HISTOPATHOLOGICAL PATTERN OF LIVER BIOPIES IN ZARIA; A TEN YEAR RETROSPECTIVE ANALYSIS [2004 2013]

Abstract

Introduction: Liver diseases account for a significant number of morbidity and mortality
worldwide. Liver biopsy and accurate histologic interpretation of the reports is an important
aspect of management of patients with chronic liver diseases.
Objective: The objective of this study was to document the histopathological patterns of liver
biopsies in Ahmadu Bello University Teaching Hospital, Zaria over a ten- year period (2004
2013) and to review all cases of chronic viral hepatitis using Ishaq modified histologic
activity index (HAI).
Materials and methods: Formalin fixed paraffin embedded tissue blocks and haematoxylin
and eosin stained slides were studied. Special stains such as reticulin, perls, masson trichome
and PAS were also used in further characterization of specific liver pathology. The biodata
and clinical history of cases were extracted from accompanying case cards and departmental
records.
Result: The samples of 197 males and 104 females (M: F; 1.9:1) were studied. The age range
was 2months to 80years with an overall peak age incidence in the 3rd decade of life. The
liver diseases were categorized into congenital (2.3%), infectious conditions (2.9%), hepatitis
(56.5%), cirrhosis (15.3%) and neoplastic diseases (18.9%). Overall, Hepatitis was the
commonest pathology with 56.5% cases while cirrhosis and hepatocellular carcinoma
accounted for 15.3% and 13.6% respectively. Chronic viral hepatitis cases had a male: female
ratio of 2.5:1.0 and 42.2% of the cases were mild grade disease while over 70% were stage 0
2 disease using Ishaq histologic activity index. Hepatocellular carcinoma showed a slight
male preponderance with peak age distribution in the 4th decade of life and 46.3% of the
cases were post-cirrhotic. Hepatotrophic viruses accounted for the bulk of aetiological factors

with hepatitis B virus (HBV) infection recorded in 41.3% of the cases, hepatitis C virus
(HCV) in 8.7% and HBV/HCV co-infection in 4.4% cases. Only 6.5% cirrhotic cases were
associated with significant alcohol consumption while 32.6% were cryptogenic with no
identifiable aetiologic agent clinico-pathologically.
Conclusions: The most common liver diseases in Zaria are hepatitis, cirrhosis and
hepatocellular carcinoma. All showed a slight male preponderance with peak age of
affectation in the third decade of life. Hepatotropic viruses, hepatitis B virus (HBV) and
hepatitis C virus (HCV) were the main implicated aetiologic factors in majority of our cases
while mild grade disease of chronic viral hepatitis accounted for bulk of the cases reviewed.

HISTOPATHOLOGICAL PATTERN OF LIVER BIOPIES IN ZARIA; A TEN YEAR RETROSPECTIVE ANALYSIS [2004 2013]