**Question:** Which one of the following is not a feature of liver histology in Non-cirrhotic portal fibrosis (NCPF)?

A. Portal tracts with increased number of portal tracts and widening of the portal tracts
B. Increased number of lymphocytes and plasma cells in portal tracts
C. Presence of granulomas
D. Increased number of neutrophils in the portal tracts

**Correct Answer: C. Presence of granulomas**

**Core Concept:** Non-cirrhotic portal fibrosis (NCPF) is a liver disease characterized by the accumulation of extracellular matrix proteins in the portal tracts, leading to portal hypertension and portal fibrosis. This condition lacks the advanced stages of liver disease seen in cirrhosis, such as nodular regeneration and cirrhotic changes.

**Why the Correct Answer is Right:** In NCPF, the liver histology demonstrates increased number of portal tracts and widening of the portal tracts, as well as increased lymphocytes and plasma cells in the portal tracts. This reflects the immune response to the fibrosis and increased collagen deposition in the portal tracts.

**Why Each Wrong Option is Incorrect:**

A. Portal tracts with increased number of portal tracts and widening of the portal tracts: This feature is present in NCPF and is correct.

B. Increased number of neutrophils in the portal tracts: Neutrophils are a type of white blood cell typically involved in acute inflammation. In NCPF, the immune response is predominantly characterized by lymphocytes and plasma cells, not neutrophils.

C. Presence of granulomas: Granulomas are collections of macrophages and lymphocytes surrounding a foreign body or microorganism. They are not a feature of NCPF but are more commonly associated with granulomatous hepatitis, tuberculosis, or other granulomatous diseases.

D. Increased number of eosinophils in the portal tracts: Eosinophils are another type of white blood cell involved in allergic reactions and parasitic infections. In NCPF, the immune response is predominantly characterized by lymphocytes and plasma cells, not eosinophils.

**Clinical Pearl:** The correct diagnosis of NCPF requires a combination of clinical, radiological, and histopathological findings. A high index of suspicion is important when evaluating patients with portal hypertension and portal fibrosis. Understanding the correct histopathological features can help differentiate NCPF from other liver diseases, such as primary biliary cholangitis and primary sclerosing cholangitis, which may also present with portal hypertension and portal fibrosis.