Gastroenterology & Hepatology · NEET PG Preparation Medicine
A 35-year-old female presents with fatigue, pruritus, and right upper quadrant discomfort. Laboratory investigations reveal elevated alkaline phospha…
Practice question from Gastroenterology & Hepatology (NEET PG Preparation Medicine), with the correct answer and a step-by-step solution.
medium · MCQ · Q-8C0FAC
A 35-year-old female presents with fatigue, pruritus, and right upper quadrant discomfort. Laboratory investigations reveal elevated alkaline phosphatase and gamma-glutamyl transferase. Serum bilirubin is mildly elevated, and transaminases are normal. Antimitochondrial antibody (AMA) is strongly positive. Which of the following is the hallmark histological finding in this patient's liver biopsy?
- A.Granulomatous destruction of interlobular bile ductsCorrect answer
- B.Concentric periductal fibrosis ("onion-skinning")
- C.Mallory-Denk bodies and neutrophilic lobular inflammation
- D.Caseating granulomas with central necrosis
Solution
Primary biliary cholangitis (PBC) is characterized by chronic, non-suppurative destructive cholangitis targeting small and medium-sized interlobular bile ducts, classically showing florid duct lesions and granulomatous destruction. Concentric periductal fibrosis is characteristic of Primary Sclerosing Cholangitis (PSC).
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