Needle biopsy specimen from liver with changes compatible with autoimmune sclerosing cholangitis. A. Marked portal enlargement due to inflammation, edema and portal/periportal fibrosis (Alcian-Picro-Sirius, bar = 1 mm). B. In the portal/periportal fields ductular reaction with severe epithelial hyperplasia, loss of polarity and focal cytoplasmic mucin accumulation (arrow) is seen (Alcian-Picro-Sirius, bar = 200 μm). C. The most pronounced inflammation occurs in small portal tracts around which also a severe lymfo-plasmacytic interface inflammation is seen (H&E, bar = 500 μm). D. Focally, bile duct epithelium is necrotic and infiltrated with neutrophils (black arrows). Pronounced interface hepatitis is present (red arrows) (H&E).
Larsen et al. Diagnostic Pathology 2012 7:100 doi:10.1186/1746-1596-7-100