Garland - wreath of flowers (gidesigns.net)].

			{\|
			[[File:1 PBC - 1 - 40X 680x512px.tif\|Acini & lobules distorted by inflammation]]
			[[File:2 PBC - 1 - 200X 680x512px.tif\|Loose granuloma in triad without duct]]
			[[File:3 PBC - 1 - 200X 680x512px.tif\|Well-formed granuloma]]
			[[File:4 PBC - 1 -200X 680x512px.tif\|Piecemeal necrosis, PAS without diastase]]
			[[File:5 PBC - 1 -400X 680x512px.tif\|Damaged bile duct, PAS with diastase]]
			[[File:6 PBC - 1 -200X 680x512px.tif\|Bridging fibrosis, trichrome]]
			\|}

			Primary biliary cirrhosis with bridging fibrosis. Acini & lobules distorted by inflammation (TL,40X) Loose granuloma in triad without duct (TR,200X) Well-formed granuloma (ML,200X) Piecemeal necrosis, PAS without diastase (MR,200X) Damaged bile duct, PAS with diastase (BL,400X) Bridging fibrosis, trichrome (BR,200X)

	===Staging PBC===		===Staging PBC===

Michael: replace

2015-04-25T19:42:18Z

replace

← Older revision		Revision as of 19:42, 25 April 2015
Line 1:		Line 1:
	{{ Infobox diagnosis		{{ Infobox diagnosis
	\| Name = {{PAGENAME}}		\| Name = {{PAGENAME}}
	\| Image = ~~Primary_biliary_cirrhosis_low_mag~~.jpg		\| Image = Primary_biliary_cirrhosis_intermed_mag.jpg
	\| Width =		\| Width =
	\| Caption = Primary biliary cirrhosis. [[H&E stain]].		\| Caption = Primary biliary cirrhosis. [[H&E stain]].

← Older revision		Revision as of 21:08, 25 August 2016
Line 85:		Line 85:
	www:		www:
	*[http://www.gidesigns.net/images/MC-copper-flower-garland-L.jpg Garland - wreath of flowers (gidesigns.net)].		*[http://www.gidesigns.net/images/MC-copper-flower-garland-L.jpg Garland - wreath of flowers (gidesigns.net)].
			{\|
			[[File:1 PBC 4 680x512px.tif\|Inflamed triads [arrows] amid undisturbed hepatocytes (Row 1 Left 40X).]]
			[[File:2 PBC 4 680x512px.tif\|Granuloma in portal triad (Row 1 Right 400X).]]
			<br>
			[[File:3 PBC 4 680x512px.tif\|Florid duct lesion (Row 2 Left 400X).]]
			[[File:4 PBC 4 680x512px.tif\|Triad missing interlobular bile duct (Row 2 Right 400X).]]
			\|}
			Primary biliary cirrhosis. Inflamed triads [arrows] amid undisturbed hepatocytes (Row 1 Left 40X). Granuloma in portal triad (Row 1 Right 400X). Florid duct lesion (Row 2 Left 400X). Triad missing interlobular bile duct (Row 2 Right 400X).

	{\|		{\|
	[[File:1 PBC 3 680x512px.tif\| Ill defined triads, inflamed lobule (40X).]]		[[File:1 PBC 3 680x512px.tif\| Ill defined triads, inflamed lobule (40X).]]
	[[File:2 PBC 3 680x512px.tif\| Triad without a bile duct. Macrophages & occasional lymphocytes without epithelioid cells needed for granuloma and space where bile duct likely once was [cyan arrowhead] (400X).]]		[[File:2 PBC 3 680x512px.tif\| Triad without a bile duct. Macrophages & occasional lymphocytes without epithelioid cells needed for granuloma and space where bile duct likely once was [cyan arrowhead] (400X).]]
			<br>
	[[File:3 PBC 3 680x512px.tif\| PAS without diastase shows triad lacking bile duct and piecemeal necrosis (200X).]]		[[File:3 PBC 3 680x512px.tif\| PAS without diastase shows triad lacking bile duct and piecemeal necrosis (200X).]]
			[[File:4 PBC 3 680x512px.tif\| PAS with diastase shows bile duct/proliferating bile ductules with epithelial injury and hepatocytes with ballooning degeneration (400X).]]
	<br>		<br>
	~~[[File:4 PBC 3 680x512px.tif\| PAS with diastase shows bile duct/proliferating bile ductules with epithelial injury and hepatocytes with ballooning degeneration (400X).]]~~
	[[File:5 PBC 3 680x512px.tif\| Trichrome shows space of Disse collagenization and periportal fibrosis without definite bridging (100X)..]]		[[File:5 PBC 3 680x512px.tif\| Trichrome shows space of Disse collagenization and periportal fibrosis without definite bridging (100X)..]]
	[[File:6 PBC 3 680x512px.tif\| Iron stain shows isolated focus of hepatocytes with cytoplasmic blue granules (200X)]]		[[File:6 PBC 3 680x512px.tif\| Iron stain shows isolated focus of hepatocytes with cytoplasmic blue granules (200X)]]
	\|}		\|}
	Primary biliary cirrhosis. AMA positive. Viral serology/ANA negative. No definite granulomas. Ill defined triads, inflamed lobule (TL 40X). Triad without a bile duct. Macrophages & occasional lymphocytes without epithelioid cells needed for granuloma and space where bile duct likely once was [cyan arrowhead] (TM 400X). PAS without diastase shows triad lacking bile duct and piecemeal necrosis (TR 200X). PAS with diastase shows bile duct/proliferating bile ductules with epithelial injury and hepatocytes with ballooning degeneration (BL 400X). Trichrome shows space of Disse collagenization and periportal fibrosis without definite bridging (BM 100X). Iron stain shows isolated focus of hepatocytes with cytoplasmic blue granules (BR 200X).		Primary biliary cirrhosis. AMA positive. Viral serology/ANA negative. No definite granulomas. Ill defined triads, inflamed lobule (Row 1 Left 40X). Triad without a bile duct. Macrophages & occasional lymphocytes without epithelioid cells needed for granuloma and space where bile duct likely once was [cyan arrowhead] (Row 1 Right 400X). PAS without diastase shows triad lacking bile duct and piecemeal necrosis (Row 2 Left 200X). PAS with diastase shows bile duct/proliferating bile ductules with epithelial injury and hepatocytes with ballooning degeneration (Row 2 Right 400X). Trichrome shows space of Disse collagenization and periportal fibrosis without definite bridging (Row 3 Left 100X). Iron stain shows isolated focus of hepatocytes with cytoplasmic blue granules (Row 3 Right 200X).

