Kahn E, Greco M A, Daum F, Magid M, Morecki R, Mahnovski V, Anderson V
North Shore University Hospital-Cornell University Medical College, Manhasset, NY 11030.
Hum Pathol. 1991 Nov;22(11):1111-9. doi: 10.1016/0046-8177(91)90263-o.
In a retrospective study we assessed the hepatic changes in children with the acquired immunodeficiency syndrome by reviewing 12 biopsy specimens and 48 autopsy specimens from 54 children. Hepatopathology differed in biopsy and autopsy material. In biopsy specimens, chronic active hepatitis with predominantly T8 lymphocytes by tissue immunochemistry was common (five of 12 specimens). Fatty degeneration and hepatocellular necrosis were either absent, mild, or patchy. On the other hand, at autopsy, chronic active hepatitis was not observed. The most prominent changes were extensive fatty degeneration, nonspecific portal mononuclear infiltration, portal fibrosis, and confluent (ischemic) necrosis. Opportunistic infections such as Mycobacterium avium-intracellulare (MAI) were noted only at autopsy. In addition, three unusual morphologic characteristics were noted: nodular lymphoplasmacytic portal infiltrate, a pseudosarcomatous variant of Mycobacterium avium-intracellulare infection, and multinucleated giant cells (foreign both type and giant cell transformation of hepatocytes).
在一项回顾性研究中，我们通过检查54例儿童的12份活检标本和48份尸检标本，评估了获得性免疫缺陷综合征患儿的肝脏变化。活检和尸检材料中的肝脏病理学表现有所不同。在活检标本中，组织免疫化学显示以T8淋巴细胞为主的慢性活动性肝炎较为常见（12份标本中有5份）。脂肪变性和肝细胞坏死要么不存在，要么很轻微，或者呈局灶性。另一方面，在尸检中未观察到慢性活动性肝炎。最显著的变化是广泛的脂肪变性、非特异性门单核细胞浸润、门脉纤维化和融合性（缺血性）坏死。机会性感染，如鸟分枝杆菌-胞内分枝杆菌（MAI）仅在尸检时被发现。此外，还注意到三个不寻常的形态学特征：结节性淋巴浆细胞门脉浸润、鸟分枝杆菌-胞内分枝杆菌感染的假肉瘤样变体以及多核巨细胞（包括肝细胞的异型和巨细胞转化）。
