Clinical, light and electron microscopic studies of 6 cases of acute and 8 cases of chronic active hepatitis were made and results were compared. Light microscopically acute viral hepatitis was dominated by intralobular changes characterized by ballooning degeneration, random individual and small group cell necrosis of hepatocytes with mononuclear cell reaction, cholestasis and Kupffer cell proliferation, while chronic. active hepatitis was dominated by periportal and portal changes characterized by piecemeal necrosis, heavy mononuclear cell infiltration, moderate fibrosis and mild biliary proliferation. Kupffer cell proliferation with large amount of diastase-resistant PAS positive pigments and patchy reticulin condensation were noted in both acute and chronic active hepatitis, but reticulin condensation was more advanced in chronic active hepatitis. Electron microscopically, acute hepatitis showed marked changes of nucleus, RER, bile canaliculus, and decrease of glycogen content, while chronic active hepatitis showed marked changes of mitochondria with giant fomrs and intramitochondrial inclusion, increase of polyribosomes and glycogen content, and appearance of collagen bundles in the sinusoidal wall. Kupffer cell changes were very marked in both acute and chronic active hepatitis showing large numbers of dense bodies. These dense bodies in acute cases were in the form of secondary lysosomes while they were residual bodies in chronic cases. A case which showed ground glass appearing cytoplasm by light microscopy showed massive fibrillar and tubular structures by electron microscopy. In all cases, no definite virus-like particles were observed within either the nucleus or cytoplasm. From the data, it was evident that distinction between acute and chronic active hepatitis is more clearly made with light microscopy, and the ultrastructural changes of intralobular lesions showed more similarities than differences. The meaning of minor ultrastructural differences is not clear and further evaluation is desirable. Clinically, acute cases showed higher serum bilirubin, transaminase level and hypoalbuminemia while in chronic active hepatitis serum globulin level was higher and hepatomegaly was more regularly observed.
Hepatitis, Viral, Human/pathology* ; Human ; Liver/ultrastructure*

OBJECTIVETo investigate the clinicopathological features of infantile cytomegalovirus hepatitis.

METHODLiver biopsies from 30 cases of infantile cytomegalovirus hepatitis were observed under optical microscope and electronic microscope.

RESULTThe main clinical manifestations were jaundice, splenohepatomegaly and hypohepatia. Laboratory test showed dysfunction of liver, high level of CMV DNA, and high titer of anti-CMV antibody. Imaging examination demonstrated hepatomegaly. The histological changes were hepatocellular degeneration, necrosis, apoptosis, and fibrosis. The histological characteristics of cytomegalovirus hepatitis, including intranuclear inclusions in multinucleated giant cells and pseudo-lumens, were also observed under optical microscope. In addition, virion was observed in the nuclei and cytoplasm of hepatocytes under electronic microscope.

CONCLUSIONThe viral DNA and serological tests have limited utility for the diagnosis of infantile cytomegalovirus hepatitis, and the final diagnosis depends on histopathology.

Biopsy, Needle ; Cytomegalovirus Infections ; pathology ; Female ; Hepatitis, Viral, Human ; pathology ; Hepatocytes ; pathology ; ultrastructure ; Humans ; Inclusion Bodies, Viral ; pathology ; Infant ; Infant, Newborn ; Liver ; pathology ; Male ; Mitochondria, Liver ; pathology ; ultrastructure

BACKGROUND/AIMS: This study was designed to clarify the fine structures of the hepatocytes and mesencymal tissues in chronic hepatitis according to severity. METHOD: For the purpose of elucidating the ultrastructural characteristics of mesenchymal tissues, liver biopsy specimens were studied by light and electron microscopy in 20 patients with chronic hepatitis. RESULTS: 1) Hepatocytes in mesenchymal tissues were thought to be in the stage of regenerated or degenerated process. 2) Regenerating nodules were surrounded by a basement membrane-like materials in the space of Disse. 3) In the widened Disse space the deposition of collagen fiber bundles and increased numbers of hepatic stellate cells in necrotic area were observed. 4) In necrotic areas, hepatic mesenchymal cell response including an increase of collagen fibers and fibroblast, angiogenesis, and a proliferation of bile ductules were also observed. CONCLUSIONS: These observations suggest that the fibrosis in severe chronic hepatitis was accompanied by the mesenchymal response including the proliferation of hepatic stellate cells, fibroblasts, capillarization of Disse space, and mesenchymal proliferation. Finally, this fibrosis observed electron microscopically may be a cause of functional hepatic failure.
Adult ; English Abstract ; Female ; Hepatitis, Chronic/*pathology/virology ; Hepatitis, Viral, Human/*pathology ; Hepatocytes/ultrastructure ; Human ; Liver/*ultrasonography ; Male ; Mesoderm/ultrastructure ; Microscopy, Electron ; Middle Aged

