MORPHOLOGICAL STUDY OF A CASE OF LIVER CIRRHOSIS OF UNKNOWN ETIOLOGY
Abstract
Background. The term "cryptogenic" cirrhosis is used to denote liver diseases when their etiology (origin) cannot be identified. Objective. To present the results of differential diagnosis of liver damage based on morphological studies of liver biopsy in a patient with chronic liver damage and suspected tumor and/or parasitic origin. Material and methods. A clinical case of newly diagnosed cryptogenic liver cirrhosis in a young man, whose clinical and laboratory examination failed to identify the etiology. The rigidity of the liver parenchyma in the shear wave elastometry mode (SWM method) is high (Vs - 2.55 m / s) - F4. Morphological diagnostics of the liver biopsy was carried out. On semi-thin sections of liver tissue there were studied: the state of the histoarchitecture of the liver plates (beams, trabeculae) and lobules; morphological changes in hepatocytes and cholangiocytes, sinusoids; the presence and quantity of stem and intermediate hepatocyte-like cells; the presence and severity of fibrosis and its localization; the state of the bile ducts; localization and severity of inflammatory infiltrate, the number of neutrophils, eosinophils, plasma cells and cytotoxic lymphocytes in the inflammatory infiltrate. Results. The detailed results of the morphological (histological) study of the liver biopsy are presented, which made it possible to diagnose various changes in all liver cell populations (hepatocytes and intracellular organelles, cholangiocytes, stellate, oval, progenitor, plasma cells), to evaluate the peculiarities of the formation of fibrosis, cholestasis, apoptosis and steatosis in the liver. The diagnosis of liver neoplasm is ruled out. After 6 months from the moment of diagnosis, a significant positive effect due to organizational and therapeutic measures has been noted. The patient’s condition is satisfactory. Biochemical parameters have reached subnormal values, the development of fibrolysis cannot be excluded. Conclusion. It has been established that the patient has cryptogenic liver cirrhosis, as evidenced by the presence of pronounced alterative and disregenerative changes in hepatocytes, unexpressed polymorphic cellular inflammatory infiltration, proliferation of connective tissue with varying degrees of maturity of its fibers.
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