GANDAKI MEDICAL COLLEGE

CORRELATION SEMINAR GI SYSTEM

PRESENTED BY:

SAJANA BHANDARI

SUDARSHAN ACHARYA

OBJECTIVE

TO DESCRIBE THE MICROSCOPIC FEATURES OF DIFFERENT TYPES OF HEPATITIS

HEPATITISIt is the inflammationof liver .Usually 2 types:

VIRAL HEPATITIS

NON-VIRAL HEPATITIS

VIRAL Hepatitis

Hepatitis A – Infectious hepatitisHepatitis B – Serum hepatitisHepatitis C – Non-A non-B or Post

transfusion hepatitisHepatitis D – associated with Hep BHepatitis E - Epidemic hepatitis

NON-Viral hepatitis

Staph aureus (toxic shock)

Gram-Negative (Cholangitis)

Parasitic (liver fluke)

Amoeba (abscesses)

AUTOIMMUNE

ALCOHOLIC HEPATITIS

MORPHOLOGY OF ACUTE AND CHRONIC HEPATITIS

Acute HepatitisHepatocyte injuryHepatocyte necrosisRegenerative changesSinusoidal cell reactive changesPortal tracts changes

1.Hepatocyte injury

Diffused swelling(ballooning degeneration)

Cholestasis: canalicular bile plug

HCV: Focal fatty changes of hepatocytes

2.Hepatocyte necrosis

Isolated cells

Cytolysis or Apoptosis

Bridging necrosis(portal-portal , central – central, portal – portal)

Lobular disarray: loss of normal architecture

5.Portal tracts:

Mixture of inflammatory cells: mainly mononuclear

Interface hepatitis

3.Regenerative changes:

hepatocyte proliferation

4.Sinusoidal cell reactive changes:

Accumulation of phagocytosed cellular debris in kupffer cells

Hypertrophy and hyperplasia of Kupffer cells

Chronic hepatitis

Like acute hepatitis has similar; Hepatocyte injury,necrosis , regeneration,

sinusoidal cell reactive changes

Portal tract changes

Fibrosis Inflammation

“Councilman” Bodies

FIBROSIS

1

• Hallmark: deposition of fibrous tissue

2• HBsAg: “Ground – glass hepatocytes”

3

• HCV infection: Lymphoid aggregation and Bile duct damage

Fibrosis of liver

Fulminant Hepatitis

Fulminant Hepatitis

Hepatic insufficiency leading to hepatic encephalopathy

Histology: 2 forms A) Submassive necrosis

Orderly regeneration

Partial necrosis usually in centrilobular and mid zone

Collapsed reticulin framework

B)Massive necrosis

• Necrosis of entire lobule

• Loss of hepatic parenchyma

• Collapsed and condensed reticulin framework

• Disordered regeneration

• Fibrosis doesn’t occur

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