Slide 1
Gross, Liver: As you know, extrahepatic obstruction is one of the causes of jaundice. Bile retained within the liver gives it a dark green color. Pathologists refer to this as cholestasis. The pathological changes that are seen in the liver are dependent on the duration of the obstruction, but long-standing obstruction will eventually progress to a micronodular cirrhosis which pathologists call secondary biliary cirrhosis. This section of liver taken from a child shows secondary biliary cirrhosis resulting from extrahepatic biliary atresia.

Slide 2
The liver that you have in your class sets is that of a patient with extrahepatic obstruction of several months duration due to carcinoma of the head of the pancreas. It can be seen at low power that this patient already has some portal scarring of the liver but does not yet have cirrhosis. There are specific pathological changes in this liver, both in the portal (P) and central (C) areas, and you should be careful to examine both of these areas.

Slide 3
One of the earliest visible changes seen in the liver following extrahepatic obstruction is bile stasis. This is typically most severe in the centrilobular areas. The bile pigment is present as fine granules in the cytoplasm of hepatocytes and as very prominent bile plugs in the biliary canaliculi. Note that the biliary canaliculi between the hepatocytes are stuffed with dark green bile pigment.