	{\|		{\|
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	[[File:4 PBC 2 680x512px.tif\|Trichrome of the same triad shows portal fibrosis (200X).]]		[[File:4 PBC 2 680x512px.tif\|Trichrome of the same triad shows portal fibrosis (200X).]]
	\|}		\|}
	Primary biliary cirrhosis. Two inflamed triads accompany acini with mild steatosis (UL 20X).		Primary biliary cirrhosis. Two inflamed triads accompany acini with mild steatosis (Row 1 Left 20X). A triad bears a poorly formed granuloma [yellow arrowhead]. A bile duct is also seen [red arrowhead] (Row 1 Right 200X). A triad lacks a bile duct (Row 2 Left 200X). Trichrome of the same triad shows portal fibrosis (Row 2 Right 200X).
	A triad bears a poorly formed granuloma [yellow arrowhead]. A bile duct is also seen [red arrowhead] (UR 200X). A triad lacks a bile duct (LL 200X). Trichrome of the same triad shows portal fibrosis (LR 200X).

	{\|		{\|
	[[File:1 PBC - 1 - 40X 680x512px.tif\|Acini & lobules distorted by inflammation]]		[[File:1 PBC - 1 - 40X 680x512px.tif\|Acini & lobules distorted by inflammation]]
	[[File:2 PBC - 1 - 200X 680x512px.tif\|Loose granuloma in triad without duct]]		[[File:2 PBC - 1 - 200X 680x512px.tif\|Loose granuloma in triad without duct]]
			<br>
	[[File:3 PBC - 1 - 200X 680x512px.tif\|Well-formed granuloma]]		[[File:3 PBC - 1 - 200X 680x512px.tif\|Well-formed granuloma]]
			[[File:4 PBC - 1 -200X 680x512px.tif\|Piecemeal necrosis, PAS without diastase]]
	<br>		<br>
	~~[[File:4 PBC - 1 -200X 680x512px.tif\|Piecemeal necrosis, PAS without diastase]]~~
	[[File:5 PBC - 1 -400X 680x512px.tif\|Damaged bile duct, PAS with diastase]]		[[File:5 PBC - 1 -400X 680x512px.tif\|Damaged bile duct, PAS with diastase]]
	[[File:6 PBC - 1 -200X 680x512px.tif\|Bridging fibrosis, trichrome]]		[[File:6 PBC - 1 -200X 680x512px.tif\|Bridging fibrosis, trichrome]]
	\|}		\|}
	Primary biliary cirrhosis with bridging fibrosis. Acini & lobules distorted by inflammation (~~TL,~~40X) Loose granuloma in triad without duct (~~TM,~~200X) Well-formed granuloma (~~TR,~~200X) Piecemeal necrosis, PAS without diastase (~~BL,~~200X) Damaged bile duct, PAS with diastase (~~BM,~~400X) Bridging fibrosis, trichrome (BR,200X)		Primary biliary cirrhosis with bridging fibrosis. Acini & lobules distorted by inflammation (Row 1 Left 40X) Loose granuloma in triad without duct (Row 1 Right 200X) Well-formed granuloma (Row 2 Left 200X) Piecemeal necrosis, PAS without diastase (Row 2 Right 200X) Damaged bile duct, PAS with diastase (Row 3 Left 400X) Bridging fibrosis, trichrome (Row 3 Right,200X)

