慢性活动型病毒性肝炎组织学和超微结构观察

本文对75例慢活肝肝穿材料进行光镜检查,其中22例进行透视电镜观察。对三型慢活肝光镜下形态特点做了详细描述,提出了掌握病理诊断的要点。对气球样变肝细胞在电镜下三种不同形态特点和细胞膜的超微结构改变给予特别的注意,提出基质水肿型气球样变肝细胞和肝细胞膜的“链环状结构”可能是重型慢活肝超微结构的特点,并对其发生机制作了初步探讨。 提高慢活肝临床诊断符合率要进行综合诊断,特别要注意对临床症状较轻病人的综合诊断。

Histopathological and Ultrastructural Observations on Liver Biopsy Specimens from Patients with Chronic Active Hepatitis

Seventy-five liver biopsy specimens taken from patients with chronic active hepatitis(CAH) were studied with light microscopy, and 22 of the 75 with electron microscopy as well. The pathological changes of CAH could be divided into mild, moderate and severe types according to the severity and extent of the liv-e'r lesions. Piecemeal necrosis was an outstanding feature of this series of cases. Ultrastructttrally, the ballooning degeneration of hepatocytes could be distinguished into 3 forms; rough endoplasmic reticulum(RER) dilatation, RER dilatation associated with mitochondrial swelling, and edema of cytosol. The last one was considered as one of the features of the severe type of CAH.Particular attention was paid to the changes of the cell membtane. Ultra-structurally, generalized thickening of the cell membrane was demonstrated in two forms, that is, (1) there was fibrillarv substance interposed between the membranes of 2 adjacent cells, and (2) the cell membrane became thickened, adhered with each other, or twisted, forming the so-called "chain-ring-like structure" , which was considered as another prominent feature of the severe type of CAH.According to our observation, the accuracy of diagnosis is chiefly dependent on the histopathological findings.