case_images: PMC11021023_01
case_images: Photomicrographs of the porta hepatis: A - histology of extrahepatic bile duct at porta highlighting focal obliteration with periductal fibrosis, while it was focally patent (duct at the bottom of picture) (H&E, 40x); B - multiple islands of mature and immature hyaline cartilage in the vicinity of peribiliary glands (H&E, 40x); C - the mature hyaline cartilage had a basophilic matrix and thick perichondrium (H&E, 200x); D - the immature hyaline cartilage was hypercellular with pale stroma and poorly defined perichondrium (H&E, 400x).
case_images: autopsy-14-e2024481-g01.jpg
case_images: PMC11021023_01_autopsy-14-e2024481-g01.jpg
case_images: gf01
case_images: The peribiliary glands around the extrahepatic bile duct showed periglandular edema and concentric fibrosis (Figure 1A). Multiple islands of mature and occasional islands of immature hyaline cartilage were noted in close approximation with the peribiliary glands (Figure 1B). The mature cartilage had well-defined perichondrium, relatively low cellularity, and basophilic chondroid matrix (Figure 1C). In contrast the immature cartilage had poorly circumscribed perichondrium merging into the adjacent soft tissue, hypercellularity, and pale matrix (Figure 1D).
case_images: Photomicrographs of the gallbladder and the liver: A - the mature hyaline cartilage at the gallbladder wall with thick perichondrium (H&E, 200x); B - liver wedge highlighting fibro edematous and expanded portal tracts with exuberant ductular reaction (H&E, 100x); C - and occasional porto-portal bridging fibrosis (Masson trichrome, 100x); D - giant cell and feathery changes of the hepatocytes (H&E, 200x).
case_images: autopsy-14-e2024481-g02.jpg
case_images: PMC11021023_01_autopsy-14-e2024481-g02.jpg
case_images: gf02
case_images: The gallbladder showed denuded lining epithelium and the presence of an occasional island of hyaline cartilage in its wall (Figure 2A). The wedge of the liver showed a classical picture of distal obstructive cholangiopathy with portal-based fibrosis, occasional porto-portal bridging, exuberant ductular reaction, ductular cholestasis, occasional ductal disarray, and the changes associated with hepatocanalicular cholestasis (Figures 2B-D).