CLINICAL AND PATHOLOGICAL STUDY ON CHANGES OF INTERLOBULAR BILE DUCTS IN CHOLELITHIASIS

Abstract

Clinical and pathological study on changes of interlobular bile ducts in 44 patients with cholelithiasis were carried out, and 8 patients with obstructive jaundice by carcinoma, which were examined as control group.Twenty-seven specimens revealed abnormal interlobular bile duct epithelium in 44 biopsy liver specimens from patients with cholelithiasis, in which cholecystolithiasis were 26 cases, choledocholithiasis were 16 cases, hepatolithiasis were 2 cases.The epithelium was frequently infiltrated by neutrophils and lymphocytes, particularly neutrophils being predominant. The lumens of interlobular bile ducts were dilated, and cellular debris were often found in the lumen. Abnormal bile ducts had eosinophilic degenerative, swollen, vacuolized or flat epithelial cells with karyopyknosis or karyorrhexis, and partial destruction of the basement membrane. Also, PAS-positive and mucicarmine positive droplets and or granules were found in some interlobular bile duct epithelium.In 5 patients, some of the interlobular bile ducts were disappeared on the serial sections.Morphological changes of the interlobular bile ducts observed in cholelithiasis were similar to those observed in obstructive jaundice, however, the degree and incidence of various changes of the former were slighter than those of the latter.On the other hand, in cases with abnormal interlobular bile ducts, fever and leukocytosis were often observed, but there was no significant difference between cases with abnormal interlobular bile ducts and cases without it. Al-Pase and serum total bilirubin of cases with abnormal interlobular bile ducts were higher than that of cases with normal interlobular bile ducts.It seems that morphological changes of interlobular bile ducts in cholelithiasis result from inflammation and obstruction of the bile ducts.