Immunostaining of Plasma Cells in Primary Biliary Cirrhosis
Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease characterized by inflammatory destruction of the intrahepatic bile ducts. The differential diagnosis for PBC often includes autoimmune hepatitis (AIH). Both diseases can show prominent plasma cells and other overlapping histologi...
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Published in | American journal of clinical pathology Vol. 131; no. 2; pp. 243 - 249 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Chicago, IL
American Society of Clinical Pathologists
01.02.2009
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Abstract | Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease characterized by inflammatory destruction of the intrahepatic bile ducts. The differential diagnosis for PBC often includes autoimmune hepatitis (AIH). Both diseases can show prominent plasma cells and other overlapping histologic features. It is interesting that both diseases can involve elevated levels of serum immunoglobulins, with IgM elevations typical of PBC and IgG elevations typical of AIH. We investigated whether this difference could be useful histologically by immunostaining plasma cells in liver biopsy specimens for IgG and IgM. We examined 56 cases: 18 of PBC and 38 of AIH. In PBC, plasma cells in the portal tracts were predominantly IgM+, whereas in AIH, plasma cells were predominately IgG+ (P < .0001). Immunostaining for IgM and IgG can be helpful in differentiating PBC from AIH. |
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AbstractList | Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease characterized by inflammatory destruction of the intrahepatic bile ducts. The differential diagnosis for PBC often includes autoimmune hepatitis (AIH). Both diseases can show prominent plasma cells and other overlapping histologic features. It is interesting that both diseases can involve elevated levels of serum immunoglobulins, with IgM elevations typical of PBC and IgG elevations typical of AIH. We investigated whether this difference could be useful histologically by immunostaining plasma cells in liver biopsy specimens for IgG and IgM. We examined 56 cases: 18 of PBC and 38 of AIH. In PBC, plasma cells in the portal tracts were predominantly IgM+, whereas in AIH, plasma cells were predominately IgG+ (P < .0001). Immunostaining for IgM and IgG can be helpful in differentiating PBC from AIH. Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease characterized by inflammatory destruction of the intrahepatic bile ducts. The differential diagnosis for PBC often includes autoimmune hepatitis (AIH). Both diseases can show prominent plasma cells and other overlapping histologic features. It is interesting that both diseases can involve elevated levels of serum immunoglobulins, with IgM elevations typical of PBC and IgG elevations typical of AIH. We investigated whether this difference could be useful histologically by immunostaining plasma cells in liver biopsy specimens for IgG and IgM. We examined 56 cases: 18 of PBC and 38 of AIH. In PBC, plasma cells in the portal tracts were predominantly IgM+, whereas in AIH, plasma cells were predominately IgG+ (P < .0001). Immunostaining for IgM and IgG can be helpful in differentiating PBC from AIH. |
Author | TORBENSON, Michael ANDERS, Robert A DANIELS, Jason A BOITNOTT, John K |
Author_xml | – sequence: 1 givenname: Jason A surname: DANIELS fullname: DANIELS, Jason A organization: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States – sequence: 2 givenname: Michael surname: TORBENSON fullname: TORBENSON, Michael organization: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States – sequence: 3 givenname: Robert A surname: ANDERS fullname: ANDERS, Robert A organization: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States – sequence: 4 givenname: John K surname: BOITNOTT fullname: BOITNOTT, John K organization: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States |
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Keywords | Immunohistochemistry Immunopathology Primary biliary cirrhosis Hepatitis Anatomic pathology Autoimmune hepatitis Digestive diseases Hepatic disease Autoimmune disease Plasmocyte |
