The aim was to construct a questionnaire analyzing pathological features possibly present in alcoholic liver disease, to assess its interobserver variation and to determine the influence of technical data on this variation. A total of 764 inpatients drinking 90 g (median) of pure alcohol per day for 25 years was observed; 402 patients were excluded because of associated nonalcoholic disease, refusal or contraindication to biopsy, leaving 362 patients included. Two pathologists independently analyzed each biopsy and completed a questionnaire including 41 items. Coefficient of concordance between observers was evaluated with the kappa statistic (k). The prevalence of 14 lesions was low, equal to or under 10%, leading to a nonsignificant concordance. For the 27 remaining features, two had an almost perfect degree of concordance (k greater than 0.81): presence of hepatocellular carcinoma and cirrhosis. Three had a substantial coefficient of concordance (k greater than 0.61): fibrous septa, size of cirrhotic nodules, and liver cell regeneration. Nine had a moderate (k greater than 0.41), 11 a fair (k greater than 0.21), and two a slight (k less than 0.21) coefficient of concordance. In terms of final diagnosis of alcoholic liver disease the concordance was substantial for cirrhosis with acute alcoholic hepatitis (k = 0.77), cirrhosis without alcoholic hepatitis (k = 0.75), acute alcoholic hepatitis without cirrhosis (k = 0.65) and normal liver (k = 0.64). Concordance was moderate for steatosis (k = 0.47) and slight for fibrosis alone (k = 0.16).(ABSTRACT TRUNCATED AT 250 WORDS)

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Patients who were treated with a palliative procedure (as defined operatively) or had invaded margins (in the pathology report) and those who had an in situ lesion or dysplasia were excluded from the study.Age, sex, signs leading to diagnosis (jaundice, pain, anaemia, bleeding), and preoperative endoscopical findings were obtained from the hospital records of the 45 patients. After surgery, the macroscopic aspect of the tumour (vegetating, nodular, ulceration), the largest diameter, and initial localisation (true tumour of the ampulla, or tumour arising from periampullary duodenal surface mucosa, from the common bile duct, or pancreatic duct) were recorded. All pathology slides were then reviewed prospectively focusing on infiltration of the tumour,

The aims of the study were to measure the collagen content in pancreas using a colorimetric method and to compare the amount of collagen in normal pancreas (11 cases), diffuse fibrosing pancreatitis (17 cases), and chronic calcifying pancreatitis (11 cases). The procedure of fibrosis measurement was based on the selective capacity of two dyes, Sirius red and fast green, to set on collagen and noncoUagenous proteins, respectively. After staining of sections, colors were eluted from the sections and the specific absorbance of each eluted dye was read on a spectrophotometer. The collagen content in normal pancreata was 26.5 ± 7.2 μg collagen/mg protein. The amount of collagen increased with the age of patients: the mean value of the patients under the age of 50 was 18.2 ± 4 μg collagen/mg protein whereas the mean value in older patients was 31.9 ± 8 μg collagen/mg protein (p < 0.01). The value of collagen in pancreas with a diffuse fibrosing pancreatitis was 44.7 ± 7.5 μg collagen/mg protein. This value was significantly different from the collagen content in normal pancreas (p < 0.001) and in pancreas with a chronic calcifying pancreatitis (77.9 ± 8 μg collagen/mg protein, p < 0.001). This method permits discrimination between different chronic diseases that can also be differentiated on a histopathologic basis.