Pathology cases — Central venule to central venule fibrosis in Hepatitis C

I’ve seen a lot of hepatic fibrosis over the past few decades.  Mostly it’s been portal-to-portal fibrosis, and occasionally portal-to-venule.  But I very rarely see venule-to-venule fibrosis.  This is a case of a young-middle-age male with a long history of intravenous drug use and hepatitis C who died of a methamphetamine and fentanyl overdose (one of the two or three I see every day I do autopsies).  In this case there were multiple examples of venule-to-venule fibrosis:

 

 

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