The liver biopsy shows generally normal lobular landmarks, but the portal tracts are expanded and fibrotic and, in a few areas, portal-based fibrous bridges have begun to appear. Focal minor ductular proliferation is identified.
Piecemeal necrosis is patchy but is of moderate degree in some areas.
Intralobular bile ducts are intact, with no florid duct lesions or granulomas identified. The lobules demonstrate minimal macrovesicular steatosis and a mild to moderate lobular inflammatory infiltrate accompanied by numerous focal necroses and occasional acidophilic bodies. No ground glass hepatocytes, viral inclusions, pigment deposition, cytoplasmic globules or steatohepatitis is seen. Overall the changes are those of a moderately active chronic hepatitis with features compatible with hepatitis C positivity. This is based on four categories of periportal and bridging necrosis, intralobular degeneration and necrosis, portal inflammation and fibrosis, with total score of up to 22.