Staging of chronic nonsuppurative destructive cholangitis (syndrome of primary biliary cirrhosis)

  title={Staging of chronic nonsuppurative destructive cholangitis (syndrome of primary biliary cirrhosis)},
  author={J. Ludwig and E. Dickson and G. McDonald},
  journal={Virchows Archiv A},
Staging of liver biopsy specimens from patients with chronic non-suppurative destructive cholangitis (CNDC or syndrome of primary biliary cirrhosis) has become an important part of clinical studies that are currently done in many centers. Therefore, staging methods should be based on uniform criteria that are applicable to all specimens and are easily reproducible. Most pathologists staging CNDC use the system proposed by Scheuer and modified slightly by Popper and Schaffner; and generally… Expand

Paper Mentions

Interventional Clinical Trial
The purpose of this study is to determine the safety and efficacy of the Oridion Breath ID machine in monitoring liver metabolic functions.  
ConditionsCirrhosis, Fatty Liver
InterventionDevice, Drug
Primary biliary cirrhosis: is there still a place for histological evaluation?
  • Y. Nakanuma
  • Medicine
  • Clinics and research in hepatology and gastroenterology
  • 2014
A new histological staging and grading system for primary biliary cirrhosis (PBC) is proposed to modernize the histological evaluation of disease progression and necro-inflammatory activities in liver biopsies from patients with PBC. Expand
New Histological Staging and Grading System for Primary Biliary Cirrhosis
A new histological staging and grading system in which the degree of fibrosis, bile duct loss, and chronic cholestasis in combination for staging is proposed, in order to reduce sampling errors. Expand
Application and Validation of a New Histologic Staging and Grading System for Primary Biliary Cirrhosis
A new grading and staging system for primary biliary cirrhosis revealed that the activities of chronic cholangitis and hepatitis did not correlate with each other in terms of degree and that the staging system properly reflected the outcome of PBC patients. Expand
Title Application and validation of a new histologic staging and grading systemfor primary biliary cirrhosis
Background:We proposed a new grading and staging system for primary biliary cirrhosis (PBC), which takes into account the degree of both chronic cholangitis activity (CA) and hepatitis activity (HA)Expand
Liver biopsy in primary biliary cholangitis: is sinusoidal fibrosis the missing key?
The Ludwig system is of more prognostic value than both Ishak and any of the three individual components of the Nakanuma staging system, but the major histological parameter providing independent prognosticvalue beyond the Mayo Score is sinusoidal fibrosis. Expand
Primary biliary cirrhosis: a new histological staging and grading system proposed by Japanese authors.
  • P. Bioulac-Sage
  • Medicine, Biology
  • Clinics and research in hepatology and gastroenterology
  • 2011
Although biochemical cholestasis is present early in the disease, morphological cholESTatic changes occur usually years after onset of symptoms, representing a feature of PBC progression. Expand
Primary biliary cirrhosis and sclerosing cholangitis
The main liver conditions in which biliary ducts are prime targets of the injury, in particular those associated with a progressive loss of the intrahepatic bile ducts or ductopenia, are considered as they enter the differential diagnosis. Expand
Lessons in Clinical Pathology
Histologic activity of chronic cholestasis and lymphocytic piecemeal necrosis, a characteristic finding of chronic active hepatitis, was examined semiquantitatively in 157 liver biopsy specimens fromExpand
Diagnosis of primary biliary cirrhosis.
  • G. Hirschfield
  • Medicine
  • Best practice & research. Clinical gastroenterology
  • 2011
Liver biopsy remains useful in certain settings where clarity is needed to confirm diagnosis, exclude alternative disease, and assess the relative contribution of PBC to other co-existent liver injury, and seeks to demonstrate in particular the classic bile duct lesions, as well as the degree of interface activity. Expand
The role of the pathologist in diagnosing and grading biliary diseases.
A new system applicable to needle liver biopsies in which staging is evaluated using a combination of three factors and necro-inflammatory activities of the bile duct and hepatic parenchyma are graded, is proposed and the clinical and therapeutic evaluation of PBC using this system is warranted. Expand


Localization of the basic injury in primary biliary cirrhosis.
The anatomic basis of this disease has been described by MacMahon whereas others have denied the existence of a characteristic pathologic entity and biopsy specimens in 10 instances were examined by histochemical, electron microscopic, and immunocytochemical techniques. Expand
Primary Biliary Cirrhosis
The primary medical treatment in PBC should focus on reducing the rate of disease progression, and ursodeoxycholic acid has been extensively evaluated and proven to improve liver biochemistries and survival in patients with PBC. Expand
A review of lobular, portal, and periportal hepatitis. Interpretation of biopsy specimens without clinical data.
This representation, in which a recently adopted terminology is used, represents a compilation of clinical diagnoses that must be considered whenever a morphologic diagnosis of lobular, portal, orExpand
as 1959. This long gap is explained by the extensive revision and pruning of the book in bringing it up to date. The authors have been able to condense a considerable amount of clinical informationExpand
A double - blind controlled study using D - penicillamine in chronic cholangiolitic hepatitis ( primary biliary cirrhosis ) . ( Abstract )
  • Gastroenterology
  • 1977
Nonsuppurative destructive chronic cholangitis and chronic hepatitis.
Studies on the pathogenesis of hepatolenticular degeneration. II. Cytochemical methods for the localization of copper.
Editorial: The problem of primary biliary cirrhosis
  • Am. J. Med. 33,
  • 1962