Pathology Journals

Claudins and tricellulin in fibrolamellar hepatocellular carcinoma.
Patonai A, Erdélyi-Belle B, Korompay A, Somorácz A, Straub BK, Schirmacher P, Kovalszky I, Lotz G, Kiss A, Schaff Z. Virchows Arch. 2011 Apr 19. [Epub ahead of print]. (CUMC Full Text PDF).
The histogenesis of fibrolamellar HCC has long been debated. With emerging evidence for 'stem cell' carcinomas and tumors with divergent/bilineal differentiation, some of the morphologic, immunohistochemical, and molecular features of FL-HCC have been re-examined in this context. The authors of this study detected a claudin expression pattern in FL-HCC that is more similar to conventional HCC's than to cholangiocarcinomas. However, tight junction protein expression is qualitatively and quantitatively different from both conventional HCCs and cholangiocarcinomas.

Advanced histology and impaired liver regeneration are associated with disease severity in acute-onset autoimmune hepatitis.
Fujiwara K, Nakano M, Yasui S, Okitsu K, Yonemitsu Y, Yokosuka O. Histopathology. 2011 Apr;58(5):693-704. (CUMC Full Text PDF).
Semiquantitative evaluation of ductular reaction, intermediate hepatocytes and hepatic progenitor cells, as assessed by cytokeratin 7 immunostaining was used by the authors to study patients presenting with autoimmune hepatitis of different severities. The authors conclude that the above features reflect impaired liver regeneration and may represent useful prognostic markers in this setting. It would have been interesting if the authors had also studied the expression of p21, a known marker of replicative arrest, in these patients.

Gastroenterology and Hepatology Journals

Histopathological stages of nonalcoholic fatty liver disease in type 2 diabetes: prevalences and correlated factors.
Leite NC, Villela-Nogueira CA, Pannain VL, Bottino AC, Rezende GF, Cardoso CR, Salles GF. Liver Int. 2011 May;31(5):700-6. (CUMC Full Text PDF).
The reported prevalence of NAFLD and NASH in type-2 diabetic patients with either ultrasonographic evidence of fatty liver or abnormal transaminase levels and negative work-up for other liver diseases was 94% and 78%, respectively. The authors suggest that liver biopsy should be considered for all type-2 diabetic patients in this setting.

Review of liver injury associated with dietary supplements.
Stickel F, Kessebohm K, Weimann R, Seitz HK. Liver Int. 2011 May;31(5):595-605. (CUMC Full Text PDF).
This is a comprehensive review of the literature regarding hepatotoxicity associated with various dietary supplements, various teas and herbal remedies, anabolic steroids, and other compounds. Clinical suspicion for hepatotoxicity by substances belonging to one of the above groups is not uncommon in practice; however, finding information in literature about these supplement and medications is often challenging. I found this review to be a very useful guide.  

Morphologic classification of microvessels in hepatocellular carcinoma is associated with the prognosis after resection.
Chen ZY, Wei W, Guo ZX, Lin JR, Shi M, Guo RP. J Gastroenterol Hepatol. 2011 May;26(5):866-74. (CUMC Full Text PDF). (also see editorial [CUMC Full Text PDF])

Liver transplantation using fatty livers: Always feasible?
McCormack L, Dutkowski P, El-Badry AM, Clavien PA. J Hepatol. 2011 May;54(5):1055-62. (CUMC Full Text PDF).
The authors review the available data about utilizing steatotic grafts in liver transplantation. As the authors point out, different methods of assessing steatosis (gross assessment, frozen H&E section, permanent H&E sections, oil-red-O, sudan black, digital analysis, chemical quantitation methods in tissue etc), evaluation of macro vs micro steatosis, and pathologists's interobserver variability are among the various problems that may contribute to the widely variable outcomes seen in different studies according to the degree of steatosis. In general, a mild degree of macrovesicular steatosis (<30%) is associated with relatively low rates of complications (prolonged ICU time, primary graft non function etc.) while severe macrovesicular steatosis (>60%) is associated with increased rates of complications. The risk associated with moderate steatosis (30-60%), however, is highly variable and the risk conferred by microvesicular steatosis is not well-established.

