Pathology Journals

Different roles of S100P Overexpression in Intrahepatic Cholangiocarcinoma: Carcinogenesis of Perihilar Type and Aggressive Behavior of Peripheral Type.
Aishima S, Fujita N, Mano Y, Kubo Y, Tanaka Y, Taketomi A, Shirabe K, Maehara Y, Oda Y. Am J Surg Pathol. 2011 Apr;35(4):590-8.
S100P is a member of the S100 family of calcium-binding proteins that has previously been shown to be overexpressed in pancreatic ductal adenocarcinoma. This group has studied the expression of S100P in cases of biliary intraepithelial neoplasia (BilIN) and cholangiocarcinoma. S100P is expressed more often in perihilar-type (68%) than in peripheral-type (12%) chCA. S100P+ peripheral chCA had a more aggressive behavior than S100P- tumors in this study.

Similarities and differences between intraductal papillary tumors of the bile duct with and without macroscopically visible mucin secretion.
Ohtsuka M, Kimura F, Shimizu H, Yoshidome H, Kato A, Yoshitomi H, Furukawa K, Takeuchi D, Takayashiki T, Suda K, Takano S, Kondo Y, Miyazaki M. Am J Surg Pathol. 2011 Apr;35(4):512-21.

What is expected from the pathologist in the diagnosis of viral hepatitis?
Denk H. Virchows Arch. 2011 Apr;458(4):377-92.

Gastroenterology and Hepatology Journals

Investigation of primary cilia in the pathogenesis of biliary atresia.
Hartley JL, O'callaghan C, Rossetti S, Consugar M, Ward CJ, Kelly DA, Harris PC. J Pediatr Gastroenterol Nutr. 2011 Apr;52(4):485-8.
This is an interesting article discussing the possible role of primary ciliary abnormalities in the pathogenesis of biliary atresia. Can biliary atresia, in particular the "embryonic"/prenatal/syndromic subgroup, in which numerous congenital maformations (including polysplenia, pre-duodenal portal vein, situs inversus etc) be part of the spectrum of "ciliopathies", which currently include ADPKD, ARPKD, congenital hepatic fibrosis, Caroli's disease, Caroli's syndrome, and polycystic liver disease? In this study, 9 of 355 children with BA developed renal cysts on follow-up (all of whom had the perinatal/nonsyndromic form). In one of seven cases (among the nine children who developed renal cysts) undergoing genetic testing, one child was a compound heterozygote for a mutation involving the PKHD1 gene. No functional ciliary abnormalities were identified in two children whose nasal cilia were studied. Interestingly, however, the bile duct epithelium in BA cases (with or without renal cysts) was uniformly negative for fibrocystin by immunohistochemistry, in contrast to strong expression in normal livers and livers with various other inflammatory/genetic/metabolic diseases


A- Autosomal recessive polycystic kidney disease with associated congenital hepatic fibrosis. Note the presence of splenomegaly secondary to portal hypertension.
B- Autosomal dominant polycystic kidney disease with associated liver cysts. In this setting, liver cysts are isolated and usually do not communicate with the biliary tree.



Normal portal tract development (left) compared to plate malformation (right) with persistence of embryonal duct plate configuration.
Reference: Gunay-Aygun M. Liver and kidney disease in ciliopathies. Am J Med Genet C Semin Genet 2009;151C(4):296-306.

Design and validation of the biliary atresia research consortium histologic assessment system for cholestasis in infancy.
Russo P, Magee JC, Boitnott J, Bove KE, Raghunathan T, Finegold M, Haas J, Jaffe R, Kim GE, Magid M, Melin-Aldana H, White F, Whitington PF, Sokol RJ; Biliary Atresia Research Consortium. Clin Gastroenterol Hepatol. 2011 Apr;9(4):357-362. (CUMC Full Text PDF)
In this study, BARC researchers evaluated 97 liver biopsy specimens from 49 cases of BA, 17 cases of idiopathic neonatal hepatitis, and 31 cases of other neonatal cholestatic diseases (including TPN-induced liver disease, alpha1-antitrypsin deficiency, Alagille's syndrome, PFIC and others). Numerous important observations were reported in this study that are of practical utility for those who evaluate liver biopsies from cholestatic newborns. The overall sensitivity for the diagnosis of BA (including the "favor BA" and "favor obstruction other than BA" groups) was 86% (among 464 biopsies from 49 patients) . Inadequate samples (small and fragmented specimens) and very early biopsies (one patient was biopsied at 2-weeks after birth, an age at which the features of BA may not be sufficiently developed for diagnosis) were identified as causes for false negative interpretations. The investigators, therefore, suggest that samples should be at least 2 cm long, 0.2 cm wide, and contain at least 10 portal tracts to be considered adequate. Among patients with idiopathic neonatal hepatitis, on the other hand, 21% of biopsies (among 156 samples from 17 patients) were incorrectly interpreted as either "favor BA" or "favor obstruction other than BA". The error rate, therefore is was approximately 14% for BA cases and 21% fo INH cases. Biopsies from the third category of patients ("other") were classified as BA or "obstruction other than BA" 50% of the time, including nearly all cases of TPN liver disease and alpha1-antitrypsin deficiency.
Among the 16 individual histologic features investigated, the most useful ones in distinguishing BA from non-BA cases on logistic regression were 1- ductular reaction, 2- portal fibrosis, and 3- lack of sinusoidal fibrosis. Bile duct and canalicular cholestasis and portal edema were also seen more commonly in BA. Interestingly, several features considered useful by many pathologists in this setting, including hepatocellular changes (swelling, necrosis) giant-cell transformation/multinucleation, pseudorosette formation, and EMH were seen as frequently in BA as in non-BA cases.

