“Onion-skin” fibrosis of bile duct is seen in
**Core Concept**
Onion-skin fibrosis of the bile duct refers to the concentric, layered deposition of collagen and other extracellular matrix proteins around the bile duct epithelium. This histopathological feature is characteristic of a specific condition that affects the bile ducts.
**Why the Correct Answer is Right**
Onion-skin fibrosis is a hallmark of primary sclerosing cholangitis (PSC), a chronic liver disease characterized by inflammation and fibrosis of the bile ducts. The condition leads to progressive destruction of the bile ducts, resulting in cholestasis and eventually cirrhosis. The fibrotic changes in PSC are thought to be mediated by immune cells and the release of various cytokines and growth factors that stimulate the deposition of extracellular matrix proteins.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because onion-skin fibrosis is not typically associated with primary biliary cholangitis (PBC), a separate chronic liver disease characterized by autoimmune destruction of the bile duct epithelium.
**Option B:** This option is incorrect because amyloidosis, a condition characterized by the deposition of amyloid proteins in various tissues, does not typically present with onion-skin fibrosis of the bile ducts.
**Option C:** This option is incorrect because chronic rejection of a liver transplant can lead to various forms of fibrosis, but onion-skin fibrosis is not a characteristic feature of this condition.
**Clinical Pearl / High-Yield Fact**
Onion-skin fibrosis is a distinctive histopathological feature that can be identified on histological examination of liver biopsy specimens. It is essential to recognize this feature in conjunction with other clinical and laboratory findings to establish a diagnosis of primary sclerosing cholangitis.
**Correct Answer:** C. Primary sclerosing cholangitis (PSC).