Cirrhosis macronodular

Type of cirrhosis Macronodular cirrhosis (which is usually a posthepatitic form of cirrhosis) is the type most often associated with HCC (about 55% of cases). Compared to micronodular cirrhosis (usually alcohol-induced), development of HCC must be anticipated in 5-10%o of patients. In this context, the actual presence of coarse-nodular cirrhosis seems to pose a greater risk of HCC than the aetiology of the underlying cirrhosis. The adenomatous and hyperplastic transformations frequently found in cirrhosis tend to develop into HCC. 

Hepatic cirrhosis is typically the end stage of liver disease. Cirrhosis describes an irreversible change (Treinen-Moslen, 2001) characterized by accumulation of excessive collagen deposition in the form of bridging fibrosis which disrupts the hepatic architecture. Cirrhosis may be micronodular or macronodular depending on the amount of fibrosis and tissue regeneration. Liver transplantation is the only solution to restore adequate liver fimction in human medicine. 

The micronodular form can develop into a macronodular form, but not vice versa. Generally, micronodular cirrhosis contains more fibrosis than parenchyma therefore it is firmer than macronodular cirrhosis. The development of micronodular cirrhosis, e. g. in alcohol abuse, may be caused by the fact that continuous alcohol intake blocks the protein synthesis, and thus the parenchyma has no time or chance for cellular proliferation. This form of cirrhosis mainly results from alcohol abuse, but may also be found in haemochromatosis,... 

Mixed-nodular cirrhosis is considered to be a transitional form between micronodular and macronodular cirrhosis (V.J. Desmet et al., 1990). Due to variations in the regenerative capacity of the cirrhotic liver, 50% of... 

Felty s syndrome (A.R. Felty, 1924) is a special form of seropositive polyarthritis. It leads to considerable changes in the articular structures. Characteristic findings include splenomegaly, leucopenia, lymphadenopathy and skin pigmentation. Men are mainly affected. The liver is involved in about 70% of patients. Transaminases and y-GT values are moderately elevated, and there is an occasional rise in alkaline phosphatase. Lymphocytic infiltrates of the sinusoids, proliferation of Kupffer cells and periportal fibrosis are detectable histologically. Nodular regenerative hyperplasia can develop, which may subsequently cause portal hypertension and macronodular cirrhosis. (71, 95, 104)... 

In countries in which the prevalence of cirrhosis is associated with chronic ethanol consumption, the incidence of PHC is typically low. For example, in the United States the incidence rate for PHC is only six cases/100,000/yr, while in sub-Saharan Africa, it is 98 cases/100,000/yr (Mason and McKay, 1976). The low incidence of PHC in the United States occurs despite a high prevalence of alcoholic cirrhosis. One explanation for this discrepancy is that cirrhosis is not just a single disease. The type of cirrhosis which develops following exposure to hepatotoxins or hepatitis B virus is macronodular, whereas chronic ethanol consumption... 

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