Upon reading my liver biopsy slides, the pathologist from my local hospital [located in a small city] gave a diagnosis of "chronic viral hepatitis C with Grade 1 mild portal and lobular inflammation and focal mild portal fibrosis". Then, when I was referred to a hepatologist [who is located in a major metropolitan area and who sees hundreds of hepatitis C patients/slides], the hepatologist read my biopsy slides and placed me at "Grade 3 with bridging fibrosis". Please explain why there is such a discrepancy in these doctors' findings and advise how I can get an accurate diagnosis. If the diagnosis is, in fact, grade 3 with bridging fibrosis what are the long term implications. Is there a real chance for misreading biopsy??
 
Thank you for your time.
 

 

In general, if the finding of bridging fibrosis was made by one pathologist, then this would be hard to refute. there can be focal areas where these features are present, but not widespread, which might explain the discrepancy. this is by no means a unique problem, but rather common given the relative experience of pathologists with HCV. it would be helpful if you could get reconciliation between the two pathologists involved.