Barbatis C, Grases P, Shepherd H A, Chapman R W, Trowell J, Jewell D P, McGee J O
J Clin Pathol. 1985 Jul;38(7):778-83. doi: 10.1136/jcp.38.7.778.
Primary sclerosing cholangitis was diagnosed radiologically in 16 of 681 patients (2.2%) with chronic ulcerative colitis in a follow up study at the gastroenterology unit in Oxford. On the basis of established histological criteria, the liver biopsy was considered diagnostic in only half of the cases. The histological findings in these cases were therefore reassessed to determine whether the accuracy of biopsy diagnosis could be improved. The most common specific histological feature was periductal concentric fibrosis of small interlobular bile ducts, even in the absence of inflammation. Other common features were bile ductular proliferation associated with diminution or absence of interlobular bile ducts. Degeneration of bile duct epithelium and diffuse infiltration of portal tracts by mononuclear cells and polymorphonuclear leucocytes were accompanying features. Piecemeal necrosis without rosette formation was found in about half the biopsies. When all these features were considered together a biopsy diagnosis of primary sclerosing cholangitis was established in 14 of 16 cases.
在牛津胃肠病科的一项随访研究中，681例慢性溃疡性结肠炎患者中有16例（2.2%）经影像学诊断为原发性硬化性胆管炎。根据既定的组织学标准，肝活检仅在半数病例中被认为具有诊断价值。因此，对这些病例的组织学检查结果进行了重新评估，以确定活检诊断的准确性是否可以提高。最常见的特异性组织学特征是小叶间小胆管的导管周围同心性纤维化，即使在无炎症的情况下也是如此。其他常见特征包括胆管增生伴小叶间胆管减少或缺失。胆管上皮变性以及单核细胞和多形核白细胞对门静脉周围的弥漫性浸润是伴随特征。约半数活检标本中发现有碎片状坏死但无玫瑰花结形成。当综合考虑所有这些特征时，16例中有14例经活检诊断为原发性硬化性胆管炎。
