[Liver biopsy in children and adolescents : Preliminary morphological examinations in diffuse liver disease]

Frequencies of types of liver disease differ between adults and nonadults (NA).

The particular problems encountered in interpreting liver-biopsy findings in NA often require referral in consultation.  To permit this efficiently, we recommend specific approaches to light microscopy, with special stains and immunohistochemistry, as well as to ultrastructural study.

Prosection and the choice of special stains are described, and are discussed in relation to clinical questions.

Histochemical stains (chromatic aniline blue [CAB], Prussian blue [Berlin blue, BBL], periodic acid-Schiff reaction [PAS], diastase-PAS [D‑PAS], reticulin, rhodanine, Victoria blue) and immunohistochemical studies to demonstrate the expression of keratin 7 (cholangiocytes) and macrosialin (CD68; macrophages) as well as electron microscopy are important techniques in the histopathologic  analysis of ontogenetic, storage, and metabolic disorders, hepatitis, hepatosplenomegaly, cholestasis, and portal hypertension.

Particular histochemical and immunohistochemical studies, as well as electron microscopy, are useful in optimising histopathologic diagnosis and in differential diagnosis.  We believe that these techniques should be part of routine work-up of NA liver-biopsy specimens.