Frequent Histology Changes of Little Significance
In the Liver at Autopsy
Autolysis of hepatocytes is often pronouced
Loss of inflammatory cells by autolysis may preclude diagnosis of hepatitis
Dilatation of sinusoidal and perisinusoidal spaces is of little significance
Focal accumulation of lymphocytes in scattered portal tracts is frequently seen
Large portal tract with abundant CNT
In Surgical Liver Biopsy Specimens
Fibrous connection between the superficial portal tract and the capsule
resembling cirrhosis
Fibrous Connections
Clusters of PMN from long surgical procedure resembling microabscesses
Prolonged Surgical Procedure
CMV Microabscess
Minor, but Significant, Hepatic Alterations
Nonspecific Reactive Hepatitis
Activation of sinusoidal lining cells with prominent Kupffer cells
Small foci of necrosis of isolated hepatocytes
Accumulation of macrophages and inflammatory cells
Chronic Persistent Hepatitis
Nonspecific Reactive Hepatitis in HIV Patient
Nonspecific hepatitis
Steatosis
Increased hepatocyte nuclei
Sinusoidal dilatation
Poorly developed granulomata
MAI Granuloma in HIV Patient
Vicinity of Space-Occupying Lesion
Triad
- Proliferated and distorted bile ductules with irregular and even
atypical epithelium
- Infiltration of scattered PMN in edematous portal tracts
- Focal sinusoidal dilatation and congestion
Sinusoidal Dilatation
Rappaport’s zone 3
- Venous congestion : Right-sided HF
- Irregular necrosis : Left-sided HF or shock
Rappaport’s zone 1
- Sinusoid dilatation : Pregnancy, renal transplant, anabolic/androgenic
or contraceptive steroids and near space-occupying lesions
Liver Histology for Pathologists
Summarized By Thirayost Nimmanon
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