Massive Hepatic Echinococcosis.
Sweetser S, Loftus, CG. Hepatology 2011 May;53(5):1771-2. (CUMC Full Text PDF).

Hepatitis C virus receptors claudin-1 and occludin after liver transplantation and influence on early viral kinetics.
Mensa L, Crespo G, Gastinger MJ, Kabat J, Pérez-Del-Pulgar S, Miquel R, Emerson SU, Purcell RH, Forns X. Hepatology. 2011 May;53(5):1436-45. (CUMC Full Text PDF).

Constitutional telomerase mutations are genetic risk factors for cirrhosis.
Calado RT, Brudno J, Mehta P, Kovacs JJ, Wu C, Zago MA, Chanock SJ, Boyer TD, Young NS. Hepatology. 2011 May;53(5):1600-7. (CUMC Full Text PDF).

Telomerase gene mutations are associated with cirrhosis formation.
Hartmann D, Srivastava U, Thaler M, Kleinhans KN, N'kontchou G, Scheffold A, Bauer K, Kratzer RF, Kloos N, Katz SF, Song Z, Begus-Nahrmann Y, Kleger A, von Figura G, Strnad P, Lechel A, Günes C, Potthoff A, Deterding K, Wedemeyer H, Ju Z, Song G, Xiao F, Gillen S, Schrezenmeier H, Mertens T, Ziol M, Friess H, Jarek M, Manns MP, Beaugrand M, Rudolph KL. Hepatology. 2011 May;53(5):1608-17. (CUMC Full Text PDF).

These two remarkably similar publications in this month's issue of Hepatology investigate the role of telomerase mutations as potential risk factors for development of cirrhosis in the setting of chronic liver disease of various types.

Incidence of primary sclerosing cholangitis: A systematic review and meta-analysis.
Molodecky NA, Kareemi H, Parab R, Barkema HW, Quan H, Myers RP, Kaplan GG. Hepatology. 2011 May;53(5):1590-9. (CUMC Full Text PDF).
The authors review the evidence for an increasing incidence of PSC in the US and European countries.

Lineage tracing demonstrates no evidence of cholangiocyte epithelial-to-mesenchymal transition in murine models of hepatic fibrosis.
Chu AS, Diaz R, Hui JJ, Yanger K, Zong Y, Alpini G, Stanger BZ, Wells RG. Hepatology. 2011 May;53(5):1685-95. (CUMC Full Text PDF) (also see editorial [CUMC Full Text PDF]).

Diagnostic accuracy of clathrin heavy chain staining in a marker panel for the diagnosis of small hepatocellular carcinoma.
Di Tommaso L, Destro A, Fabbris V, Spagnuolo G, Laura Fracanzani A, Fargion S, Maggioni M, Patriarca C, Maria Macchi R, Quagliuolo M, Borzio M, Iavarone M, Sangiovanni A, Colombo M, Roncalli M. Hepatology. 2011 May;53(5):1549-57. (CUMC Full Text PDF). (also see editorial [CUMC Full Text]).
Di Tommaso et al investigate the contribution of clathrin heavy chain (in addition to glypican-3, glutamine synthetase, and heat-shock protein 70) in the diagnosis of HCC on needly biopsy. The addition of CHC to the panel increased the diagnostic accuracy for small HCCs from 76.9% to 84.3%, and there was an increase in sensitivity from 46.8% to 63.8%.

General Medicine Journals

Primary biliary cirrhosis.
Selmi C, Bowlus CL, Gershwin ME, Coppel RL. Lancet. 2011 May 7;377(9777):1600-9. (CUMC Full Text PDF).

Surgery and Liver Transplantation Journals

Liver and portal histopathological correlation with age and survival in extra hepatic biliary atresia.

Sharma S, Das P, Dattagupta S, Kumar L, Gupta DK. Pediatr Surg Int. 2011 May;27(5):451-61. (CUMC full text PDF)