Morphological characteristics of secondary pulmonary hypertension in liver cirrhosis]

Morphological examinations of 24 autopsy cases of liver cirrhosis demonstrated the development of secondary postcapillary pulmonary hypertension with an increase of the muscular mass of the right ventricle and rearrangement of the blood vessels of pulmonary circulation. Most important morphological changes were observed in intraorgan veins and microcirculatory bed of the visceral pleura (particularly in the venular knee) indicating early reaction of the veins to hemodynamic disorders. It is suggested that hypervolemia in the pulmonary circulation system developing at the expence of blood discharge from the portal system into direct portopulmonary anastomoses plays an important role in the genesis of pulmonary hypertension in patients with hepatic cirrhosis.     

IgM HCV antibody in chronic hepatitis and liver cirrhosis]

To evaluate the role of IgM specific antibody in the diagnosis and monitoring of the patients with chronic hepatitis C, sera from 114 cases with chronic hepatitis C and liver cirrhosis were tested. IgM antibody to hepatitis C virus was detected in 40.0% of CAH, as compared with 21.4% of CIH, 17.4% of LC, 20.0% of LC with HCC. IgM antibody was also detectable in cases with high level of s-ALT. Patients with positive this antibody have high titer of IgG antibody to hepatitis C virus. In summary, testing for this antibody may be useful to evaluate the recurrence or disease activity and may also be helpful in IFN therapy.     

Morphological characteristics of acute alcoholic hepatitis]

Liver biopsies from 60 patients with acute alcoholic hepatitis (AAH) developing against the background of steatosis, chronic hepatitis and cirrhosis were studied histologically, histochemically and electron microscopically. AAH is characterized by necrosis of hepatocytes with deposition of alcoholic hyalin, obesity of the organ, and polymorphonuclear leukocyte infiltration. Hyperplasia of the smooth endoplasmic reticulum, the appearance of megamitochondria, and an increased amount of peroxisomes reflect the participation of MEOS and the catalase system in alcohol metabolism with a progressive decrease in the activity of alcoholdehydrogenase. Acute alcoholic hepatitis is a connecting link between steatosis and cirrhosis of the liver in which the accompanying autoimmune mechanism and microcirculation disorder followed by activation of lipofibroblasts are conducive to the progression of the pathologic process.     

Morphological characteristics of chronic endometritis]

The immunohistochemical examination of 46 endometrial biopsies from women with chronic endometritis (CE) suffering from habitual abortions has found disturbance of correlations between various types of immunocompetent cells with domination of T-suppressors, increased accumulation of IgG on the surface of glandular epithelium. In CE, thickening of spiral arteries occurs not because of sclerosis but due to muscular hypertrophy, endometrial stromal-epithelial relations are impaired. Alterations in the distribution of the extracellular matrix components indicate defective endometrium maturation which may lead to inadequate oocyte implantation.     

Morphological characteristics of acute viral hepatitis]

From the literature and their own observations the authors present morphological criteria of acute viral hepatitis which may be used for differential diagnosis from hepatites of other etiology (toxic, drug). Examinations of liver biopsies from patients with viral hepatitis permit to establish the stage of the disease and to predict its possible outcomes.     

Hepatitis B surface antigen in the liver and pericholedochal lymph nodes in chronic hepatitis and cirrhosis of the liver]

Morphological characteristics of the liver and the presence of HBsAg in the blood serum, liver tissue, and pericholedocheal lymph nodes were examined in 25 patients with chronic liver diseases and 2 asymptomatic carriers of HBsAg. The antigen in tissues was demonstrated by indirect immunofluorescence and histochemically by staining with alcohol-arsein and aldehyde-fuxin. The antigen was found in the blood, liver tissue, and hepatocyte cytoplasm in both carriers and 10 patients. In 5 patients with liver cirrhosis and HBsAg antigenemia the antigen was also found in the liver tissue, in 1 patient it was absent in the blood but found in the liver, and in 2 patients it was absent in the blood and in the liver. In 5 patients with chronic hepatitis the antigen was demonstrated in the blood serum and the liver, in 12 patients it was not detected either in the blood or in the liver. In 8 patients enlarged pericholedocheal lymph nodes were examined, and in 6 of them HBsAg was detected in macrophages of the lymph nodes.     

小儿慢性乙型肝炎临床与肝纤维化病理的有关特征

目的 分析我国小儿慢性乙型肝炎临床与肝纤维化病理的有关特征。方法 对６６例小儿慢性乙型肝炎患者常规进行甲、乙、丙、戊型肝炎病毒血清学检测,肝功能检查及肝穿病理组织检查。结果 年龄、病程、起病方式在无纤维化组（Ｓ０组）和明显肝纤维化组（≥Ｓ３）间统计学处理差异无显著性意义;脾大在Ｓ０组占２．９％,≥Ｓ３组占３２．３３％,Ｓ０组ＨＢｅＡｇ阳性率明显高于≥Ｓ３组（分别为７４．２９％和２９．０３％）;肝脏     

Alpha1-antichymotrypsin globules within hepatocytes in patients with chronic hepatitis C and cirrhosis

Alpha1-antichymotrypsin (A1AC) is an acute phase serine protease inhibitor, similar to alpha1-antitrypsin (A1AT) in amino acid sequence. A1AT deficiency is known to be associated with emphysema and cirrhosis; deficiency of serum A1AC has been reported to be associated with emphysema, childhood asthma, and cryptogenic cirrhosis. The hepatocyte globules associated with A1AT deficiency have been well described; A1AC deficiency also has been reported to be associated with hepatocyte globules. The aim of this study was to describe the globules of A1AC and to compare them with A1AT globules. Immunohistochemistry for A1AC and A1AT was performed on liver biopsy specimens from 15 hepatitis C virus (HCV)-positive cirrhotic patients, 14 non-HCV cirrhotic patients, and 12 other patients with chronic hepatitis C but no cirrhosis, all of whom had known serum levels of A1AC; most had known serum levels of A1AT. Five of 15 HCV-positive cirrhotic patients, 1 of 14 non-HCV cirrhotic patients, and 1 of 12 noncirrhotic chronic hepatitis C patients had A1AC globules. Two of 15 HCV-positive cirrhotic patients and 2 of 14 non-HCV cirrhotic patients had A1AT globules. Histologically, the globules of A1AC were similar to those of A1AT but were smaller and fewer; the PAS/D stain was not as helpful for A1AC as it was for A1AT; immunohistochemistry was most useful. There was not a good correlation between serum levels of A1AC and its globules in hepatocytes. A1AC globules should be included in the differential diagnosis of hepatocyte inclusions.