Uncertainties in the Diagnosis of Liver Cirrhosis

Overview

Liver cirrhosis is not yet uniformly defined even from morphological aspects, although there isagreement in basic tissue changes involved. The conflicting features include particularly theso-called regeneration nodes and a prognosis-related favourable transformation of micro-nodulesin macro-nodules. The nodulation visible by eye remains a doubtful feature in diagnosis.Thecases of cirrhosis with a smooth surface escape clinical diagnosis. The diagnosis should betherefore based on the previously acknowledged pseudolobulus, a histologically typical islandof parenchyma (at least two in the biopsy preparation) considering the possibility that it maybe connected with parenchyma outside the plane of cut (according to net structure of nodule-likereconstructed liver). The basic architectonics of the liver is not yet fully recognized, sincea unicellular muralium appears to be one of extreme structures, less frequent than bi-cellulartrabeculae according to our experience; the organization of hepatocytes in a mixture of unicellularand bi-cellular plates appear to be commonly present. For the evaluation of regenerationof hepatocytes in cirrhosis the findings of Ki-67, PCNA, etc. appear to be more reliable thanhistological criteria.

Key words:
liver - cirrhosis - morphological - development - diagnostic criteria