Ludwig J, Czaja A J, Dickson E R, LaRusso N F, Wiesner R H
Liver. 1984 Apr;4(2):105-16. doi: 10.1111/j.1600-0676.1984.tb00914.x.
The features of nonsuppurative cholangitis were studied in liver biopsy specimens from 185 patients with chronic active hepatitis (CAH), 280 patients with primary biliary cirrhosis (PBC), and 55 patients with primary sclerosing cholangitis (PSC). Specimens from patients with other liver diseases in which the presence of nonsuppurative cholangitis had been recorded were also studied. We identified four types of nonsuppurative cholangitis: granulomatous cholangitis, lymphoid cholangitis, fibrous cholangitis, and pleomorphic cholangitis. Granulomatous cholangitis almost always seemed to be destructive; the other types were either destructive or nondestructive. Granulomatous cholangitis was, for all practical purposes, diagnostic of PBC and the obliterative form of fibrous cholangitis was similarly diagnostic for the hepatic manifestations of PSC in adults and paucity of intrahepatic bile ducts in infants. All other types of cholangitis were found in CAH, PBC, PSC, and other liver diseases. Thus, the term "nonsuppurative cholangitis" describes a spectrum of morphologic lesions that differ in incidence, morphogenesis, usefulness for liver biopsy diagnosis, and, probably, pathogenesis.
对185例慢性活动性肝炎（CAH）患者、280例原发性胆汁性肝硬化（PBC）患者和55例原发性硬化性胆管炎（PSC）患者的肝活检标本中无化脓性胆管炎的特征进行了研究。对其他已记录有无化脓性胆管炎的肝病患者的标本也进行了研究。我们确定了四种无化脓性胆管炎：肉芽肿性胆管炎、淋巴细胞性胆管炎、纤维性胆管炎和多形性胆管炎。肉芽肿性胆管炎几乎总是具有破坏性；其他类型要么具有破坏性，要么无破坏性。实际上，肉芽肿性胆管炎可诊断PBC，而闭塞性纤维性胆管炎同样可诊断成人PSC的肝脏表现以及婴儿肝内胆管稀少的情况。所有其他类型的胆管炎在CAH、PBC、PSC和其他肝病中均有发现。因此，“无化脓性胆管炎”一词描述了一系列形态学病变，这些病变在发病率、形态发生、对肝活检诊断的有用性以及可能的发病机制方面存在差异。