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References_xml | – volume: 22 start-page: 696 year: 1995 ident: 2023011905502242600_b3-1310243 article-title: Histological grading and staging of chronic hepatitis publication-title: J Hepatol doi: 10.1016/0168-8278(95)80226-6 contributor: fullname: Ishak – volume: 111 start-page: 285 year: 1960 ident: 2023011905502242600_b5-1310243 article-title: Immunocytochemical study of gamma globulin in liver in hepatitis and postnecrotic cirrhosis publication-title: J Exp Med doi: 10.1084/jem.111.2.285 contributor: fullname: Cohen – volume: 31 start-page: 705 year: 1986 ident: 2023011905502242600_b13-1310243 article-title: Frequency and significance of antimitochondrial antibodies in severe chronic active hepatitis publication-title: Dig Dis Sci doi: 10.1007/BF01296447 contributor: fullname: Kenny – start-page: 33 volume-title: Gallbladder and Biliary Tract Diseases year: 2000 ident: 2023011905502242600_b8-1310243 contributor: fullname: Afdhal – volume: 99 start-page: 1316 year: 2004 ident: 2023011905502242600_b10-1310243 article-title: The prevalence of autoantibodies and autoimmune hepatitis in patients with nonalcoholic fatty liver disease publication-title: Am J Gastroenterol doi: 10.1111/j.1572-0241.2004.30444.x contributor: fullname: Adams – volume: 31 start-page: 929 year: 1999 ident: 2023011905502242600_b2-1310243 article-title: International Autoimmune Hepatitis Group Report: review of criteria for diagnosis of autoimmune hepatitis publication-title: J Hepatol doi: 10.1016/S0168-8278(99)80297-9 contributor: fullname: Alvarez – volume: 26 start-page: 561 year: 1997 ident: 2023011905502242600_b11-1310243 article-title: Serum autoantibodies in chronic hepatitis C: comparison with autoimmune hepatitis and impact on the disease profile publication-title: Hepatology doi: 10.1002/hep.510260305 contributor: fullname: Cassani – volume: 379 start-page: 103 year: 1978 ident: 2023011905502242600_b4-1310243 article-title: Staging of chronic nonsuppurative destructive cholangitis (syndrome of primary biliary cirrhosis) publication-title: Virchows Arch A Pathol Anat Histol doi: 10.1007/BF00432479 contributor: fullname: Ludwig – volume: 45 start-page: 435 year: 1999 ident: 2023011905502242600_b12-1310243 article-title: Prevalence of non–organ-specific autoantibodies and chronic liver disease in the general population: a nested case-control study of the Dionysos cohort publication-title: Gut doi: 10.1136/gut.45.3.435 contributor: fullname: Lenzi – volume: 289 start-page: 674 year: 1973 ident: 2023011905502242600_b1-1310243 article-title: The presentation and diagnosis of 100 patients with primary biliary cirrhosis publication-title: N Engl J Med doi: 10.1056/NEJM197309272891306 contributor: fullname: Sherlock – volume: 11 start-page: 150 year: 1962 ident: 2023011905502242600_b6-1310243 article-title: Local formation of gamma-globulin in the diseased liver, and its relation to hepatic necrosis publication-title: Lab Invest contributor: fullname: Paronetto – volume: 271 start-page: 1123 year: 1964 ident: 2023011905502242600_b7-1310243 article-title: Immunocytochemical and serologic observations in primary biliary cirrhosis publication-title: N Engl J Med doi: 10.1056/NEJM196411262712201 contributor: fullname: Paronetto – volume: 5 start-page: 14 year: 1987 ident: 2023011905502242600_b9-1310243 article-title: An autoantibody profile in primary sclerosing cholangitis publication-title: J Hepatol doi: 10.1016/S0168-8278(87)80055-7 contributor: fullname: Zauli |
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SubjectTerms | Adult Aged Aged, 80 and over Bile Ducts, Intrahepatic - metabolism Bile Ducts, Intrahepatic - pathology Biological and medical sciences Biomarkers - metabolism Diagnosis, Differential Female Gastroenterology. Liver. Pancreas. Abdomen Hepatitis, Autoimmune - diagnosis Humans Immunoglobulin G - metabolism Immunoglobulin M - metabolism Immunohistochemistry Investigative techniques, diagnostic techniques (general aspects) Liver - metabolism Liver - pathology Liver Cirrhosis, Biliary - metabolism Liver Cirrhosis, Biliary - pathology Liver. Biliary tract. Portal circulation. Exocrine pancreas Male Medical sciences Middle Aged Other diseases. Semiology Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques Plasma Cells - metabolism Plasma Cells - pathology Portal System - metabolism Portal System - pathology Young Adult |
Title | Immunostaining of Plasma Cells in Primary Biliary Cirrhosis |
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