Hepatic sinusoidal obstruction syndrome associated with consumption of Gynura segetum.
Lin G, Wang JY, Li N, Li M, Gao H, Ji Y, Zhang F, Wang H, Zhou Y, Ye Y, Xu HX, Zheng J. J Hepatol. 2011 Apr;54(4):666-73. (CUMC Full Text PDF)

Aberrant DNA methylation distinguishes hepatocellular carcinoma associated with HBV and HCV infection and alcohol intake.
Lambert MP, Paliwal A, Vaissière T, Chemin I, Zoulim F, Tommasino M, Hainaut P, Sylla B, Scoazec JY, Tost J, Herceg Z. J Hepatol. 2011 Apr;54(4):705-15. (CUMC Full Text PDF) (also see editorial PDF)

Endoplasmic reticulum stress in liver disease.
Malhi H, Kaufman RJ. J Hepatol. 2011 Apr;54(4):795-809. (CUMC Full Text PDF)

Liver transplantation as a model to better understand the cell entry of hepatitis C virus.
Féray C. J Hepatol. 2011 Apr;54(4):825-6. (CUMC Full Text PDF)

Nuclear receptors as new perspective for the management of liver diseases.
Trauner M, Halilbasic E. Gastroenterology. 2011 Apr;140(4):1120-1125. (CUMC Full Text PDF)

Clinicopathological features of severe and fulminant forms of autoimmune hepatitis.
Yasui S, Fujiwara K, Yonemitsu Y, Oda S, Nakano M, Yokosuka O. J Gastroenterol. 2011 Mar;46(3):378-90. (CUMC Full Text PDF)

GB virus C infection among young, HIV-negative injection drug users with and without hepatitis C virus infection.
Boodram B, Hershow RC, Klinzman D, Stapleton JT. J Viral Hepat. 2011 Apr;18(4):e153-9. (CUMC Full Text PDF)

Hepatic steatosis and insulin resistance are associated with severe fibrosis in patients with chronic hepatitis caused by HBV or HCV infection.
Petta S, Cammà C, Marco VD, Macaluso FS, Maida M, Pizzolanti G, Belmonte B, Cabibi D, Stefano RD, Ferraro D, Guarnotta C, Venezia G, Craxì A. Liver Int. 2011 Apr;31(4):507-15. (CUMC Full Text PDF)

A novel and comprehensive mouse model of human non-alcoholic steatohepatitis with the full range of dysmetabolic and histological abnormalities induced by gold thioglucose and a high-fat diet.
Ogasawara M, Hirose A, Ono M, Aritake K, Nozaki Y, Takahashi M, Okamoto N, Sakamoto S, Iwasaki S, Asanuma T, Taniguchi T, Urade Y, Onishi S, Saibara T, Oben JA. Liver Int. 2011 Apr;31(4):542-51. (CUMC Full Text PDF) (also see editorial PDF)

Clinical characterization of patients developing histologically-proven fibrosing cholestatic hepatitis C post-liver transplantation.
Satapathy SK, Sclair S, Fiel MI, Del Rio Martin J, Schiano T. Hepatol Res. 2011 Apr;41(4):328-39. (CUMC Full Text PDF)

Utility of simplified criteria for the diagnosis of autoimmune hepatitis in children.
Hiejima E, Komatsu H, Sogo T, Inui A, Fujisawa T. J Pediatr Gastroenterol Nutr. 2011 Apr;52(4):470-3.

Simplified criteria for AIH have been shown to be a reliable alternative to the more complex original criteria proposed by the IAIHG in 1998, with >90% doagnostic specificity and sensitivity. This Japanese group, however, draws attention to the fact that the simplified criteria may be significantly less accurate in the pediatric population.

General Medicine Journals

A new era of hepatitis C therapy begins.
Jensen DM. N Engl J Med. 2011 Mar 31;364(13):1272-4. (CUMC Full Text PDF)

Surgery and Liver Transplantation Journals

Visceral Leishmaniasis in Liver Transplant Recipients From an Endemic Area.
Clemente WT, Faria LC, Romanelli RM, Lima SS, Cortes JR, Oliveira AP, Carvalho AL, Ferreira AR, Lima AS. Transplantation. 2011 Apr 15;91(7):806-808. 

The importance of portal venous blood flow in ischemic-type biliary lesions after liver transplantation.
Farid WR, de Jonge J, Slieker JC, Zondervan PE, Thomeer MG, Metselaar HJ, de Bruin RW, Kazemier G. Am J Transplant. 2011 Apr;11(4):857-62. (CUMC Full Text PDF)

Characterization of HCV-Specific CD4+Th17 Immunity in Recurrent Hepatitis C-Induced Liver Allograft Fibrosis.
Basha HI, Subramanian V, Seetharam A, Nath DS, Ramachandran S, Anderson CD, Shenoy S, Chapman WC, Crippin JS, Mohanakumar T. Am J Transplant. 2011 Apr;11(4):775-85. (CUMC Full Text PDF)

Characterization of the cross-neutralizing antibody response against hepatitis C virus in the liver transplantation setting.
Dragun J, Pérez-Del-Pulgar S, Crespo G, Ramírez S, Coto-Llerena M, Mensa L, García-Valdecasas JC, Navasa M, Forns X. Am J Transplant. 2011 Apr;11(4):767-74. (CUMC Full Text PDF)

Liver allograft antibody-mediated rejection with demonstration of sinusoidal C4d staining and circulating donor-specific antibodies.
Kozlowski T, Rubinas T, Nickeleit V, Woosley J, Schmitz J, Collins D, Hayashi P, Passannante A, Andreoni K. Liver Transpl. 2011 Apr;17(4):357-68. (CUMC Full Text PDF)