Faculty Bibliography

Clinicopathological concepts on acute and chronic liver disease have evolved rapidly during the last few years, with advances in general and specific treatment options and improved patient outcomes. The old paradigm of 'irreversibility' of cirrhosis had been challenged in major ways, and the validity of the usage of the term 'cirrhosis' has come into question. This paper addresses aetiology-based clinicopathological concepts and features that may deserve attention because they may determine disease outcome and, specifically, patterns of regression and remodelling. A variety of therapeutic interventions may influence remaining disease features after elimination of damaging agents (virus, alcohol, etc.), and determine the final clinical outcome including the risk of hepatocellular carcinoma (HCC). New concepts create new responsibilities and opportunities for the pathologist to contribute to the understanding of liver pathology and communicate this with clinical colleagues and researchers.

Recent WHO classification for combined hepatocellular-cholangiocarcinoma and recognized stem cell subtypes has increased attention to such tumors; however, the resulting burst of reporting and research indicates that this classification, while provocative, is incomplete for description of the full array of primary liver carcinomas with biphenotypic (hepatobiliary) differentiation. We review the history of such lesions and consider the wider array of such tumors previously described. Mixed hepatobiliary phenotypes and immunophenotypes are found in individual tumors at the tissue level - with architectural and cytologic features supportive of both differentiation states - and at the cellular level, with individual cells that display cytology of one cell type, but immunophenotypically showing mixed expression. Pathobiologic and clinical questions to be answered by future research are suggested.

Neil Theise speaks to Georgia Patey, Commissioning Editor: Neil Theise is a diagnostic liver pathologist, adult stem cell researcher and complexity theorist in New York City, where he is a Professor of Pathology at the Mount Sinai Beth Israel Medical Center of Icahn School of Medicine at Mount Sinai. He received his medical degree from Columbia University College of Physicians and Surgeons, where he also received his training in Anatomic Pathology. Subspecialty training was pursued in gastrointestinal (NYU), liver (Royal Free Hospital) and liver transplant (Mount Sinai, NYC) pathology. His earliest research focus was on defining the premalignant dysplastic nodules in human chronic liver disease. He revised understandings of human liver microanatomy, which in turn, led directly to identification of possible liver stem cell niches and the marrow-to-liver regeneration pathway. He is considered a pioneer of multiorgan adult stem cell plasticity. His publications on these topics in model systems and human liver stem cells have been highlighted on a record five covers of Hepatology.

This article briefly reviews the biofield hypothesis and its scientific literature. Evidence for the existence of the biofield now exists, and current theoretical foundations are now being developed. A review of the biofield and related topics from the perspective of physical science is needed to identify a common body of knowledge and evaluate possible underlying principles of origin of the biofield. The properties of such a field could be based on electromagnetic fields, coherent states, biophotons, quantum and quantum-like processes, and ultimately the quantum vacuum. Given this evidence, we intend to inquire and discuss how the existence of the biofield challenges reductionist approaches and presents its own challenges regarding the origin and source of the biofield, the specific evidence for its existence, its relation to biology, and last but not least, how it may inform an integrated understanding of consciousness and the living universe.