{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T08:59:21Z","timestamp":1790067561875,"version":"4.0.1"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,11]]},"abstract":"Abstract<\/jats:title>\n \n Introduction:<\/jats:title>\n Extrahepatic biliary atresia (EHBA) is a fibroinflammatory disorder characterised by the fibrosed development of extrahepatic biliary ducts, resulting in cholestatic jaundice. Inflammation and inflammatory cytokines have been implicated as causative factors in the development of fibrosis. The disease, in essence, is a rare entity with an incidence varying from 1 in 5000 to 1 in 18,000 live births in India. The role of inflammatory cells, such as mast cells, in causing fibrosis in liver biopsies is being researched in recent times to determine their impact on patient prognosis.<\/jats:p>\n <\/jats:sec>\n \n Aims and Objectives:<\/jats:title>\n The aim of the study was to assess the number of mast cells in cases diagnosed as EHBA and correlate that with the degree of fibrosis and other histopathological findings in order to indicate the role of mast cells as fibrogenic inflammatory mediator.<\/jats:p>\n <\/jats:sec>\n \n Material and Methods:<\/jats:title>\n The department of pathology carried out a retrospective observational study on 7 cases of suspected EHBA, in samples received from cases with ages from 8 weeks to 2 years, which were sent to the lab from the department of pediatric surgery. Extrahepatic biliary atresia was confirmed by histopathological examination of the liver biopsy specimen and intraoperative cholangiography taken during Kasai\u2019s portoenterostomy. Multiple stains were done on sections, and the common scoring systems mentioned by Lee.WS and Russo P in their respective papers, were used in reporting the cases for EHBA. Fibrosis was scored as per the modified Scheuer\u2019s system.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n All the cases showed similar findings with a fair number of mast cells, variable degree of fibrosis accompanying inflammation, biliary bile plugs and degeneration in the hepatocytes. A positive trend was noted between an increase in mast cells and the degree of fibrosis in the biopsies, which were reported out as EHBA. Eosinophils were present in all the cases analyzed.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Presence of Mast cells in all cases of EHBA with an increasing number of mast cells with a higher degree of fibrosis can be a potential or probable indicator of prognosis and scoring in EHBAs, however in view of the study being a pilot study with a small sample size, a larger cohort with control arm needs to be studied to confirm the findings of our study.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/aam.aam_411_25","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T11:00:20Z","timestamp":1763636420000},"page":"1602-1607","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Role of Mast Cells in Assessing the Degree of Fibrosis in Histopathological Scoring of Extrahepatic Biliary Atresia"],"prefix":"10.4103","volume":"25","author":[{"given":"Neema","family":"Tiwari","sequence":"first","affiliation":[{"name":"Department of Pathology, Post Graduate Institute of Child Health, Noida, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyotsna","family":"Madan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Post Graduate Institute of Child Health, Noida, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devajit","family":"Nath","sequence":"additional","affiliation":[{"name":"Department of Pathology, Post Graduate Institute of Child Health, Noida, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umesh","family":"Shukla","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Post Graduate Institute of Child Health, Noida, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"R1-20260922","first-page":"1","article-title":"Extrahepatic bile duct atresia from the pathologist's perspective: Pathological features and differential diagnosis","volume":"3","author":"Eyken","year":"2014","journal-title":"J Pediatr Neonatal Individ Med"},{"key":"R2-20260922","doi-asserted-by":"crossref","first-page":"964887","DOI":"10.3389\/fphys.2022.964887","article-title":"Exploring the role of mast cells in the progression of liver disease","volume":"13","author":"Huang","year":"2022","journal-title":"Front Physiol"},{"key":"R3-20260922","doi-asserted-by":"crossref","first-page":"380","DOI":"10.4103\/0377-4929.138722","article-title":"A histopathological study of liver and biliary remnants in the long-term survivors (>10 years) of cases of biliary atresia","volume":"57","author":"Mukhopadhyay","year":"2014","journal-title":"Indian J Pathol Microbiol"},{"key":"R4-20260922","doi-asserted-by":"crossref","first-page":"5326","DOI":"10.3748\/wjg.15.5326","article-title":"Usefulness of a scoring system in the interpretation of histology in neonatal cholestasis","volume":"15","author":"Lee","year":"2009","journal-title":"World J Gastroenterol"},{"key":"R5-20260922","doi-asserted-by":"crossref","first-page":"101","DOI":"10.4103\/0377-4929.59194","article-title":"A histopathological study of liver and biliary remnants with clinical outcome in cases of extrahepatic biliary atresia","volume":"53","author":"Roy","year":"2010","journal-title":"Indian J Pathol Microbiol"},{"key":"R6-20260922","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.epag.2013.05.001","article-title":"Histopathological features and accuracy for diagnosing biliary atresia by prelaparotomy liver biopsy in Egypt","volume":"61","author":"Rashed","year":"2013","journal-title":"Egypt Pediatr Assoc Gazette"},{"key":"R7-20260922","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1097\/PAS.0000000000000755","article-title":"Key histopathologic features of liver biopsies that distinguish biliary atresia from other causes of infantile cholestasis and their correlation with outcome: A multicenter study","volume":"40","author":"Russo","year":"2016","journal-title":"Am J Surg Pathol"},{"key":"R8-20260922","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.jpeds.2003.09.042","article-title":"Hepatic fibrosis and survival in biliary atresia","volume":"144","author":"Weerasooriya","year":"2004","journal-title":"J Pediatr"},{"key":"R9-20260922","first-page":"845","volume":"37","year":"2000","journal-title":"Pediatric Gastroenterology Subspecialty Chapter of Indian Academy of Pediatrics. Indian Pediatr"},{"key":"R10-20260922","doi-asserted-by":"crossref","first-page":"38","DOI":"10.5114\/pjp.2020.95414","article-title":"Role of mast cells in the pathogenesis of liver fibrosis in nonalcoholic fatty liver disease","volume":"71","author":"Lewandowska","year":"2020","journal-title":"Pol J Pathol"},{"key":"R11-20260922","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.1002\/hep.29079","article-title":"Bile duct ligation-induced biliary hyperplasia, hepatic injury, and fibrosis are reduced in mast cell-deficient Kit (W-SH) mice","volume":"65","author":"Hargrove","year":"2017","journal-title":"Hepatology"},{"key":"R12-20260922","doi-asserted-by":"crossref","first-page":"375","DOI":"10.3390\/cells11030375","article-title":"Mast cells in immune-mediated cholangitis and cholangiocarcinoma","volume":"11","author":"Gonz\u00e1lez","year":"2022","journal-title":"Cells"},{"key":"R13-20260922","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s00428-023-03704-5","article-title":"Pathologic approach to neonatal cholestasis with a simple scoring system for biliary atresia","volume":"484","author":"Ali","year":"2024","journal-title":"Virchows Arch"},{"key":"R14-20260922","doi-asserted-by":"crossref","first-page":"147","DOI":"10.4103\/0971-9261.102326","article-title":"Extrahepatic biliary atresia: Correlation of histopathology and liver function tests with surgical outcomes","volume":"17","author":"Gupta","year":"2012","journal-title":"J Indian Assoc Pediatr Surg"}],"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_411_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T08:00:35Z","timestamp":1790064035000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_411_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,20]]},"references-count":14,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/aam.aam_411_25","relation":{},"ISSN":["1596-3519","0975-5764"],"issn-type":[{"value":"1596-3519","type":"print"},{"value":"0975-5764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,20]]},"assertion":[{"value":"2025-08-10","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-15","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}