	===Staging PBC===		===Staging PBC===

← Older revision		Revision as of 17:01, 29 July 2016
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	www:		www:
	*[http://www.gidesigns.net/images/MC-copper-flower-garland-L.jpg Garland - wreath of flowers (gidesigns.net)].		*[http://www.gidesigns.net/images/MC-copper-flower-garland-L.jpg Garland - wreath of flowers (gidesigns.net)].
			{\|
			[[File:1 PBC 3 680x512px.tif\| Ill defined triads, inflamed lobule (40X).]]
			[[File:2 PBC 3 680x512px.tif\| Triad without a bile duct. Macrophages & occasional lymphocytes without epithelioid cells needed for granuloma and space where bile duct likely once was [cyan arrowhead] (400X).]]
			[[File:3 PBC 3 680x512px.tif\| PAS without diastase shows triad lacking bile duct and piecemeal necrosis (200X).]]
			<br>
			[[File:4 PBC 3 680x512px.tif\| PAS with diastase shows bile duct/proliferating bile ductules with epithelial injury and hepatocytes with ballooning degeneration (400X).]]
			[[File:5 PBC 3 680x512px.tif\| Trichrome shows space of Disse collagenization and periportal fibrosis without definite bridging (100X)..]]
			[[File:6 PBC 3 680x512px.tif\| Iron stain shows isolated focus of hepatocytes with cytoplasmic blue granules (200X)]]
			\|}
			Primary biliary cirrhosis. AMA positive. Viral serology/ANA negative. No definite granulomas. Ill defined triads, inflamed lobule (TL 40X). Triad without a bile duct. Macrophages & occasional lymphocytes without epithelioid cells needed for granuloma and space where bile duct likely once was [cyan arrowhead] (TM 400X). PAS without diastase shows triad lacking bile duct and piecemeal necrosis (TR 200X). PAS with diastase shows bile duct/proliferating bile ductules with epithelial injury and hepatocytes with ballooning degeneration (BL 400X). Trichrome shows space of Disse collagenization and periportal fibrosis without definite bridging (BM 100X). Iron stain shows isolated focus of hepatocytes with cytoplasmic blue granules (BR 200X).

	{\|		{\|
	[[File:1 PBC 2 680x512px.tif\|Two inflamed triads accompany acini with mild steatosis (20X).]]		[[File:1 PBC 2 680x512px.tif\|Two inflamed triads accompany acini with mild steatosis (20X).]]
	[[File:2 PBC 2 680x512px.tif\|A triad bears a poorly formed granuloma [yellow arrowhead]. A bile duct is also seen [red arrowhead] (200X).]]		[[File:2 PBC 2 680x512px.tif\|A triad bears a poorly formed granuloma [yellow arrowhead]. A bile duct is also seen [red arrowhead] (200X).]]
			<br>
	[[File:3 PBC 2 680x512px.tif\|A triad lacks a bile duct (200X).]]		[[File:3 PBC 2 680x512px.tif\|A triad lacks a bile duct (200X).]]
	[[File:4 PBC 2 680x512px.tif\|Trichrome of the same triad shows portal fibrosis (200X).]]		[[File:4 PBC 2 680x512px.tif\|Trichrome of the same triad shows portal fibrosis (200X).]]
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	[[File:2 PBC - 1 - 200X 680x512px.tif\|Loose granuloma in triad without duct]]		[[File:2 PBC - 1 - 200X 680x512px.tif\|Loose granuloma in triad without duct]]
	[[File:3 PBC - 1 - 200X 680x512px.tif\|Well-formed granuloma]]		[[File:3 PBC - 1 - 200X 680x512px.tif\|Well-formed granuloma]]
			<br>
	[[File:4 PBC - 1 -200X 680x512px.tif\|Piecemeal necrosis, PAS without diastase]]		[[File:4 PBC - 1 -200X 680x512px.tif\|Piecemeal necrosis, PAS without diastase]]
	[[File:5 PBC - 1 -400X 680x512px.tif\|Damaged bile duct, PAS with diastase]]		[[File:5 PBC - 1 -400X 680x512px.tif\|Damaged bile duct, PAS with diastase]]
	[[File:6 PBC - 1 -200X 680x512px.tif\|Bridging fibrosis, trichrome]]		[[File:6 PBC - 1 -200X 680x512px.tif\|Bridging fibrosis, trichrome]]
	\|}		\|}
			Primary biliary cirrhosis with bridging fibrosis. Acini & lobules distorted by inflammation (TL,40X) Loose granuloma in triad without duct (TM,200X) Well-formed granuloma (TR,200X) Piecemeal necrosis, PAS without diastase (BL,200X) Damaged bile duct, PAS with diastase (BM,400X) Bridging fibrosis, trichrome (BR,200X)
	Primary biliary cirrhosis with bridging fibrosis. Acini & lobules distorted by inflammation (TL,40X) Loose granuloma in triad without duct (TR,200X) Well-formed granuloma (ML,200X) Piecemeal necrosis, PAS without diastase (MR,200X) Damaged bile duct, PAS with diastase (BL,400X) Bridging fibrosis, trichrome (BR,200X)

	===Staging PBC===		===Staging PBC===