Liver Fibrosis

Fibrosis - Repair

• any hepatic injury of consequence is going to cause a degree of fibrosis when the lesion has resolved
• the fibrosis comes from the proliferation of the supportive connective tissue in the liver
• fibrosis isolates the liver cells by effectively changing the sinusoids into capillaries
• when a certain amount of fibrosis occurs, it can be self-perpetuating
  • the end result is a small scarred liver with functional failure

Histological patterns

Periacinar fibrosis

• the fibrosis surrounds the hepatic venule (centrilobular vein)
• can be seen when there is chronic passive congestion with atrophy of the surrounding periacinar hepatocytes and condensation of the remaining connective tissue

Biliary fibrosis

• accompanying inflammation centered on the portal triads

Post necrotic scarring

• following massive necrosis where the necrotic cells are removed and the defect is reapired by fibrosis
• seen as bands of fibrous tissue

Diffuse fibrosis

• resulting from repeated damage to one or more zones
• the fibrosis generated proliferates throughout to involve all the tissue