Leverpathologie

Leverpathologie, or liver pathology, is the branch of pathology concerned with diseases of the liver and their microscopic and molecular features. It relies on examination of liver tissue obtained by biopsy or surgical resection, supported by immunohistochemistry and, when needed, molecular testing. The field integrates clinical information and laboratory data to reach diagnostic and prognostic conclusions.

Common histologic patterns include hepatitis with hepatocyte injury and inflammatory infiltrates, steatosis (macro- or microvesicular fat), and cholestasis with bile plugs. Chronic injury drives fibrosis and can progress to cirrhosis, accompanied by architectural distortion and regenerative nodules. Neoplastic lesions, such as hepatocellular carcinoma, hepatocellular adenoma, and cholangiocarcinoma, have distinct patterns. Other conditions encompass vascular disorders, storage diseases, iron or copper overload, and autoimmune processes.

Diagnosis in leverpathologie combines histology with clinical context, serology, and imaging. Liver biopsy remains a key tool for staging fibrosis and grading inflammation in diseases like NAFLD/NASH or autoimmune hepatitis, though noninvasive elastography and serologic panels are increasingly used. Staging and grading systems (for example METAVIR or Ishak) guide prognosis and therapy in several conditions.

Common etiologies encountered in practice include viral hepatitis (HBV, HCV), alcoholic liver disease, nonalcoholic fatty liver disease, autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis, and metabolic disorders such as hemochromatosis or Wilson disease. Pathology reports often specify pattern, severity, and stage, and may include ancillary findings like iron, copper, or lipid deposition, bile duct injury, or signatures of specific tumors.

Overall, leverpathologie is essential for diagnosis, prognosis, and treatment planning in liver disease and contributes to research on liver biology and disease mechanisms.