Benign recurrent cholestasis: a light and electron microscopic study with emphasis on sinusoidal cells

Area of Science:

• Hepatology
• Cell Biology
• Pathology

Background:

• Benign recurrent cholestasis is a liver condition characterized by impaired bile flow.
• Understanding the cellular and ultrastructural changes in cholestasis is crucial for diagnosis and treatment.

Observation:

• Liver biopsy revealed centrolobular cholestasis with macrophage infiltration and no necrosis.
• Electron microscopy showed classic cholestasis ultrastructural criteria in hepatocytes.
• Perfusion-fixation enabled detailed visualization of sinusoids, Kupffer cells, endothelial cells, and the Disse space.

Findings:

• Hepatocytes exhibited significant injury and intense phagocytic activity.
• Kupffer cells were abundant, phagocytosing debris and infiltrating the Disse space.
• Endothelial cells showed reduced fenestrae and contained dense bodies.
• Cellular debris was extruded into sinusoids via endothelial pores or invagination.
• The Disse space contained amorphous material and collagen, with transitional perisinusoidal cells.

Implications:

• Cholestasis induces not only hepatocyte damage but also sinusoidal cell injury.
• Extracellular matrix remodeling occurs in the Disse space during cholestasis.
• These findings highlight the complex cellular responses to cholestasis beyond the hepatocyte.