{"id":2609,"date":"2022-04-13T17:15:17","date_gmt":"2022-04-13T21:15:17","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pathology\/?post_type=chapter&#038;p=2609"},"modified":"2025-08-25T14:05:58","modified_gmt":"2025-08-25T18:05:58","slug":"histopathology-of-cirrhosis","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pathology\/chapter\/histopathology-of-cirrhosis\/","title":{"raw":"Histopathology of Cirrhosis","rendered":"Histopathology of Cirrhosis"},"content":{"raw":"<div class=\"textbox textbox--learning-objectives\"><header class=\"textbox__header\">\r\n<p class=\"textbox__title\">Learning Objectives<\/p>\r\n\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\nBy the end of this section, you will be able to:\r\n<ul>\r\n \t<li>List the effects of scar tissue on the flow of bile and blood in the liver.<\/li>\r\n \t<li>correlate the microscopic findings of cirrhosis with the nodules seen by the naked eye.<\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>\r\nThe 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 (especially 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.\r\n\r\n[h5p id=\"137\"]\r\n<p style=\"text-align: center;background-color: #f0f0f0;padding: 5px\"><sup><em><strong>Histopathology of liver cirrhosis<\/strong> presented by Yimei Qin using specimen from Dr. Gang Wang's private collection<\/em>, licensed under <a href=\"https:\/\/choosealicense.com\/no-license\/\">All Rights Reserved<\/a><\/sup><\/p>\r\n\r\n<h2>Section Review<\/h2>\r\nNodules 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.\r\n<h1>Review Questions<\/h1>\r\n<div class=\"h5p\">[h5p id=\"178\"]<\/div>\r\n<div class=\"pdf\">\r\n\r\n<strong>1. Select the correct word\/phrase.<\/strong>Liver lobules are filled with <strong>biliary OR fibrotic<\/strong> tissue as a result of <strong>stellate\u00a0OR hepatocyte OR Kupffer cell<\/strong> activation in reaction to inflammation. As a result, the normally homogenous pattern of thousands of <strong>Kupffer cells OR macrophages OR hepatocytes<\/strong> are interrupted to form visibly distinct nodules. The resulting scar tissue will prevent blood flowing from the larger <strong>hepatic OR portal OR bile<\/strong> vessel to the central vein. Similarly, the reverse flow of <strong>blood OR bile<\/strong> will be slowed down by this scar tissue, causing an accumulation within the lobule. This explains why jaundice is often a symptom of cirrhosis.\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n<div class=\"textbox\">\r\n<h2>Answer Key<\/h2>\r\n<ol>\r\n \t<li>fibrotic, stellate, hepatocytes, portal, bile<\/li>\r\n<\/ol>\r\n<\/div>\r\n&nbsp;\r\n\r\n<\/div>","rendered":"<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<p class=\"textbox__title\">Learning Objectives<\/p>\n<\/header>\n<div class=\"textbox__content\">\n<p>By the end of this section, you will be able to:<\/p>\n<ul>\n<li>List the effects of scar tissue on the flow of bile and blood in the liver.<\/li>\n<li>correlate the microscopic findings of cirrhosis with the nodules seen by the naked eye.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<p>The obvious nodular pattern &#8211; seen in gross specimens &#8211; 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 (especially 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.<\/p>\n<div id=\"h5p-137\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-137\" class=\"h5p-iframe\" data-content-id=\"137\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Cirrhosis Histology\"><\/iframe><\/div>\n<\/div>\n<p style=\"text-align: center;background-color: #f0f0f0;padding: 5px\"><sup><em><strong>Histopathology of liver cirrhosis<\/strong> presented by Yimei Qin using specimen from Dr. Gang Wang&#8217;s private collection<\/em>, licensed under <a href=\"https:\/\/choosealicense.com\/no-license\/\">All Rights Reserved<\/a><\/sup><\/p>\n<h2>Section Review<\/h2>\n<p>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.<\/p>\n<h1>Review Questions<\/h1>\n<div class=\"h5p\">\n<div id=\"h5p-178\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-178\" class=\"h5p-iframe\" data-content-id=\"178\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Cirrhosis Histopathology of Cirrhosis\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"pdf\">\n<p><strong>1. Select the correct word\/phrase.<\/strong>Liver lobules are filled with <strong>biliary OR fibrotic<\/strong> tissue as a result of <strong>stellate\u00a0OR hepatocyte OR Kupffer cell<\/strong> activation in reaction to inflammation. As a result, the normally homogenous pattern of thousands of <strong>Kupffer cells OR macrophages OR hepatocytes<\/strong> are interrupted to form visibly distinct nodules. The resulting scar tissue will prevent blood flowing from the larger <strong>hepatic OR portal OR bile<\/strong> vessel to the central vein. Similarly, the reverse flow of <strong>blood OR bile<\/strong> will be slowed down by this scar tissue, causing an accumulation within the lobule. This explains why jaundice is often a symptom of cirrhosis.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<div class=\"textbox\">\n<h2>Answer Key<\/h2>\n<ol>\n<li>fibrotic, stellate, hepatocytes, portal, bile<\/li>\n<\/ol>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n","protected":false},"author":1232,"menu_order":9,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["jen-2","yimei-qin"],"pb_section_license":""},"chapter-type":[],"contributor":[59,103],"license":[],"class_list":["post-2609","chapter","type-chapter","status-publish","hentry","contributor-jen-2","contributor-yimei-qin"],"part":2545,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapters\/2609","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/wp\/v2\/users\/1232"}],"version-history":[{"count":16,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapters\/2609\/revisions"}],"predecessor-version":[{"id":9444,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapters\/2609\/revisions\/9444"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/parts\/2545"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapters\/2609\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/wp\/v2\/media?parent=2609"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapter-type?post=2609"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/wp\/v2\/contributor?post=2609"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/wp\/v2\/license?post=2609"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}