Morphological aspects of small-duct cholangiopathies: A minireview

Figure 1 Histology of small intrahepatic bile ducts. A: Septal bile duct lined by a columnar epithelium supported by a fibrous wall; B: Interlobular bile duct (arrow) lined by cuboidal epithelia. Haematoxylin and eosin; bar corresponds to 50 µm.

Figure 2 Morphology of chronic cholestasis. A: Orcein-positive periseptal depositions of copper-binding protein in hepatocytes; B: Aberrant cytokeratin 7 immunoexpression on periportal hepatocytes. Bar corresponds to 100 µm (A) and 50 µm (B).

Figure 3 Primary biliary cholangitis. A: Biliary-type cirrhosis with a signature “halo” at the peripheries of parenchymal nodules; B: Detail of portal tract with lymphoplasmacytic infiltrate and granulomatous destruction of the interlobular bile duct. Haematoxylin and eosin; bar corresponds to 500 µm (A) and 50 µm (B).

Figure 4 Primary sclerosing cholangitis. A: Concentric periductal lamellar fibrosis; B: Complete fibrous obliteration of the interlobular duct (arrow). Haematoxylin and eosin; bar corresponds to 100 µm.

Figure 5 Morphology of IgG4-related sclerosing cholangiopathy. A: Marked fibroinflammatory thickening of the bile duct wall; B: Increased numbers of IgG4-positive plasma cells. Haematoxylin and eosin (A), IgG4 immunohistochemistry (B). Bar corresponds to 1000 µm (A) and 100 µm (B).

Figure 6 Rejection cholangiopathy. A: Inflammatory damage of interlobular bile duct (arrow) in acute T cell-mediated rejection; B: Senescence-related changes of the interlobular bile duct in chronic rejection. Haematoxylin and eosin; bar corresponds to 50 µm (A) and 25 µm (B).

Figure 7 Tumour-forming biliary processes. A: Hamartomatous proliferation of ductular structures in ductal plate malformation. B: Intrahepatic cholangiocarcinoma with perineural invasion (arrow). Haematoxylin and eosin; bar corresponds to 100 µm (A) and 50 µm (B).