Liver Cirrhosis and the Role of Bridging Necrosis

Bridging necrosis is a key pathological process that can eventually lead to liver cirrhosis when it occurs repeatedly over time. This condition is frequently observed in liver biopsy reports and refers to the connection of necrotic areas between different regions of the liver tissue. Specifically, bridging necrosis occurs when dead or damaged tissue extends from one portal area to another, or from a portal region to a central vein. In some cases, necrotic zones around two central veins may also merge, forming what is known as bridging necrosis.

Following bridging necrosis, fibrous tissue begins to form bridges—known as fibrous septa—that gradually alter the liver's internal structure. As this process repeats, multiple fibrous bands develop and begin to fragment the normal liver lobules. These fibrous partitions encase liver cells, changing their organization from a regular lobular pattern into irregular clusters or nodules.

Once these nodules are fully surrounded by fibrous tissue, they become what is known as pseudo-lobules. Pseudo-lobules are a hallmark of liver cirrhosis and signify a significant disruption in liver architecture and function. This transformation highlights how chronic liver damage, especially through repeated episodes of bridging necrosis, lays the foundation for cirrhosis to develop. Understanding this progression is crucial for early diagnosis and effective management of liver disease.