Uneven hepatic copper distribution in Wilson's disease

Faa, Gavino; Nurchi, Valeria Marina; Demelia, Luigi; Ambu, Rossano; Parodo, Giuseppina; Congiu, Terenzio; Sciot, Raf; Eyken, Peter Van; Silvagni, Roberta; Crisponi, Guido

doi:10.1016/0168-8278(95)80283-5

Cited by 98 publications

(62 citation statements)

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“…To accurately diagnose diffuse liver disease, a biopsy specimen must reliably represent the abnormalities throughout the hepatic parenchyma. In several species important lesions are distributed throughout the liver in consistent relationship with hepatic architecture 3, 4, 5, 6, 7. Whereas a good quality biopsy would be expected to reveal most of these lesions, biopsy collects only a small portion of tissue and error associated with nonhomogenous distribution of disease is possible.…”

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confidence: 99%

“…Whereas a good quality biopsy would be expected to reveal most of these lesions, biopsy collects only a small portion of tissue and error associated with nonhomogenous distribution of disease is possible. In humans, hepatopathies considered diffuse can have unevenly distributed histopathologic changes 3, 4, 5, 6, 7. However, caution must be used when extrapolating results in humans to dogs.…”

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confidence: 99%

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Histopathologic Variation between Liver Lobes in Dogs

Kemp

Zimmerman

Panciera

et al. 2015

Veterinary Internal Medicne

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BackgroundBiopsy of the liver evaluates a small portion of tissue, with inferences made to the entire organ. The method and number of biopsies obtained are tempered by consideration of the risks and benefits. Recommendations often include biopsy of more than one liver lobe, although the consistency of histopathology among lobes in dogs is unknown.Hypothesis/ObjectivesTo describe the distribution of histopathologic abnormalities between liver lobes. We hypothesized that discordant results would be evenly distributed among all liver lobes.AnimalsSeventy dogs undergoing necropsy.MethodsProspective study. Liver samples were obtained from all lobes. A primary diagnosis was assigned to each liver sample based on the predominant histopathologic abnormality.ResultsIn this population of dogs, biopsy of at least 2 liver lobes identified the predominant histologic abnormality in 98.6% of the cases. Ten (14%) of the dogs had ≤3 lobes in agreement and could not be assigned a predominant diagnosis. The same diagnosis was present in 6/6 lobes in 39 (56.5%) dogs, 5/6 lobes in 10 (14.5%) dogs, 4/6 lobes in 10 (14.5%) dogs, 3/6 lobes in 7 (10.1%) dogs, and 2/6 in 3 (4.3%) dogs. The number of discordant results did not differ between the liver lobes.Conclusion and Clinical ImportanceThe likelihood of obtaining a sample that is reflective of the predominant histologic abnormality in the liver is increased when multiple liver lobes are biopsied.

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confidence: 99%

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confidence: 99%

Histopathologic Variation between Liver Lobes in Dogs

Kemp

Zimmerman

Panciera

et al. 2015

Veterinary Internal Medicne

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“…Previous studies have revealed that there is an unexplained and striking inter-and intralobular variability of acute hepatic necrosis with some regions having massive necrosis and adjacent areas within the lobe or other lobes from the same animal showing no injury at all (Figure 1) (Irwin et al, 2004b). Variability between lobes has previously been observed in the severity of acetaminophen toxicity (Heinloth et al, 2004;Irwin et al, 2004aIrwin et al, , 2004b, copper distribution (Haywood, 1981;Faa et al, 1987Faa et al, , 1995, iron and phosphorous , chemical and spontaneous carcinogenesis (Solt et al, 1977;Richardson et al, 1986;Elba et al, 2002;Garcia-Torres et al, 2003), cirrhosis (Matsuzaki et al, 1997;Regev et al, 2002), and regeneration (LaBrecque, 1994). The mechanism is often uncertain, however factors such as portal streamlining of blood to the liver (Duchen, 1961;Daniel et al, 2004), redistribution Vol.…”

Section: Functional Gradientsmentioning

confidence: 99%

“…Also localized or generalized core redistribution of blood flow or blood pooling is controlled by nerve stimulation (Stuart and Wheatley, 1995;Oakley et al, 2003) or hepatic stellate cells (Ratziu and Friedman, 1997;MacSween et al, 2002;Mabuchi et al, 2004) that can potentially lead to lobe variation in liver disease. Lobe variation has been reported for acetaminophen hepatotoxicity (Heinloth et al 2004;Irwin et al 2004aIrwin et al , 2004b, copper distribution (Haywood, 1981;Faa et al 1987Faa et al , 1995, iron and phosphorous , chemical carcinogenesis (Solt et al, 1977;Richardson et al, 1986), cirrhosis (Matsuzaki et al, 1997;Regev et al, 2002), and regeneration (LaBrecque, 1994). The conducting portal vessels deliver blood to the parenchymal vessels called preterminal and terminal portal venules, respectively.…”

Section: Lobes and Lobulesmentioning

confidence: 99%

“…The portal blood drains from the mesenteric, gastric, splenic, and pancreatic veins and travels to the liver where it branches into the right and left sides of the liver. There can be incomplete mixing of blood coming from the gastrointestinal tract and spleen leading to variation in delivery of various nutrients, toxins, and other elements to the liver lobes (called portal streamlining) (Haywood, 1981;Faa et al, 1987Faa et al, , 1994Faa et al, , 1995Thein et al, 2003;Dantel et al, 2004). For example, the blood draining the stomach and spleen tend to flow to the left side of the liver.…”

Section: Lobes and Lobulesmentioning

confidence: 99%

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New Insights into Functional Aspects of Liver Morphology

et al. 2005

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The liver is structurally and functionally complex and has been considered second only to brain in its complexity. Many mysteries still exist in this heterogeneous tissue whose functional unit of the lobule has continued to stump morphologists for over 300 years. The primary lobule, proposed by Matsumoto in 1979, has been gaining acceptance as the functional unit of the liver over other conceptual views because it's based on vessel architecture and includes the classic lobule as a secondary feature. Although hepatocytes comprise almost 80% of the liver, there are at least another dozen cell types, many of which provide "cross-talk" and play important functional roles in the normal and diseased liver. The distribution and functional roles of all cells in the liver must be carefully considered in both the analysis and interpretation of research data, particularly data in the area of genomics and "phenotypic anchoring" of gene expression results. Discoveries regarding the functional heterogeneity of the various liver cell types, including hepatocytes, hepatic stellate cells, sinusoidal endothelia, and Kupffer cells, are providing new insights into our understanding of the development, prevention and treatment of liver disease. For example, functional differences along zonal patterns (centrilobular or periportal) have been demonstrated for sinusoidal endothelium, Kupffer cells, and hepatocytes and can explain the gradients and manifestations of disease observed within lobules. Intralobular gradients of bile uptake, glycogen depletion, glutamine synthetase, and carboxylesterase by hepatocytes; widened fenestrations in centrilobular sinusoidal lining cells; and differences in the components of centrilobular extracellular matrix or function of Kupffer cells have been demonstrated. Awareness of the complexities and heterogeneity of the liver will add to a greater understanding of liver function and disease processes that lead to toxicity, cancer, and other diseases.

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