Histopathology of the human liver in yellow fever with special emphasis on the diagnostic role of the Councilman body

Liver specimens from 10 cases of yellow fever (YF) were studied by light and four by electron microscopy to review morphological aspects of the disease relevant to its diagnosis, with special emphasis on acidophilic bodies (AB) and on the possible presence of the virus within infected cells. The AB were compared with those found in 22 out of 69 liver specimens with other pathological processes. In YF the typical alteration was an acidophilic hepatocellular necrosis with a preferential midzonal distribution. Ceroid pigment was abundant, its amount was proportional to the degree of liver cell damage and it was found in altered hepatocytes and Kupffer cells in the most damaged areas. The inflammatory infiltrate was scanty, not only in portal tracts but also within the lobules. Electron microscopically, no viral particles were found in liver cells or AB. The latter appeared as round or elliptical cytoplasmic masses, surrounded by a conspicuous cellular membrane and densely packed with organelles, fat vacuoles and residual bodies. They differed from AB in other liver diseases by the presence of fat vacuoles and ceroid pigment. Some peculiarities of AB in other liver diseases such as presence of bile pigment and iron, would depend upon the presence of these pigments in the hepatocytes which originated them.