Tsuchiya Hiroko, Hoshikawa Kyoko, Nishina Taketo, Mizuno Kei, Haga Hiroaki, Okumoto Kazuo, Utsunomiya Aya, Yamakawa Mitsunori, Ueno Yoshiyuki
Department of Gastroenterology, Faculty of Medicine, Yamagata University.
Department of Pathological Diagnostics, Faculty of Medicine, Yamagata University.
Nihon Shokakibyo Gakkai Zasshi. 2020;117(8):726-732. doi: 10.11405/nisshoshi.117.726.
A 66-year-old woman was diagnosed as primary biliary cholangitis (PBC) and was previously hospitalized for ascites and jaundice. She came to our hospital for further examination of the liver by needle biopsy, which showed interface hepatitis that mainly comprised lymphocytes and inflammatory infiltrates in the bile duct in the portal area. On the other hand, numerous intracytoplasmic inclusions that were positive for fibrinogen immunostaining were seen in the lobular area. Finally, we histologically diagnosed as PBC with fibrinogen storage disease (FSD). FSD is rare disease that leads to liver damage caused by abnormal fibrinogen storage in the endoplasmic reticulum of hepatocytes, with only four cases reported in Japan until now.
一名66岁女性被诊断为原发性胆汁性胆管炎(PBC),此前因腹水和黄疸住院治疗。她来我院通过肝穿刺活检进行肝脏进一步检查,结果显示界面性肝炎,主要表现为淋巴细胞浸润以及门管区胆管的炎性浸润。另一方面,在小叶区域可见大量纤维蛋白原免疫染色呈阳性的胞质内包涵体。最终,我们经组织学诊断为PBC合并纤维蛋白原贮积病(FSD)。FSD是一种罕见疾病,由肝细胞内质网中纤维蛋白原异常贮积导致肝脏损伤,截至目前日本仅报道过4例。