Pre-Treatment Biopsy - February 19, 1998

MICROSCOPIC: Step-serial sections of liver incorporate portions of several portal triads. These are expanded and ill-defined, due to increased fibrosis and a polymorphous infiltrate of lymphocytes and plasma
cells. Focal bridging fibrosis is present, a feature best appreciated on the Trichrome stained sections. There is entrapment of small aggregates of hepatocytes within inflammatory and fibrous elements along limited plates, and in some areas a suggestion of micronodular architecture bordering upon cirrhosis. The hepatocytes show mild generalized fatty infiltration with somewhat variable distribution, and a patchy parenchymal cellular infiltrate of monouclear cells. No abnormal iron deposition is demonstrated on iron
stained sections. There is no evidence of malignancy in the material submitted.

DIAGNOSIS: LIVER, PERCUTANEOUS NEEDLE BIOPSY -- ACTIVE CHRONIC HEPATITIS WITH PERIPORTAL AND
                         INTERPORTAL FIBROSIS (HEPATITIS C DISEASE CLINNICALLY)
 
 
 

***During these 2 years, I went on 22 months of treatment, starting with mono-therapy with Intron A for 4 months. I did not respond. I then went directly into Rebetron treatment for 1 year. Again I did not respond. After a 2 month break in treatment, I began INFERGEN high dosage daily treatment. I was forced to stop INFERGEN because my body couldn't handle it. Again, I did not respond. We had hoped that the treatment would at least stop or slow the progression of the liver disease.***
 
 
 

Post-Treatment Biopsy - April 13, 2000

MICROSCOPIC: Sections of core needle biopsy of liver show mild portal fibrosis with dense lymphoplasmacytic infiltrates of triads and focal piecemeal entrapment of necrotic hepatocytes. There is septal fibrosis. The bile ducts are recognized lined by recognizable cubiodal epithelium. Some hepatocytes contain large vacuoles of lipid material.

Special Stains:

Iron - Negative for hemosiderin.
Trichrome - Positive for portal and septal fibrosis.
PAS - Confirmatory of macrovaculor steatosis, moderate and additional H&E findings, negative for malignancy.

DIAGNOSIS:  LIVER, CORE BIOPSY: CHRONIC ACTIVE HEPATITIS C WITH FOCAL PIECEMEAL NECROSIS (GRADE 2) AND BRIDGING FIBROSIS WITH ARCHITECTURAL DISTORTION (STAGE 3).