The modular microarchitecture of human liver.

The morphological homogeneity of the liver parenchyma has represented a major obstacle in finding an acceptable definition of the structural/functional units of the liver. Concepts such as the "lobule," the "portal unit" and the "acinus" remain debatable. This study investigates the modular microarchitecture on the basis of the lobular concept. Using alkaline phosphatase activity as a histochemical marker, modules could be recognized clearly. In autopsy specimens of human liver, modules were traced through sequential cryosections, and a "secondary" module having a height of 1.9 mm, a surface of 14.7 mm(2), and a volume of 5.1 mm(3) was reconstructed three-dimensionally. It was subdivided into 14 "primary" modules by portal tracts and vascular septa and by a common draining central venular tree. Primary modules were polyhedral, with seven to nine facets, having heights from 0.3 to 0.9 mm, surface areas from 1.7 to 5.0 mm(2), and volumes from 0.1 to 0.9 mm(3). Such variation in shape and size is considered an important part of the modular organization of the human liver. In conclusion, the findings on the three-dimensionality and microcirculation of liver modules support and extend the lobular concept and, at the same time, make apparent the shortcomings of the concepts of acinar and portal units. The results of this study should permit a better interpretation of histological sections of normal and pathological liver and provide a basis for understanding the metabolic heterogeneity of liver cells and their functional integration into parenchymal units.