This is a liver biopsy from a patient with primary biliary cholangitis (the updated term for primary biliary cirrhosis). The chronic cholestasis can be subtle on H&E. Since copper is secreted into the bile, it accumulates in hepatocytes near the portal tracts when it cannot be secreted. The copper stain (rhodanine) shows it well as red cytoplasmic spheres. Try our survival guide to Liver Pathology!
Case provided by Dr. Elizabeth Montgomery, Professor of Pathology and Vice Chair of Anatomic Pathology at the University of Miami, and Editor-In-Chief at Innovative Science Press. You can also check out her Soft Tissue and GI Survival Guides as well as our new titles at: