Histopathological diagnosis of intra- and extrahepatic neonatal cholestasis
Autor(a) principal: | |
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Data de Publicação: | 1998 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/21120 |
Resumo: | The histopathology of the liver is fundamental for the differential diagnosis between intra- and extrahepatic causes of neonatal cholestasis. However, histopathological findings may overlap and there is disagreement among authors concerning those which could discriminate between intra- and extrahepatic cholestasis. Forty-six liver biopsies (35 wedge biopsies and 11 percutaneous biopsies) and one specimen from a postmortem examination, all from patients hospitalized for neonatal cholestasis in the Pediatrics Service of Hospital de Clínicas de Porto Alegre, were prospectively studied using a specially designed histopathological protocol. At least 4 of 5 different stains were used, and 46 hepatic histopathological variables related to the differential diagnosis of neonatal cholestasis were studied. The findings were scored for severity on a scale from 0 to 4. Sections which showed less than 3 portal spaces were excluded from the study. Sections were examined by a pathologist who was unaware of the final diagnosis of each case. Bile tract permeability was defined by scintigraphy of the bile ducts and operative cholangiography The F test and discriminant analysis were used as statistical methods for the study of the hepatic histopathological variables. The chi-square method with Yates correction was used to relate the age of the patients on the date of the histopathological study to the discriminatory variables between intraand extrahepatic cholestasis selected by the discriminant function test. The most valuable hepatic histopathological variables for the discrimination between intra- and extrahepatic cholestasis, in decreasing order of importance, were periportal ductal proliferation, portal ductal proliferation, portal expansion, cholestasis in neoductules, foci of myeloid metaplasia, and portal-portal bridges. The only variable which pointed to the diagnosis of intrahepatic cholestasis was myeloid metaplasia. Due to the small number of patients who were younger than 60 days on the date of the histopathological study (N = 6), no variable discriminated between intra- and extrahepatic cholestasis before the age of 2 months and all of them, except for the portal expansion, were discriminatory after this age. In infants with cholestasis, foci of myeloid metaplasia, whenever present in the liver biopsy, suggested intrahepatic cholestasis. Periportal ductal proliferation, portal ductal proliferation, portal expansion, cholestasis in neoductules, portal cholestasis and portal-portal bridges suggested extrahepatic obstructive cholestasis. |
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Santos, Jorge Luiz dosAlmeida, Hilberto Corrêa deCerski, Carlos Thadeu SchmidtSilveira, Themis Reverbel da2010-04-24T04:15:24Z19980100-879Xhttp://hdl.handle.net/10183/21120000307606The histopathology of the liver is fundamental for the differential diagnosis between intra- and extrahepatic causes of neonatal cholestasis. However, histopathological findings may overlap and there is disagreement among authors concerning those which could discriminate between intra- and extrahepatic cholestasis. Forty-six liver biopsies (35 wedge biopsies and 11 percutaneous biopsies) and one specimen from a postmortem examination, all from patients hospitalized for neonatal cholestasis in the Pediatrics Service of Hospital de Clínicas de Porto Alegre, were prospectively studied using a specially designed histopathological protocol. At least 4 of 5 different stains were used, and 46 hepatic histopathological variables related to the differential diagnosis of neonatal cholestasis were studied. The findings were scored for severity on a scale from 0 to 4. Sections which showed less than 3 portal spaces were excluded from the study. Sections were examined by a pathologist who was unaware of the final diagnosis of each case. Bile tract permeability was defined by scintigraphy of the bile ducts and operative cholangiography The F test and discriminant analysis were used as statistical methods for the study of the hepatic histopathological variables. The chi-square method with Yates correction was used to relate the age of the patients on the date of the histopathological study to the discriminatory variables between intraand extrahepatic cholestasis selected by the discriminant function test. The most valuable hepatic histopathological variables for the discrimination between intra- and extrahepatic cholestasis, in decreasing order of importance, were periportal ductal proliferation, portal ductal proliferation, portal expansion, cholestasis in neoductules, foci of myeloid metaplasia, and portal-portal bridges. The only variable which pointed to the diagnosis of intrahepatic cholestasis was myeloid metaplasia. Due to the small number of patients who were younger than 60 days on the date of the histopathological study (N = 6), no variable discriminated between intra- and extrahepatic cholestasis before the age of 2 months and all of them, except for the portal expansion, were discriminatory after this age. In infants with cholestasis, foci of myeloid metaplasia, whenever present in the liver biopsy, suggested intrahepatic cholestasis. Periportal ductal proliferation, portal ductal proliferation, portal expansion, cholestasis in neoductules, portal cholestasis and portal-portal bridges suggested extrahepatic obstructive cholestasis.application/pdfengBrazilian journal of medical and biological research. Ribeirão