On iron staining, which pattern is characteristic of primary hemochromatosis?

On iron staining, which pattern is characteristic of primary hemochromatosis?

• A. Iron overload in hepatocytes
• B. Iron overload in macrophages
• C. No iron staining
• D. Iron in bile ducts

Answer: (A)

The hallmark pattern in primary hemochromatosis is iron deposition mainly in hepatocytes, i.e., parenchymal cells of the liver. On Prussian blue iron staining, you’ll see iron as blue in the cytoplasm of hepatocytes, reflecting increased intestinal iron absorption and storage in the liver’s parenchymal cells. This parenchymal (hepatocyte) iron overload distinguishes hereditary hemochromatosis from secondary iron overload, where iron more prominently accumulates in macrophages due to transfusion-related iron. Iron in bile ducts or absence of iron staining would not fit the typical pattern of primary hemochromatosis.

The hallmark pattern in primary hemochromatosis is iron deposition mainly in hepatocytes, i.e., parenchymal cells of the liver. On Prussian blue iron staining, you’ll see iron as blue in the cytoplasm of hepatocytes, reflecting increased intestinal iron absorption and storage in the liver’s parenchymal cells. This parenchymal (hepatocyte) iron overload distinguishes hereditary hemochromatosis from secondary iron overload, where iron more prominently accumulates in macrophages due to transfusion-related iron. Iron in bile ducts or absence of iron staining would not fit the typical pattern of primary hemochromatosis.