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Review Question - QID 214684

Primary Sclerosing Cholangitis imaging Magnetic resonance cholangiography/pancreatography (MRCP) QID: 214684 (M2.OMB.74)
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QID 214684 (Type "214684" in App Search)
A 53-year-old man presents to the office with fatigue, itchy skin, and yellowing of his eyes for the past 2 weeks. His medical history includes ulcerative colitis diagnosed 9 years ago for which he is on mesalamine. He denies current smoking, alcohol, or drug use. The patient’s temperature is 99.3°F (37.4°C), blood pressure is 120/86 mmHg, pulse is 80/min, and respirations are 15/min. On physical exam, he has scleral icterus bilaterally and multiple excoriations on his trunk and extremities. Abdominal exam is unremarkable. Serum studies reveal:

Total bilirubin: 3.6 mg/dL
Direct bilirubin: 2.7 mg/dL
Alkaline phosphatase: 470 U/L
Aspartate aminotransferase (AST): 138 U/L
Alanine aminotransferase (ALT): 90 U/L

Magnetic resonance cholangiopancreatography (MRCP) findings are shown in Figure A. Which of the following would most likely be found on liver biopsy?
  • A
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  • A