Recurrence of viral hepatitis after liver transplantation (LT) can progress to graft failure and lead to a decrease in long-term survival. Recently, there have been remarkable improvement in the treatment of chronic hepatitis B (CHB) using potent antiviral agents. Combination of hepatitis B immunoglobulin and potent antiviral therapy has brought marked advances in the management of CHB for liver transplant recipients. Post-transplant antiviral therapy for hepatitis C virus infection is generally reserved for patients showing progressive disease. Acheiving a sustained virological response in patients with LT greatly ameliorates graft and overall survival, however this only occurs in 30% of transplant recipient using pegylated interferon and ribavirin (RBV). Direct acting antivirals such as protease inhibitors, polymerase or other non-structural proteins inhibitors are anticipated to establish the new standard of care for transplant recipients. In liver transplant recipients, hepatitis E virus infection is an uncommon disease. However, it can lead to chronic hepatitis and cirrhosis and may require retransplantation. Recently, 3-month course of RBV monotherapy has been reported as an effective treatment. This review focuses on the recent management and therapeutic approaches of viral hepatitis in liver transplant recipient.
Antiviral Agents/therapeutic use ; Hepatitis B/drug therapy/pathology/surgery ; Hepatitis C/drug therapy/pathology/surgery ; Hepatitis E/drug therapy/pathology/surgery ; Hepatitis, Viral, Human/drug therapy/pathology/*surgery ; Humans ; *Liver Transplantation ; Recurrence

OBJECTIVETo investigate clinicopathological features of DiGeorge syndrome (DGS).

METHODThe clinical features, histological and immunohistochemical findings were analyzed in 5 cases of DGS by autopsy.

RESULTSFive cases of DGS in male infants aged 4 days, 1 month, 7 months, 10 months, and 13 months respectively. Gross and microscopic observations revealed that thymic cortex was depleted of lymphocytes or showed few, dispersed lymphocytes. The thymic medulla showed predominantly epithelial cells with calcified Hassall bodies as well as lymphocyte depletion. T lymphocytes were also scarce in the tonsils, lymph nodes, spleen, and mucosa-associated lymphatic tissue of ileum. In addition, 3 of the 5 patients also showed parathyroid aplasia or dysplasia, and congenital hypertrophy of the ventricular septum.

CONCLUSIONSThe pathological changes indicate that clinicians should be aware of defects of immune system if the infants suffer from severe infections. Pathologists should recognize the importance of abnormalities of lymphohematopoietic tissues in the diagnosis of primary immunodeficiency diseases such as DGS.

Autopsy ; DiGeorge Syndrome ; immunology ; pathology ; virology ; Hepatitis, Viral, Human ; pathology ; Humans ; Hypertrophy, Left Ventricular ; pathology ; Infant ; Infant, Newborn ; Lymphocyte Count ; Male ; Parathyroid Glands ; pathology ; Pneumonia, Viral ; pathology ; T-Lymphocytes ; immunology ; pathology ; Thymus Gland ; pathology

Hepatitis, Viral, Human ; pathology ; Humans ; Liver ; pathology ; Liver Cirrhosis ; pathology ; Liver Neoplasms ; genetics ; pathology ; Loss of Heterozygosity ; Microsatellite Instability ; Polymorphism, Single Nucleotide

Adolescent ; Adult ; Aged ; Alanine Transaminase ; blood ; Aspartate Aminotransferases ; blood ; DNA, Viral ; blood ; genetics ; Female ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; blood ; complications ; pathology ; Hepatitis, Viral, Human ; complications ; virology ; Humans ; Male ; Middle Aged ; Severity of Illness Index

To evaluate the distribution pattern of renal diseases based on needle biopsy, we analyzed 2361 cases of renal biopsy and necropsy material examined at the Department of Pathology from 1973 to 1988. The average age was 21.1 years for males and 23.7 years for females. The adult cases comprised 60.2% and the child cases 39.8%. The male to female ratio was 1.6: 1 in adults and 2.3:1 in children. Glomerular diseases were 97.8% of the total; primary glomerulonephritis (GN) 59.8% and secondary GN 27.6% The major glomerular diseases, in descending order of frequency, were; minimal change nephrotic syndrome (MCNS; 24.2%), IgA nephropathy (IgAN; 17.8%), benign recurrent hematuria (BRH; 8.8%), membranous GN (MGN; 7.9%), acute poststreptococcal GN (APSGN; 7.3%), mesangioproliferative GN (MspGN; 5.5%), minimal mesangiopathy (5.5%), membranoproliferative GN(4.1%), and focal segmental glomerulosclerosis (FSGS; 2.7%). GN of systemic disease included 77 cases of lupus nephritis, 157 cases of Henoch-Schonlein purpura nephritis (HSPN) and 7 cases of systemic infection excluding Hepatitis B viral hepatitis. The most common glomerular diseases were MCNS, IgAN, MGN and MspGN in adults, and MCNS, BRH, HSP-N and APSGN in children. HBs antigenemia was found in 71 cases, of which MGN and IgAN were the most frequent. HBs antigenemia-associated MGN was prevalent in male children, whereas IgAN was prevalent in adults.
Adult ; Antigens, Viral/analysis ; Biopsy ; Child ; Female ; Glomerulonephritis/pathology ; Hepatitis B Virus/immunology ; Human ; Kidney/*pathology ; Kidney Diseases/pathology ; Male ; Retrospective Studies

