Primary Sclerosing Cholangitis ⭐
Also written as PSC.
Ulcerative colitis raises the risk of colorectal cancer and primary sclerosing cholangitis.
Primary Sclerosing Cholangitis (PSC) ⭐
- Inflammation + obliterative fibrosis + segmental dilation of both intrahepatic + extrahepatic bile ducts ⭐ - Irregular strictures + dilations → characteristic "beading" picture on barium contrast radiography ⭐
- Demographics: - 3rd-5th decades - M:F = 2:1 ⭐
- KEY ASSOCIATION: - 70% of patients have associated Ulcerative Colitis ⭐ - About 4% of UC patients have PSC
- Clinical: - Progressive fatigue, pruritis + jaundice - Signs + symptoms of chronic liver disease
- Lab: - ↑ Alkaline phosphatase ⭐
Read this in Liver Histology & Physiology
Primary Sclerosing Cholangitis (PSC) ⭐
- Inflammation + obliterative fibrosis + segmental dilation of both intrahepatic + extrahepatic bile ducts ⭐ - Irregular strictures + dilations → characteristic "beading" picture on barium contrast radiography ⭐
- Demographics: - 3rd-5th decades - M:F = 2:1 ⭐
- KEY ASSOCIATION: - 70% of patients have associated Ulcerative Colitis ⭐ - About 4% of UC patients have PSC
- Clinical: - Progressive fatigue, pruritis + jaundice - Signs + symptoms of chronic liver disease
- Lab: - ↑ Alkaline phosphatase ⭐
Read this in Liver Histology & Physiology
What our notes say
- Ulcerative colitis raises the risk of colorectal cancer and primary sclerosing cholangitis. (Endocrinology and Gastroenterology Question Bank: 12 Clinical MCQs)
- Aetiology: chronic alcohol use, chronic viral hepatitis (B, C), non-alcoholic fatty liver disease, autoimmune hepatitis, biliary disease (primary biliary cholangitis, primary sclerosing cholangitis), haemochromatosis, Wilson disease, alpha-1-antitrypsin deficiency. (Eoy paper 2 gen systemic Patho 2025 — Past Paper Questions & Answers)
- Primary Sclerosing Cholangitis (PSC) — bile duct scarring; associated with IBD (CRUSH COURSE (PART 2) Clinical Chem Patho)
- Autoimmune hepatitis, primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC) (Gastrointestinal System: Symptoms, Diseases, & VINDICATE Guide)
- Examples: Extrahepatic: gallstones, pancreatic cancer, cholangiocarcinoma; Intrahepatic: primary biliary cholangitis, primary sclerosing cholangitis, drug-induced cholestasis (Chemical Pathology Sem 1)
- Extraintestinal manifestations: arthritis, uveitis, erythema nodosum, primary sclerosing cholangitis (less common than UC) (GASTROINTESTINAL PATHOLOGY (Part 2))
Study material on Primary Sclerosing Cholangitis ⭐
- Liver Histology & Physiology
- Liver Histology & Physiology
- GASTROINTESTINAL PATHOLOGY (Part 2)
- CRUSH COURSE (PART 2) Clinical Chem Patho
- Gastrointestinal System: Symptoms, Diseases, & VINDICATE Guide
- Weekly Pathology Exam - March 7, 2026 (Section A: MCQs)
- MCQ: Ompath Study Home Blog Flashcards MCQs Dashboard Toggle the
Practice questions on Primary Sclerosing Cholangitis ⭐
A 70-year-old man with Primary Sclerosing Cholangitis (PSC) develops jaundice and an intrahepatic mass with normal AFP. Which primary liver malignancy is most consistent?
- Hepatocellular Carcinoma
- Cholangiocarcinoma
- Angiosarcoma
- Hepatoblastoma
Answer: B. Cholangiocarcinoma arises from the bile duct epithelium. Risk factors include PSC, liver flukes, and Caroli disease. AFP is usually normal, but CA 19-9 may be elevated. ---
A 70-year-old man with a history of Primary Sclerosing Cholangitis (PSC) develops jaundice and an intrahepatic mass. His serum alpha-fetoprotein (AFP) level is within the normal range. Which primary liver malignancy is most consistent with this presentation?
- Hepatocellular Carcinoma
- Fibrolamellar HCC
- Angiosarcoma
- Cholangiocarcinoma
Answer: D. Cholangiocarcinoma is a bile duct origin tumor associated with PSC and is characterized by a normal AFP level, differentiating it from typical HCC. ---