A 45-year-old man with a 20-year history of heavy alcohol consumption presents to the clinic with progressive jaundice and right upper quadrant discomfort. He reports increased abdominal distension over the past 3 months. Vital signs are BP 134/88 mmHg, HR 88/min, RR 14/min, temperature 37.0°C. Physical examination reveals hepatomegaly, mild splenomegaly, and mild ascites. Laboratory studies show AST 285 U/L, ALT 95 U/L, alkaline phosphatase 180 U/L, total bilirubin 4.2 mg/dL, and albumin 2.8 g/dL. Abdominal ultrasound demonstrates a cirrhotic liver with heterogeneous echotexture and ascites. A liver biopsy is obtained to assess the stage of liver disease. Microscopic examination reveals extensive collagen deposition with bands of fibrous tissue spanning between portal triads and between portal areas and the hepatic venule, completely disrupting the normal hepatic architecture and replacing much of the normal parenchyma with regenerative nodules. Which histologic finding best explains the advanced stage of this patient's liver disease?
- A)Portal tract inflammation with focal hepatocyte apoptosis but preservation of the limiting plate
- B)Bridging fibrosis extending from portal tracts to central veins with disruption of hepatic architecture and formation of regenerative nodulesGABARITO
- C)Perisinusoidal fibrosis with a reticular (chicken-wire) pattern surrounding individual hepatocytes
- D)Kupffer cell hyperplasia with lipofuscin deposition and mild bile duct proliferation
- E)Microvesicular steatosis with inflammatory infiltration limited to portal tracts
Explicação
Bridging fibrosis that connects portal-to-portal regions and portal-to-central regions (portal-to-hepatic vein) represents the histologic hallmark of advanced cirrhosis. This finding indicates progression beyond earlier stages of chronic liver disease. The pre... Ver explicação completa e trilha adaptativa →