Path-Viral Hepatitis Flashcards
in general when we refer to hepatitis, we are talking about hepatitis caused by?
one of the hepatotropic viruses: Hep A,B,C,D, or E
non-hepatotropic viruses are ____ and more commonly arise in ______ patients
rare; immunocompromised
hepatitis is considered chronic when abnormalities persist for more than _________
6 months
resolution of acute hepatitis is common for _____ (3 things)
hep A, EBV hepatitis, drug-induced hepatitis
resolution of hepatitis is less common for (3 things) and may be clinically silent during the acute phase
hep B, hep C, steatohepatitis
liver biopsies for acute hepatitis are useful when?
the diagnosis is uncertain or when it is important to assess extent of liver injury
lobular ____ and _____ increase as severity of hepatitis advances
inflammation, necrosis
acidophil bodies are?
singly necrotic hepatocytes
later in the course of severity, necrosis becomes ____
confluent
if you were to biopsy acute hepatitis, you would see?
scattered lymphocytes in the portal area, lymphocyte-mediated necrosis of hepatocytes (acidophil bodies)
describe the histological structure of acidophil bodies
condensed cytoplasm is deeply eosinophilic, shrinks forming retraction halo, small dark nucleus (can be fragmented or disappear)
in addition to the lobular inflammation and acidophil bodies seen in acute hepatitis, chronic hepatitis is characterized by?
expansion of portal areas by lymphocytes, which extends across the limiting plate + necrosis of periportal hepatocytes (interface hepatitis)
longstanding persistent injury at limiting plate results in?
fibrous portal expansion, fibrotic bridging between adjacent portal areas, and regenerative nodules of cirrhosis
what is the limiting plate?
space between portal area and hepatocyte plates
interface hepatitis results in?
lymphocytes and acidophilic bodies surrounding the portal area
the most striking feature of chronic hepatitis at low power is the presence of?
dense portal, periportal mononuclear infiltrate
the presence of ________ points to chronic hep B
ground glass hepatocytes
the presence of ________ points to chronic hep C
well-formed lymphoid nodules
hepatocytes infected with hep B have a ground glass appearance due to?
hep B surface antigen accumulates in the cytoplasms as pale, hazy, granular material (and pushes nucleus to edge)
the best way to tell that a cell is infected by hep B/has ground glass cytoplasm is that the cytoplasm lacks _____
course reticulations
how do you detect hep B by immunohistochemistry?
stain for hep B surface antigen
hep C typically has distinctly nodular _____ aggregates in ______ areas
lymphocytic, portal areas
hepatocellular carcinoma stains (lighter/darker) than cirrhotic liver
darker
herpes simplex hepatitis results _____ necrosis with what pattern?
hemorrhagic “geographic “necrosis
in HSV hepatitis, residual intact hepatocytes have _____
herpetic viral cytopathic effect
what are the 3 M’s of herpetic viral cytopathic effect?
Multinucleation, Molding of nuclei, and Margination of nuclear chromatin about central ground-glass nucleoplasm
