Abnormal bile duct epithelium accompanying septicaemia

A 56-year-old female without previous hepatobiliary disease developed a severe obstructive cholestasis followingE. coli urinary tract infection with septicaemia. Liver biopsy showed cholangiolitis and a unique abnormality of almost all the interlobular bile ducts; the epithelium was irregular with polymorphic, angular, and hyperchromatic or pyknotic nuclei. Some ducts were ectatic, others narrowed due to protrusion of proliferating epithelium. In some areas the ducts were blurred or completely destroyed. Cholangitis or granulomas were, however, not present.