chronic cholangitis

Definition: Inflammation of bile ducts by mononucleate cells (Nonsuppurative Cholangitis)

Various liver diseases are associated with interlobular bile ducts surrounded and infiltrated by lymphocytes (“non-suppurative cholangitis”).

The bile duct epithelium shows variable cytologic atypia, consisting of cytoplasmic eosinophilia, increased nuclear:cytoplasmic ratio, nuclear hyperchromasia, uneven nuclear spacing, and in some instances reactive epithelial hyperplasia.

In many of the listed diseases in this table, depletion of ducts may eventually result and is often, but not always, associated with a biliary fibrosis or even biliary cirrhosis.

Nonsuppurative cholangitis may be diffuse, involving the majority of portal tracts (e.g., severe acute cellular rejection), or focal (e.g., early stages of primary biliary cirrhosis).

As in duct paucity, the mechanism is multi-factorial, and relates to host immune responses against infectious agents, auto-antigens, and alloantigens.

Etiology

 Acute viral hepatitis, HCV
 Acute viral hepatitis, HEV
 Allograft, acute (cellular) rejection
 Autoimmune hepatitis (autoimmune cholangitis)
 Caroli disease (biliary cyst walls)
 Chronic viral hepatitis, HCV
 Cryptosporidiosis
 Cytomegalovirus
 Drug-induced (see Table 5-11)
 Epstein-Barr virus
 Graft versus host disease
 Hodgkin’s lymphoma
 Human immunodeficiency virus (HIV) (HIV-associated cholangiopathy)
 Idiopathic adulthood ductopenia
 Paucity of ducts syndrome, syndromatic (Alagille syndrome)
 Primary biliary cirrhosis
 Primary sclerosing cholangitis (also large ducts)
 Recurrent pyogenic cholangiohepatitis (large ducts only)
 Sarcoidosis

See also

 cholangitis

• acute cholangitis