Pathology of neonatal liver biopsy

Neonatal liver biopsy is most frequently performed in the setting of conjugated hyperbilirubinaemia. In order to provide a differential diagnosis, the biopsy can be assigned to one of four histological patterns: biliary, neonatal/giant cell hepatitis, paucity of intrahepatic bile ducts and bland cholestasis. Within each category, clues can be sought to narrow the differential diagnosis still further. Potential aetiologies, emphasizing the most common and including the iatrogenic changes of total parenteral nutrition, are discussed, with a brief consideration of concepts in aetiopathogenesis.