Korean J Pathol.  2002 Dec;36(6):420-424.

Primary Sclerosing Cholangitis: A Report of Two Liver Explants

• Jun SY
• Kim JS
• Yu ES

Abstract

Primary sclerosing cholangitis (PSC) is usually progressive to the end stage liver disease and a common indication for liver transplantation (LT). We report two cases of liver explants with PSC. Case 1 was that of a 35-year-old male who was admitted for 4 weeks because he had jaundice. He had been treated several times without receiving a definite diagnosis during the last 7 years because he was excreting dark urine. Case 2 was that of a 30-year-old female who had taken a prednisolone for 6 years for treatment of ulcerative colitis. She also had stones and underwent a cholecystectomy and choledocholithotomy 2 years ago. She had complained of epigastric pain and febrile sensation for 2 months. In both cases, serum levels of aspartate aminotransferase, alanine aminotransferase, alkaline phospatase, gamma glutamyl transpeptidase, and direct builirubin were elevated. Autoantibodies were not detected. Computerized tomography scan and endoscopic retrograde cholangiopancreatography revealed hepato-splenomegaly, stricture of intra- and extra-hepatic bile ducts, and beaded dilatation of the intrahepatic bile ducts. Despite stent insertions and medication, another episode of jaundice occurred in case 1 and cirrhosis finally developed in case 2. The histopathologic features of liver needle biopsy specimens were nonspecific, while explant livers displayed periductal fibrosis, ductopenia, and/or ductular proliferation, which are characteristic features for PSC.

Keyword

Cholangitis; Sclerosing; Liver Transplantation

MeSH Terms

Adult
Alanine Transaminase
Aspartate Aminotransferases
Autoantibodies
Bile Ducts
Bile Ducts, Intrahepatic
Biopsy, Needle
Cholangiopancreatography, Endoscopic Retrograde
Cholangitis
Cholangitis, Sclerosing*
Cholecystectomy
Colitis, Ulcerative
Constriction, Pathologic
Diagnosis
Dilatation
End Stage Liver Disease
Female
Fibrosis
gamma-Glutamyltransferase
Humans
Jaundice
Liver Transplantation
Liver*
Male
Prednisolone
Sensation
Stents
Alanine Transaminase
Aspartate Aminotransferases
Autoantibodies
Prednisolone
gamma-Glutamyltransferase