Liver, Primary biliary cirrhosis, H&E stain

Primary biliary cirrhosis (PBC) is a chronic cholestatic disease, where the intrahepatic bile ducts are progressively destroyed. Serology is often helpful, with increased anti-mitochondrial antibody (AMA) and IgM. Patient demographics (male vs. female) and radiology can also be helpful in distinguishing from another important differential diagnosis: primary sclerosing cholangitis. Liver transplant is currently the only life-saving procedure in these patients.

Looking closely at the portal tract, the absence of ducts, which were obliterated in this case, with numerous lymphocytes are seen. Granulomas can be seen, although rare in this case. This is an unfortunate case of primary biliary cirrhosis/cholangitis (PBC) that occurred in the transplant liver.

This slide shows H&E stain. See related content for trichrome stain.