Histochemical and Immunohistochemical Staining for Markers of Fibrosis in Embalmed Cadavers

Abstract

Liver fibrosis is a significant liver disease, but its incidence in the elderly is not known. Embalmed cadavers used for teaching human anatomy provide liver tissue for analysis of fibrosis in this population. Livers from 32 cadavers (age 64–100 yrs) with diverse causes of death were embedded in paraffin, sectioned and stained for markers of fibrosis: Sirius red stain for collagen, resorcin fuchsin and van Gieson stains for elastin and collagen, and á‐smooth muscle actin (á‐SMA) antibody, followed by Sirius red, for á‐SMA expression by hepatic stellate cells (HSCs) and myofibroblasts. As determined by collagen staining and morphometry, central vein fibrosis was seen in 21 livers, perisinusoidal fibrosis in 25, portal tract fibrosis in 16, short and long fibrous septa in 12, bridging septa (portal‐portal, portal‐central, central‐central) in 10 and cirrhosis in 1. Only 3 livers showed minimal change. Although absent in the space of Disse, elastic fibers co‐distributed with collagen in the portal tracts, septa, central veins and walls of blood vessels. á‐SMA‐stained HSCs localized to collagen fibers in the space of Disse, while myofibroblasts were found with collagen and elastin in portal tracts, septa and central veins, consistent with their role in fibrogenesis. Conclusions: Liver fibrosis, from early to late stages, is prevalent in older adults, and this pathology may have exacerbated the health of this population.