Hepatic stem cells and cancers: a pathologist's view

Abstract

There are relatively few specialists in liver pathology in the world compared with other fields of medicine in general, and pathology in particular, and we each prize our descent from the Founder, himself, Hans Popper. I can do so through three pupils/peers of his, each a master of liver pathology in their own right: P Scheuer (Royal Free Hospital), J Lefkowitch (Columbia College of Physicians and Surgeons) and S Thung (Icahn School of Medicine at Mount Sinai). Classically, as these mentors of mine have done, academic pathologists distribute their efforts equally among three sets of activities: clinical practice , teaching and scientific research; in the 21st century, this means 60% clinical, 60% teaching and 60% research! I would consider my own successes in each of these three realms to be equally important (and always in collaboration with clinical colleagues and other hepatopathology peers). I have helped to identify and define diagnostic criteria for human premalignant liver lesions (in particular, dysplastic nodules), new diagnostic criteria for primary biliary cirrhosis, and have helped to confirm the important role of ductular reactions in assessing human liver diseases. My interdisciplinary collaborations with radiologists and transplant surgeons to promote criteria and approaches to diagnostic screening for premalignancy and early 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.