Liver bile duct proliferation
was rated using the scoring developed by Karatepe et al., modifying the scoring system of Cheen-Shen et al.
The histological features of SAL seem to vary based on when the biopsy is taken: early in the course (first stage), the lesion is characterised by collapsed hepatic parenchyma with associated islands of residual hepatocytes, chronic inflammation and marked bile duct proliferation
. Later in the course (second stage), histological findings are characterised by little to no ductal proliferation, a decrease of chronic inflammation and increased amount of elastosis.
Portal inflammation and bile duct proliferation
in the periportal area can also be seen (24).
Histopathology demonstrated bile duct proliferation
(Figure 3), cholestasis (Figure 4), chronic inflammation, and periportal fibrosis without bridging, consistent with the diagnosis of BA; additionally, hepatocytes with PASpositive, diastase-resistant globules (Figure 5) were seen supporting the additional diagnosis of A1AT.