OBJECTIVETo explore the pathological and clinical characteristics of children with liver diseases by retrospective study on clinical and liver biopsy pathological data of children with liver diseases.

METHODThis retrospective analysis was performed at Beijing No. 302 Hospital among 3 932 children with liver diseases who visited the hospital from January 2001 to December 2012. The kinds of diseases were compared with the results of 1983-2000.

RESULT(1) Liver biopsy was successful in 99.72% (3 932/3 943) of cases of 2001-2012 group, complications occurred in 31 children only. (2) Of the 3 932 cases, 2 647 (67.32%) had hepatitis , non-hepatotropic viral hepatitis and non viral liver disease were seen in 365 cases (9.28%), and 920 cases (23.4%), respectively. Among 2 647 cases with viral hepatitis, 2 115 were hepatitis B (79.90%), 521 hepatitis C (19.69%), 7 were hepatitis A (0.26%) and 4 hepatitis E (0.15%), respectively. (3) In 2001-2012 group, the degrees of inflammatory activity (>G2) of liver were seen in 9.57% (202/2 111) patients with hepatitis B, while 23.57% (132/560) in 1983-2000 group. There was significant difference between the two groups (χ(2)=80.36, P=0.00 ). (4) Significant difference was observed in the rate of non viral liver disease between 2001-2012 group (23.40%, 920/3 932) and 1983-2000 group (9.61%, 98/1 020) (χ(2)=93.46, P=0.00). In 2001-2012 group, including 46 kinds of diseases, which were significantly higher than those of 1983-2000 group (18 kinds). In 2000-2012, the main causes of diseases were liver degeneration (18.26%, 168/920), drug-induced liver injury (13.59%, 125/920), fatty liver (8.80%, 81/920) and liver glycogen accumulation disease (8.70%, 80/920). While in 1983-2000 group, the main causes were liver degeneration (20.41%, 20/98), fatty liver (16.33%, 16/98), glycogen storage disease (10.20%, 10/98) and myopathy (9.18%, 9/98).

CONCLUSIONLiver biopsy in children is safe and feasible. Hepatitis B virus was ranked first in children with liver diseases in 2001-2012 group. The kinds of non viral hepatic disorders had changed and extended.

Adolescent ; Biopsy, Needle ; Child ; Child, Preschool ; Female ; Hepatitis B ; pathology ; Hepatitis, Viral, Human ; pathology ; Hepatolenticular Degeneration ; epidemiology ; pathology ; Humans ; Infant ; Liver ; pathology ; Liver Diseases ; pathology ; Liver Function Tests ; Male ; Retrospective Studies

OBJECTIVETo explore the relation between the pathogenesis and IL-8 level in the chronic hepatic disease and primary hepatocellular carcinoma.

METHODS5ml venous blood was with drawn from 80 hospitaliged patients with different types of hepatic diseases and 14 healthy people. The serum was separated from the blood and then kept at -40 degrees Centigrade, and finally detected for IL-8 by ELISA.

RESULTSThere was an obvious difference among the IL-8 level in the serum from different types of hepatic disease patients. The IL-8 level was 75.80 microg/L 33.39 microg/L in chronic virus hepatitis and it was 89.54 microg/L 13.24 microg/L for primary hepatoma patients (t=10.48 and 4.01, respectively, P<0.01, as compared with control group).

CONCLUSIONSThere is a close relation between the level of IL-8 in serum and the state of illness. For patients with chronic hepatic diseases and primary hepatocellular carcinoma, the higher the IL-8 level is, the more serious the patients' condition, the worse the prognosis, and the higher the death rate would be.

Adult ; Carcinoma, Hepatocellular ; blood ; pathology ; Chronic Disease ; Enzyme-Linked Immunosorbent Assay ; Female ; Hepatitis ; blood ; pathology ; Hepatitis, Viral, Human ; blood ; pathology ; Humans ; Interleukin-8 ; blood ; Liver Diseases ; blood ; pathology ; Liver Neoplasms ; blood ; pathology ; Male ; Middle Aged