Related Experiment Videos
Histologic features in autoimmune hepatitis
H P Dienes1, H Popper, M MAnns
1Institut für Pathologie, Universität Mainz, FRG.
Insights
The term "plasma cell hepatitis" is not a valid morphological diagnosis for autoimmune chronic hepatitis (AICH). Histopathology does not distinguish subgroups in AICH, which presents a spectrum of chronic liver inflammation.
Area of Science:
- Hepatology
- Immunology
- Pathology
Background:
- Autoimmune chronic hepatitis (AICH) diagnosis has historically considered "plasma cell hepatitis."
- Understanding the histopathological features of AICH is crucial for diagnosis and prognosis.
- The existence of potential subgroups within AICH requires investigation through histopathology.
Purpose of the Study:
- To evaluate the validity of "plasma cell hepatitis" as a morphological diagnosis for AICH.
- To determine if distinct subgroups of AICH are reflected in histopathological findings.
- To analyze the histopathological spectrum of AICH and compare it with viral hepatitis.
Main Methods:
- Investigated 26 patients meeting AICH criteria based on serological markers (antinuclear, SMA, LKM, LMA, SLA).
- Analyzed histopathological features of liver biopsies.
- Compared findings with viral hepatitis A and non-A, non-B.
Main Results:
- Plasma cells were not a characteristic feature of AICH.
- Characteristic histopathological findings included hypocellular collapse areas and microacinar hepatocyte transformation with hydropic swelling.
- Eosinophilic clumping and acidophilic necrosis were minimal; histopathology did not differentiate subgroups.
Conclusions:
- The term "plasma cell hepatitis" is not a valid morphological diagnosis for AICH.
- AICH exhibits a histopathological spectrum from persistent to severe active hepatitis, sometimes progressing to cirrhosis.
- Histopathology does not distinguish subgroups within AICH, which can have a variable clinical course.
Abstract:
In order to see if the term of "plasma cell hepatitis", dating back to the early sixties, is still valid as a morphological diagnosis for autoimmune chronic hepatitis (AICH), and to find out if the existence of several subgroups is reflected by histopathology, we investigated 26 patients with chronic hepatitis, who met the criteria of autoimmune hepatitis based on tests for antinuclear, anti-smooth muscle antibodies (SMA) and on immunoassays for liver-kidney-microsomal (LKM) antigen, liver membrane antigen (LMA), and soluble liver antigen (SLA). In our material autoimmune hepatitis represent the entire spectrum of chronic hepatitis with variable inflammatory activity ranging from chronic persistent hepatitis to severe inflammatory lesions in chronic active hepatitis with transition to cirrhosis. When compared to viral chronic hepatitis A and non-A, non-B, however, characteristic features can be evaluated consisting in broad hypocellular areas of collapse and microacinar transformation of hepatocytes with hydropic swelling being the predominant type of cell lesion. Eosinophilic clumping and acidophilic necrosis were insignificant. Plasma cells were not a constituent feature of AICH. From this histopathologic pattern it may be concluded that the disease seems to run a sluggish course in most patients, however, in few cases a dramatic development may determine the disease with fatal acute episodes which are terminated by death or fade into slow progression. The different subgroups could not be distinguished by histopathology.(ABSTRACT TRUNCATED AT 250 WORDS)