Preto, SP. Vol. 31, no. 7 (July 1998), p. 911-919ColestaseRecém-nascidoBiópsiaAtresia biliarLiver biopsyNeonatal cholestasisBiliary atresiaHistopathological diagnosis of intra- and extrahepatic neonatal cholestasisinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/otherinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSORIGINAL000307606.pdf000307606.pdfTexto completo (inglês)application/pdf73022http://www.lume.ufrgs.br/bitstream/10183/21120/1/000307606.pdf07ca92febd9ffbd9798eb7f0eae0129cMD51TEXT000307606.pdf.txt000307606.pdf.txtExtracted Texttext/plain30876http://www.lume.ufrgs.br/bitstream/10183/21120/2/000307606.pdf.txt2b25ff00f3da621d6c7d456d3f658285MD52THUMBNAIL000307606.pdf.jpg000307606.pdf.jpgGenerated Thumbnailimage/jpeg1730http://www.lume.ufrgs.br/bitstream/10183/21120/3/000307606.pdf.jpgb7f2d298563e66594d263f22cb91ac63MD5310183/211202018-10-08 07:54:44.258oai:www.lume.ufrgs.br:10183/21120Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2018-10-08T10:54:44Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Histopathological diagnosis of intra- and extrahepatic neonatal cholestasis |
title |
Histopathological diagnosis of intra- and extrahepatic neonatal cholestasis |
spellingShingle |
Histopathological diagnosis of intra- and extrahepatic neonatal cholestasis Santos, Jorge Luiz dos Colestase Recém-nascido Biópsia Atresia biliar Liver biopsy Neonatal cholestasis Biliary atresia |
title_short |
Histopathological diagnosis of intra- and extrahepatic neonatal cholestasis |
title_full |
Histopathological diagnosis of intra- and extrahepatic neonatal cholestasis |
title_fullStr |
Histopathological diagnosis of intra- and extrahepatic neonatal cholestasis |
title_full_unstemmed |
Histopathological diagnosis of intra- and extrahepatic neonatal cholestasis |
title_sort |
Histopathological diagnosis of intra- and extrahepatic neonatal cholestasis |
author |
Santos, Jorge Luiz dos |
author_facet |
Santos, Jorge Luiz dos Almeida, Hilberto Corrêa de Cerski, Carlos Thadeu Schmidt Silveira, Themis Reverbel da |
author_role |
author |
author2 |
Almeida, Hilberto Corrêa de Cerski, Carlos Thadeu Schmidt Silveira, Themis Reverbel da |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Santos, Jorge Luiz dos Almeida, Hilberto Corrêa de Cerski, Carlos Thadeu Schmidt Silveira, Themis Reverbel da |
dc.subject.por.fl_str_mv |
Colestase Recém-nascido Biópsia Atresia biliar |
topic |
Colestase Recém-nascido Biópsia Atresia biliar Liver biopsy Neonatal cholestasis Biliary atresia |
dc.subject.eng.fl_str_mv |
Liver biopsy Neonatal cholestasis Biliary atresia |
description |
The histopathology of the liver is fundamental for the differential diagnosis between intra- and extrahepatic causes of neonatal cholestasis. However, histopathological findings may overlap and there is disagreement among authors concerning those which could discriminate between intra- and extrahepatic cholestasis. Forty-six liver biopsies (35 wedge biopsies and 11 percutaneous biopsies) and one specimen from a postmortem examination, all from patients hospitalized for neonatal cholestasis in the Pediatrics Service of Hospital de Clínicas de Porto Alegre, were prospectively studied using a specially designed histopathological protocol. At least 4 of 5 different stains were used, and 46 hepatic histopathological variables related to the differential diagnosis of neonatal cholestasis were studied. The findings were scored for severity on a scale from 0 to 4. Sections which showed less than 3 portal spaces were excluded from the study. Sections were examined by a pathologist who was unaware of the final diagnosis of each case. Bile tract permeability was defined by scintigraphy of the bile ducts and operative cholangiography The F test and discriminant analysis were used as statistical methods for the study of the hepatic histopathological variables. The chi-square method with Yates correction was used to relate the age of the patients on the date of the histopathological study to the discriminatory variables between intraand extrahepatic cholestasis selected by the discriminant function test. The most valuable hepatic histopathological variables for the discrimination between intra- and extrahepatic cholestasis, in decreasing order of importance, were periportal ductal proliferation, portal ductal proliferation, portal expansion, cholestasis in neoductules, foci of myeloid metaplasia, and portal-portal bridges. The only variable which pointed to the diagnosis of intrahepatic cholestasis was myeloid metaplasia. Due to the small number of patients who were younger than 60 days on the date of the histopathological study (N = 6), no variable discriminated between intra- and extrahepatic cholestasis before the age of 2 months and all of them, except for the portal expansion, were discriminatory after this age. In infants with cholestasis, foci of myeloid metaplasia, whenever present in the liver biopsy, suggested intrahepatic cholestasis. Periportal ductal proliferation, portal ductal proliferation, portal expansion, cholestasis in neoductules, portal cholestasis and portal-portal bridges suggested extrahepatic obstructive cholestasis. |
publishDate |
1998 |
dc.date.issued.fl_str_mv |
1998 |
dc.date.accessioned.fl_str_mv |
2010-04-24T04:15:24Z |
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http://hdl.handle.net/10183/21120 |
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0100-879X |
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dc.relation.ispartof.pt_BR.fl_str_mv |
Brazilian journal of medical and biological research. Ribeirão Preto, SP. Vol. 31, no. 7 (July 1998), p. 911-919 |
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