By the end of this section, you will be able to:
- List the effects of scar tissue on the flow of bile and blood in the liver
- correlate the microscopic findings of cirrhosis with the nodules seen by the naked eye
The obvious nodular pattern – seen in gross specimens – is also evident in the histology of cirrhotic livers. The deposition of stiff, fibrotic, scar tissue interrupts the normally homogenous pattern of hepatocytes organized into lobules. This scar tissue will cause resistance to both blood flowing into the liver (esp portal vein) and bile leaving the liver (i.e. bile ducts). There is a limited amount of regeneration of tissues to try to replace the damaged hepatocytes, but they are outpaced by the scar tissue deposition.
Histopathology of liver cirrhosis presented by Yimei Qin using specimen from Dr. Gang Wang’s private collection.
Nodules seen in the gross specimens are a continuation of the fibrotic scar tissue that is deposited in and around liver lobules. The liver tries to regenerate the damaged liver cells, but is outpaced by the scar tissue. As a result, there is a resistance to blood flowing into the liver leading to portal hypertension AND a restriction to bile leaving the liver.