A 38yo man has had a liver biopsy as part of inv for abnormal LFTs

A 38yo man has had a liver biopsy as part of inv for abnormal LFTs. The pathologist report states:special stains demonstrate the presence of a very large amount of iron pigment within the hepatocytes. What single condition is identified by the pathologists report?

a. Alpha 1 antitrypsin deficiency
b. Hemangioma
c. Hemochromatosis
d. Hemosiderosis
e. Wilson’s disease

Ans. The key is D. Hemosiderosis. It is a wrong key! The correct key should be C. Hemochromatosis. [In
hemochromatosis distribution pattern of iron in liver biopsy by pearl’s stain is more prominent iron
granules in periportal hepatocyte and relative sparing of kupffer cells and decreased intensity near the
central vein. By contrast iron overload in hemosiderosis causes to accumulation of iron granules
predominantly in kupffer cells and more in central area rather than peripheral hepatocyte. In given case
there are large amount of iron pigment in hepatocyte which is diagnostic of hemochromatosis].