The liver biopsy in acute hepatitis due to hepatitis B virus is likely to show all of the following, except ?
Ans. is 'b' i.e., Ground glass hepatocytesGround glass hepatocytes are large hepatocytes containing surface antigen. Their cytoplasm is ground glass in appearanceo These cells are seen in chronic hepatitis (not acute hepatitis)o Ground glass hepatocytes can be identified histochemically with orcein or aldehyde fuschin stain.Pathological features of acute viral hepatitis 1. Panlobular infiltration of mononuclear cellsThis mononuclear infiltration primarily consists of --> Lymphocytes, Plasma cells, EosinophilsInflammatory infiltrate may spill over into the adjacent parenchyma to cause necrosis of peripoal hepatocytes -3 interface hepatitis, can occur in both acute and chronic hepatitis.2. Hepatic cell damage - It consits of(a) Hepatic cell necrosis - The necrosis is usually focal or centirzonal.Sometimes severe necrosis such as bridging or subacute hepatic necorsis occurs.(b) Ballooning of cells -- Damaged cells show diffuse swelling known as ballooning degeneration.(c) Acidophilic degeneration of hepatocytes - In this single necrotic liver cell has coagulated pink cytoplasm and it shows pyknosis or karyolysis. These are called councilman bodies.(d) Cell dropout3. Hyperplasia of kupffer cells4. Variable degree of cholestasis with brown pigmentation of hepatocytes.5. Hepatic cell regeneration - It is indicated by increased mitotic figures, rosette or pseudoacinar formation and multi nucleated cells.6. Lobular disarray --> Loss of normal lobular architecture.o Note that these morphological lesions are similar in all types of viral hepatitis.o A few histological changes may be indicative of paicular type of virus.1.In hepatitis C the histological lesion is characterized by -a Relative paucity of inflammation Marked increase in activation of sinusoidal lining cells. Presence of lymphoid aggregates Presence offal Macrovesicular steatosis Bile duct lesions.2.In Hepatitis D -* Microvesicular steatosis occurs.3.In Hepatitis E --)Marked cholestasis occurs.
Ballooning change of hepatocytes
Ground glass hepatocytes
Focal or spotty necrosis
Acidophil bodies