Portal (septal) cirrhosis

Portal (septal) cirrhosis is characterized by homogeneity of changes throughout the liver, the small size of the false slices, approximately equal to the size of a normal segments (Fig. 62).

Fig. 62. Portal cirrhosis of the liver. Explanation in the text.

Portal cirrhosis also has three stages of development. Morphological changes in the liver in the initial stages of portal cirrhosis mainly correspond to chronic hepatitis. The body is not deformed, dense, slightly increased. The surface of the liver may be smooth, more often it is fine. The region of the liver (especially of the left lobe) whitish - RublevoUspenskoye. Microscopically, the picture of chronic hepatitis: connective tissue wedged in the hepatic parenchyma of the extended periportal spaces and thickened liver capsule, in the course of connective tissue fibers is determined kletskova infiltration of various degrees. The artery walls were thickened. Fibrous bands connect the Central channel and periportal space, but the structure of the segments have not completely broken.
In the stage formed portal cirrhosis of the liver is reduced, its surface a fine-grained or finely tuberous. Often the liver in size is enlarged spleen. Microscopically - lobular structure lost, hepatic lobules is divided into nodes of the wrong form is "false slices", connective tissue layer is rich in blood vessels and contain lymphoid infiltrates, especially abundant in places of joining of connective tissue fibers. In periods of activity detected focal necrosis and signs of regeneration of the hepatic parenchyma.
In the final stage of portal cirrhosis of the liver is reduced significantly (up 900-1018 g), deformed, extremely dense. Microscopic examination reveals a picture that matches that of the final stage of postnecrotic cirrhosis: expressed the structure of the body with a clear reduction parenchyma. Separate the false slices of various sizes, improperly built - included in the layer of Mature dense connective tissue.
Changes that can be detected by electron microscopy, the same for both types of cirrhosis.
In hepatocytes are marked increase in the number and consolidation of granules ribonucleoproteins in the cytoplasm; congregations granular membranes elastoplast around of nucleus, expressed tension elastoplasticity tanks; the consolidation and improvement of osmoticnosti mitochondria, the emergence of their lipid inclusions, increasing the number of lysosomes (A. I. Chlebowski and A. S. Loginov, 1963; A. F. of Bluger and others, 1964; Popper, 1962). Characterized by the development of connective tissue in the portal tracts. Space of the thesis contain collagen fibers and layers of mesenchymal cells; many sinusoid lined basal membranes. In hepatic nodules visible expansion of intercellular spaces that form pericellular channels, connected to perisinusoidal spaces and connective tissue portal tracts and partitions. The surface of hepatocytes in these canals is equipped with abnormal microvilli. It is possible that these pericellular channels and high absorbent surface of liver cells are the mechanism of compensation of the reduced blood flow in the sinusoids (Phillips, 1968).