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10913 Pathology

A 63-year-old man with a 30-year history of alcohol abuse notes hematemesis for the past day. On examination, he has ascites, mild jaundice, and an enlarged spleen. He also has gynecomastia, spider telangiectasias of the skin, and testicular atrophy. Rectal examination indicates prominent hemorrhoids and a normal-sized prostate. An emergent upper endoscopy shows dilated, bleeding submucosal vessels in the esophagus. Laboratory studies show total protein, 5.9 g/ dL; albumin, 3.2 g/dL; AST, 137 U/L; ALT, 108 U/L; total bilirubin, 5.4 mg/d; prothrombin time, 20 seconds; ammonia, 76 mmol/L; and hematocrit, 21%. Which of the following pathologic findings in his liver is most likely to explain the hematemesis?

ACholangitis
BCholestasis
CCirrhosis
DHepatitis
Pathology
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