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Fibrosis, cirrhosis, focal fibrosis minimal fatty change, focal hepatocelluar necrosis, parenchymal iron deposition. Liver biopsy test

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Practicing since : 2000
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liver biopsy results
hello my name is XXXXXXX thank you for takeing my question, the summary reports says portal periportal necroinflammatory activity 2/4 lobular necroinflammatory activity 2/4 fibrosis and cirrhosis 2/4 number of portals 5. total length of biopsy 12mm microscopic sections of liver core biopsy reveal intact lobular architecture with portal and focal fibrosis minimal fatty change and focal hepatocelluar necrosis.there is a mixed inflammatory portal infitrate consisting mostly of mixed lymphocytes.there is no evidence of parenchymal iron deposition [iron stain] there is no evidence of alpha -1-antitrypsin deficiency [pas stain]. trichrome and reticulin stains reviewed. am 52 years old i had this virus for 25 to 30 years take supplements fish oil supplements for the liver and try to get in decent shape. just had my biopsy on march 1 2012 allready had a appoinment with my doctor just wanted another expert advised thank you for your response.
Posted Tue, 22 May 2012 in GERD
Answered by Dr. Poorna Chandra K.S 9 hours later
Hi and thanks for the query.

By the virus I believe it is hepatitis B. The biopsy picture is suggestive of ongoing hepatitis and liver injury. Traditionally this inflammation is usually associated with elevated liver enzymes.

However in ~25% of people the enzymes can be normal due to unknown reasons. In liver biopsy an inflammatory score of 2 and fibrosis score of 2 is significant and can be an indication for treatment even if liver enzymes are normal.

Hence discuss with your doctor the merits and demerits of the treatment and decide on the future course of action.

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Follow-up: Fibrosis, cirrhosis, focal fibrosis minimal fatty change, focal hepatocelluar necrosis, parenchymal iron deposition. Liver biopsy test 3 days later
thank you dr for your response, by the way dr i have hep c not b and i wanted to know also about what they mean by mixed lympocytes intact lobular architecture and other written words on the report. and yes dr i had treatment 5 years ago but only lasted 4 months side effects too much to handle. am thinking maybe next year trying again. my doctor just advised me just take care of my self no drinking beer and it will be alright. but am looking to find a specialist to advise me how my liver overall. thank you dr
Answered by Dr. Poorna Chandra K.S 13 hours later

Liver cells are arranged in a number of subunits called lobules. Each lobule is a functional unit and has liver cells, blood and bile channels arranged in a definite fashion. This arrangement is very essential to the normal functioning of the liver and progressive liver damage obliterates this architecture.

In your case since the damage is not so progresseda the architecture is maintained ('intact lobular architexture')

The infiltrate at the portal area of the lobule in like lymphocytes, plasmacells and neutrophils depending on the stage of the disease and this is reported as a 'mixed inflammatory infiltrate'.

Hope this answers your query.

Wish you good health.

Above answer was peer-reviewed by
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