Lefkowitch Jay H
Department of Pathology, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA.
Curr Opin Gastroenterol. 2007 May;23(3):221-31. doi: 10.1097/MOG.0b013e3280adc92e.
Recent papers on disorders of the liver and biliary tract which clarify their pathogenesis and attendant morphologic changes are highlighted.
The concept of 'bystander hepatitis' was cited in studies showing hepatic infiltration of CD8-positive T cells in the setting of extrahepatic infections such as influenza virus and severe acute respiratory syndrome. Diabetic liver lesions include glycogenic hepatopathy (in which poor diabetic control leads to swollen, glycogen-filled hepatocytes without fat, steatohepatitis or fibrosis) and diabetic hepatosclerosis in which there is diffuse perisinusoidal fibrosis (type IV collagen) without zonal predilection. Ground-glass hepatocellular inclusions (positive with periodic acid-Schiff stain for glycogen) were reported in three separate series of patients who were hepatitis B virus-negative, often transplant recipients, immunosuppressed and on multiple medications. A Banff consensus paper expertly compared and contrasted the histologic features which characterize the various causes of late liver allograft dysfunction.
Informative papers emerged this past year concerning collateral damage to the liver in extrahepatic infections, diabetic lesions and causes of liver dysfunction after transplantation, among other topics.
重点介绍近期关于肝脏和胆道疾病的论文，这些论文阐明了其发病机制及相关形态学变化。
“旁观者性肝炎”的概念在研究中被提及，这些研究表明在诸如流感病毒和严重急性呼吸综合征等肝外感染情况下，CD8阳性T细胞会浸润肝脏。糖尿病性肝损害包括糖原性肝病（血糖控制不佳导致肝细胞肿胀，充满糖原，但无脂肪、脂肪性肝炎或纤维化）和糖尿病性肝硬变，其中存在弥漫性窦周纤维化（IV型胶原），无区域偏好。在三个不同系列的患者中报告了毛玻璃样肝细胞包涵体（糖原染色呈过碘酸-希夫阳性），这些患者乙肝病毒阴性，通常是移植受者，免疫抑制且服用多种药物。一篇班夫共识论文对表征晚期肝移植功能障碍各种原因的组织学特征进行了专业的比较和对比。
过去一年出现了一些有价值的论文，内容涉及肝外感染对肝脏的附带损害、糖尿病性损害以及移植后肝功能障碍的原因等诸多主题。
