Dr. Shahrier Amin

Resident PGY4

Case Two

Overview

Clinical history: A 57 year old female presented with nonspecific symptoms, fatigue, pruritus and right upper hypochondriac pain. Subsequent investigations showed high serum alkaline phosphatase, high cholesterol, negative antinuclear antibodies, negative rheumatoid factor, positive antimitochondrial antibodies and high IgM. A core needle biopsy of liver showed the following:

What is the diagnosis, the main differential, and pathological features that help to distinguish between them?


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