More Info on Cirrhosis Regression

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A review of liver fibrosis and cirrhosis regression Michael J. Lee Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA

Journal of Pathology and Translational Medicine 2023 Jun 20 [Epub ahead of print] https://doi.org/10.4132/jptm.2023.05.24

The conclusion of the article reads:

"Cirrhosis was once thought to be an irreversible process of endstage liver disease. This is no longer the case with treatment options for most chronic liver diseases. Fibrosis regression is characterized by thinning of the fibrous septa with hepatocytes pushing into the septa and eventual perforation. This leads to periportal Table 2. Beijing classification system Description Hepatitis assessment Inactive Portal inflammation only or rare foci of interface or lobular hepatitis, no confluent necrosis Active, non-severe Varying degrees of interface and lobular hepatitis easily identified at low power, no confluent necrosis Active, severe Confluent necrosis (perivenular drop out or bridging necrosis or parenchymal collapse) Fibrosis stage Early No fibrosis or portal fibrosis Intermediate Fibrous septa, focal or frequent Advanced Fibrous septa with focal or diffuse nodularity (developing or established cirrhosis) P-I-R fibrosis quality Predominantly progressive Most of the specimen shows progressive forms of stroma Indeterminate Uncertain mix or balance between progressive and regressive forms of stroma Predominantly regressive Most of the specimen shows regressive forms of stroma https://jpatholtm.org/ https://doi.org/10.4132/jptm.2023.05.24 6 • Lee MJ spiking within portal tracts and prolapsed hepatocytes into the boundaries of the portal tract stroma. Obliterated portal veins during progressive fibrosis and cirrhosis due to parenchymal extinction, vascular remodeling, and thrombosis often leaves behind a bile duct and hepatic artery within the portal tract. To characterize these histopathologic features, the Beijing classification system offers an accurate snapshot of a dynamic process between fibrogenesis and fibrolysis. Even with fibrosis regression, vascular lesions/remodeling, parenchymal extinction, and cumulative mutational burden persists and patients should continue to undergo clinical surveillance."