Practical Guide, Challenges, and Pitfalls in Liver Fibrosis Staging

Karen Matsukuma; Matthew M Yeh

doi:10.1016/j.path.2023.04.002

Practical Guide, Challenges, and Pitfalls in Liver Fibrosis Staging

Surg Pathol Clin. 2023 Sep;16(3):457-472. doi: 10.1016/j.path.2023.04.002. Epub 2023 Jun 4.

Authors

Karen Matsukuma¹, Matthew M Yeh²

Affiliations

¹ University of California Davis, Pathology and Laboratory Medicine, 4400 V Street, Sacramento, CA 95817, USA. Electronic address: kmatsukuma@ucdavis.edu.
² University of Washington Medical Center - Montlake, Box 356100, 1959 NE Pacific Street, Seattle, WA 98195, USA.

PMID: 37536882
DOI: 10.1016/j.path.2023.04.002

Abstract

Liver fibrosis staging has many challenges, including the large number of proposed staging systems, the heterogeneity of the histopathologic changes of many primary liver diseases, and the potential for slight differences in histologic interpretation to significantly affect clinical management. This review focuses first on fibrosis regression. Following this, each of the major categories of liver disease is discussed in regard to (1) appropriate fibrosis staging systems, (2) emerging concepts, (3) current clinical indications for liver biopsy, (4) clinical decisions determined by fibrosis stage, and (5) histologic challenges and pitfalls related to staging.

Keywords: Cirrhosis; Fibrosis regression; Hepatic repair complex; Liver; Liver biopsy; Liver fibrosis; Staging system.

Publication types

Review

MeSH terms

Biopsy
Fibrosis
Humans
Liver Cirrhosis* / diagnosis
Liver Cirrhosis* / pathology