Qualitative and quantitative differences between bile ducts in chronic hepatitis and in primary biliary cirrhosis

Aim-Lymphocytic infiltration in the portal triads usually conceals the dete ction-in haematoxylin and eosin (H&E) stained sections-of bile ducts in two Liver diseases: chronic hepatitis and primary biliary cirrhosis. The aim w as to assess the number and the characteristics of the bile ducts in those diseases with the aid of an antibody to cytokeratin 7 (CK7) Methods-Consecu tive sections from 99 liver biopsies were stained with H&E and anti-CK7. Results-In H&E sections the total number of central bile ducts in the triad s was 52 in primary biliary cirrhosis (n = 37), 69 in chronic hepatitis (n = 43), and 30 in miscellaneous cases (n = 19). Using anti-CK7, the number o f central bile ducts was 276 in primary biliary cirrhosis, 348 in chronic h epatitis, and 96 in miscellaneous cases. Central bile ducts with lumen were found in 93.0% of chronic hepatitis cases and in 89.5% of the miscellaneou s cases, but in only 13.5% of the primary biliary cirrhosis cases. Peripher al bile ducts in groups of greater than or equal to 4/triad were found in a ll cases of chronic hepatitis (100%) and in 75.7% primary biliary cirrhosis cases, but only in 10.5% of the miscellaneous cases. In 21.6% of primary b iliary cirrhosis cases, no bile ducts (central and/or peripheral) were pres ent. Conclusions-Anti-CK7 detects bile ducts in the triads that are concealed by chronic inflammatory cells. Central and peripheral bile ducts in groups of greater than or equal to 4 were significantly more common in primary bilia ry cirrhosis and chronic hepatitis than in other liver diseases. The lack o f lumen in central bile ducts, as well as the absence of central and/or per ipheral bile ducts in CK7 stained liver sections, seem to be valuable addit ional parameters in the differential diagnosis between primary biliary cirr hosis and chronic hepatitis.