[Accessory parameters in the histopthology of hepatitis C. Comparative analysis]

Fifty three consecutive cases of chronic hepatitis C ("b" series) were considered and strictly (numerically and qualitatively) compared with the series ("a") reported by Scheuer et al. Two groups (gr.) respectively inclusive of chronic persistent hepatitis, chronic lobular hepatitis and mild/moderate chronic active hepatitis (gr. I) and severe chronic active hepatitis, developing cirrhosis and established cirrhosis (gr. II) were identified, studied and scored according to the following accessory histological parameters: "lymphoid aggregates and follicles" (LA&F), "bile duct damage" (BDD), "acidophil bodies" (AB), "lymphocytic infiltration of sinusoids" (LIS) and "fatty changes" (FC). In order to interpret the results the "b" series was further examined in relation to lobular "spotty necrosis" (SN) and subtle morphology of FC (type of vacuolarity and topography). Moreover dysplasia (in "a" and "b") and other minor accessory parameters (in "b" only) were briefly considered. In conclusion the comparison of "b" versus "a" confirms a characteristic histomorphological pattern in chronic hepatitis C. As far as the major accessory parameters are concerned the reproducibility was acceptable for BDD and FC, but inadequate for LA&F, LIS and AB. In particular the following points seem to be the most critical challenges: reassessment of the morphological criteria for LA&F, LIS and AB; improvement of the analysis of FC; elucidation of the relation between LIS, AB, SN and LA&F; ascertainment of sensibility and specificity of the accessory parameters in relation to "grading", "staging", differential diagnosis, post-therapy evaluation and non histological findings.