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Abstract
The histopathology of the liver is fundamental for the differential diagnosis between intra- and extra- hepatic causes of neonatal cholestasis. To the histopathologist, cholestasis means the appearance of bile within the elements of the liver and usually associated with secondary cell injury.
Aim:
The aim of this study is to evaluate the role of histopathology in the diagnosis of cholestatic neonatal liver disease.
METHODS:
The histological studies:
Sections were evaluated as following:
? Cholestasis was graded as: Grade (1+), Grade (2+), and Grade (3+).
? Portal oedema was graded as: Grade (1+), Grade (2+), and Grade (3+).
? Proliferation of ducts graded as: Grade (1+), Grade (2+), and Grade (3+).
? Cholangitis: was graded as: Grade (1+), Grade (2+), and Grade (3+).
? Fibrosis was scored as follows: (0), (1+), (2 +), (3 +) and (4 +).
Results:
NH was found to be the commonest cause of neonatal cholestasis. Biliary atresia and neonatal hepatitis were diagnosed approximately in 82% of cholestatic cases during neonatal period.
CONCLUSION:
Portal tract changes were discriminatory variables between IHC and EHC. Features supporting the diagnosis of extra-hepatic cholestasis include portal fibrosis, portal oedema, proliferation of interlobular bile ducts, cholestasis in neoductules and cholangitis. Only extra-medullary hematopoiesis pointed to diagnosis of intra-hepatic cholestasis.