Liver biopsy in congestive hepatopathy

(A) Congestive hepatopathy. Liver biopsy showing centrilobular sinusoidal dilatation with associated atrophy of hepatocyte plates. Very delicate fibrous tissue is noted lining the sinusoids (perisinusoidal fibrosis), corresponding to congestive hepatic fibrosis score (CHFS) 1. Note that portal tracts are not expanded by fibrosis. Masson trichrome stain (original magnification, 10×).

(B) Congestive hepatopathy with more significant fibrosis. Liver biopsy showing centrilobular sinusoidal dilatation with more prominent perisinusoidal fibrosis. The portal tract in this picture is also expanded by fibrous tissue deposition (periportal fibrosis). The presence of both perisinusoidal and periportal fibrosis corresponds to CHFS 2. Masson trichrome stain (original magnification, 10×).

(C) Congestive hepatopathy with advanced fibrosis. Liver biopsy showing distortion of the architecture with prominent fibrous tissue deposition in both centrilobular and portal zones and the formation of septa that bridge central to central and central to portal zones. This type of advanced fibrosis corresponds to CHFS 3. Masson trichrome stain (original magnification, 10×).

(D) Congestive hepatopathy with cirrhosis. Liver biopsy showing the parenchyma partly replaced by extensive fibrosis. Note the prominent sinusoidal dilatation. Broad bands of fibrous tissue are noted that surround an irregular nodule. These findings correspond to CHFS 4. Masson trichrome stain (original magnification, 20×).