Biliary cirrhosis

Biliary cirrhosis have two forms, usually referred to as primary and secondary biliary cirrhosis.
Primary biliary cirrhosis ("biliary cirrhosis without obturation extrahepatic biliary tract, chronic nagnoenie destructive cholangitis) is treated as a disease autoimmunedeseases of geita (see "Pathogenesis"), developing in persons with genetically modified sensitive to various influences. Guess the reason may be that epidemic hepatitis, or some medicinal substances (chlorpromazine, methyltestosterone, and others).
In the initial stage of primary biliary cirrhosis is missing cholestasis, jaundice capillaries not modified liver cells are normal, electrodeposition material is visible in the Golgi apparatus. Portal tracts diffuse expanded. Magdalsophia and septal bile ducts swollen, their epithelium nekrotizirovanne around develop inflammatory infiltrates, consisting of lymphocytes and plasma cells. Sometimes inflammatory response takes the form of granulomas that resemble those with sarcoidosis (Sherlock, 1968). Mesenchymal cells, adjacent to the bile ducts contain PAS-positive substance that when immunofluorescence analysis is ' -M-globulin.
In the next stage revealed the expressed proliferation of the bile ducts, some of them subcourse or disappear. Cholestasis is visible on the periphery of the segments. Around the portal tracts appear dense connective tissue fibers. In restrictive plate segments can be found necrosis, however, architectonics cloves not broken. The last stage is developed through many years of onset. Morphological changes correspond to true cirrhosis and similar changes in the same stage of secondary biliary cirrhosis.
Secondary biliary cirrhosis is formed on the grounds of obturation extrahepatic biliary tract and chronic intrahepatic bacterial cholangitis. Therefore, from the very beginning of the disease is expressed, the violation of bile secretion: advanced and crowded bile ducts and capillaries. They are frequently subjected to divide, forming a "red lake", around which are visible pockets swollen, bright, pale cells with brown striation of cytoplasm - "Cirrus degeneration". Inflammation along omologului and vnutriposelkovykh ducts, and lymph vessels lead to the development of periportal fibrosis spaces and vnutriposelkovykh bars containing bile ducts, arterioles and lymphatic vessels. Peridomiciliary fibrosis forms a strip crossing slice, like the grid. At this stage there are no regeneration units, architectonics cloves saved, fibrous cords do not violate lobular circulation. So often used the term pseudocorus". At the further progression of the disease fibrous bands become interconnected connective tissue walls, diaphragms. A slice is dissected, private Islands parenchyma are isolated, there regeneration sites and developed morphological picture, almost indistinguishable from the portal cirrhosis of the liver. Differential features can serve expressed signs of cholestasis and macroscopic view of a liver, a well-distinguishable by laparoscopy. When biliary cirrhosis of the liver is green, enlarged, its surface is long stays smooth and shrinks sometimes only in the late stages of the disease.
Cirrhosis can be mixed, combining morphological peculiarities of different types.