10. Haemosiderosis of liver

Portal triad. Note the varying levels of hemosiderin pigment in the cell around.

Staining: Prussian blue, HE

Organ: Liver

Description:

With the Prussian blue stain, we can see normal liver tissue with small, medium and large accumulation of blue pigment. Notably, the pigment can be seen inside the epithelial cells of the bile duct in the portal triads.

With the HE stain, the description is similar, however the pigment is brownish instead of bluish.

Diagnosis: Hemosiderosis in the liver

Theory:

Haemosiderin can be seen in the biliary epithelial cells in the bile duct, meaning that this is a severe case.

The pigment can not only be found in the Kupffer cells (liver macrophages), but also in hepatocytes and even in the biliary epithelial cells in the bile ducts. Cases where hemosiderosis can be seen in these biliary cells are more severe than when the biliary cells don’t have the pigment.

Close-up of the cells. Note the Kupffer cell that is full of pigment.