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Inflammation, Active Fibroplasia, and End-stage Fibrosis in 172 Biliary Atresia Remnants Correlate Poorly With Age at Kasai Portoenterostomy, Visceral Heterotaxy, and Outcome
- Source :
- The American journal of surgical pathology, vol 42, iss 12
- Publication Year :
- 2018
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2018.
-
Abstract
- Published histologic studies of the hilar plate or entire biliary remnant at the time of Kasai portoenterostomy (KHPE) have not provided deep insight into the pathogenesis of biliary atresia, relation to age at surgery, prognosis or the basis for successful drainage. We report detailed histologic findings in 172 centrally reviewed biliary remnants with an average of 6 sections per subject. Active lesions were classified as either necroinflammatory (rare/clustered in a few subjects) or active concentric fibroplasia with or without inflammation (common). Inactive lesions showed bland replacement by collagen and fibrous cords with little or no inflammation. Heterogeneity was common within a given remnant; however, relatively homogenous histologic patterns, defined as 3 or more inactive or active levels in the hepatic ducts levels, characterized most remnants. Homogeneity did not correlate with age at KHPE, presence/absence of congenital anomalies at laparotomy indicative of heterotaxy and outcome. Remnants from youngest subjects were more likely than older subjects to be homogenously inactive suggesting significantly earlier onset in the youngest subset. Conversely remnants from the oldest subjects were often homogenously active suggesting later onset or slower progression. More data are needed in remnants from subjects
- Subjects :
- Liver Cirrhosis
Male
Pathology
Databases, Factual
Cholangitis
Biopsy
medicine.medical_treatment
Portoenterostomy, Hepatic
Heterotaxy Syndrome
Histogenesis
Severity of Illness Index
Oral and gastrointestinal
Pathogenesis
0302 clinical medicine
Hepatic
Risk Factors
Fibrosis
Laparotomy
extrahepatic bile ducts
2.1 Biological and endogenous factors
Aetiology
Pediatric
histogenesis
medicine.diagnostic_test
Liver Cirrhosis, Biliary
Liver Disease
Biliary
Age Factors
Treatment Outcome
030220 oncology & carcinogenesis
outcome
Female
030211 gastroenterology & hepatology
Anatomy
medicine.medical_specialty
Clinical Sciences
biliary atresia
Article
Pathology and Forensic Medicine
Databases
03 medical and health sciences
Biliary Atresia
Biliary atresia
medicine
Humans
Factual
hilar plate
business.industry
Infant, Newborn
Infant
Portoenterostomy
heterotaxy
Newborn
medicine.disease
age
Visceral Heterotaxy
North America
Surgery
Digestive Diseases
business
Heterotaxy
Kasai portoenterostomy
Subjects
Details
- ISSN :
- 01475185
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- American Journal of Surgical Pathology
- Accession number :
- edsair.doi.dedup.....590965f4614717a5e6cd71c1f9c28132