Patterns of Acute Hepatitis

Question 1

What is the pattern of liver injury seen in acute infection with HAV and HBV?

Answer 1

Apoptosis, lobular disarray, inflammation of entire lobule and portal tracts

Question 2

What histological features are characteristic of acute HAV and HBV infection?

Answer 2

Disruption of hepatocyte plates and swelling
Councilman body (hepatocyte undergoing apoptosis)
Lymphocytes surrounding infected hepatocytes
Compression of sinusoids
Enlarged Kupffer cells containing bile and lipofuscin

Question 3

What is the hallmark feature of acute viral hepatitis?

Answer 3

Apoptosis

Question 4

What causes liver injury in paracetamol toxicity?

Answer 4

NAPQI metabolite

Question 5

What histological features are characteristic of paracetamol toxicity?

Answer 5

Coagulative necrosis, predominantly in zone 3 (closest to central vein)

Question 6

What histological features are characteristic of acute alcoholic hepatitis?

Answer 6

Steatosis (large fat droplets)
Collagen deposition around hepatocyte plates
Sclerosing hyaline necrosis (fibrosis) around central vein
Ballooned hepatocyte with Mallory body