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Copyright ©The Author(s) 2015.
World J Hepatol. Aug 28, 2015; 7(18): 2162-2170
Published online Aug 28, 2015. doi: 10.4254/wjh.v7.i18.2162
Table 1 Liver biopsy findings suggestive of biliary strictures and differential diagnosis (BANFF[18])
Histopathological featuresPSC/BSChronic rejectionPrimary biliary cirrhosis
Distribution, severity and composition of portal inflammationUsually patchy to diffuse; mild neutrophilic, eosinophilic, or occasionally mononuclear predominantPatchy; usually minimal or mild lymphoplasmacyticNoticeably patchy and variable intensity; predominantly mononuclear; nodular aggregates and granulomas
Presence and type of interface activityProminent and defining feature: ductular type with portal and periportal edemaMinimal to absentImportant feature later in disease development: ductular and necroinflammatory-type with copper deposition
Bile duct inflammation and damagePeriductal lamellar edema "fibrous cholangitis"; acute cholangitis; multiple intra-portal ductal profilesFocal ongoing lymphocytic bile duct damage; inflammation wanes with duct lossGranulomatous or focally severe lymphocytic cholangitis is diagnostic in proper setting
Biliary epithelial senescence changes and small bile duct lossSmall bile duct loss associated with ductular reactionSenescence/atrophy/atypia involve a majority of remaining ductsSmall bile duct loss associated with ductular reaction
Perivenular mononuclear inflammation and/or hepatocyte dropoutAbsentUsually present but variableVariable but generally mild; if present, involves a minority of perivenular regions
Lobular findings and necroinflammatory activityDisarray unusual; neutrophil clusters; ± cholestasisVariable; if present, concentrated in perivenular regionsMild disarray; parenchymal granulomas; periportal copper deposition and cholestasis are late features
Pattern of fibrosis during progression towards cirrhosisBiliary patternUncommon; if present usually a venocentric pattern; may evolve to biliary patternBiliary pattern