Paties C, Peveri V, Falzi G
Department of Pathology, Piacenza Hospital, Italy.
Forensic Sci Int. 1987 Sep;35(1):11-26. doi: 10.1016/0379-0738(87)90019-3.
Liver specimens of 150 randomly selected autopsied drug addicts from the province of Milan (Italy) were studied using light microscopy, polarized light and immunohistochemical methods. Simple histological changes and the main diagnoses are described. The main histological diagnoses in order of frequency were: non-specific reactive hepatitis (NSRH) (52%), chronic aggressive hepatitis (CAH) (24%), acute hepatitis (AH) (12%), normal liver (6%), steatosis only (3.3%) and cirrhosis (2%). In 24 cases (16%) one or more viral antigens (HBsAg, HBcAg and Delta Ag) were detected in hepatocytes by immunohistochemical methods. Three liver specimens revealed epithelioid cell granulomas, but in no case was birefringent material identified in the liver. AH and CAH were more frequent in the group of livers with viral antigens. Our histological and immunohistochemical data confirm the current opinion that, in most cases, liver pathology in drug addicts has a viral aetiology, while no significant pathogenic role has been identified for drugs, alcohol or contaminants. Recurrent infections by one or several viruses possibly explain the relatively peculiar histological features of hepatitis in drug addicts.
我们采用光学显微镜、偏振光和免疫组织化学方法，对从意大利米兰省随机选取的150例吸毒成瘾者的肝脏标本进行了研究。文中描述了简单的组织学变化及主要诊断结果。按出现频率排序，主要的组织学诊断结果为：非特异性反应性肝炎（NSRH）（52%）、慢性侵袭性肝炎（CAH）（24%）、急性肝炎（AH）（12%）、正常肝脏（6%）、仅有脂肪变性（3.3%）和肝硬化（2%）。通过免疫组织化学方法，在24例（16%）肝细胞中检测到一种或多种病毒抗原（HBsAg、HBcAg和Delta Ag）。三份肝脏标本显示有上皮样细胞肉芽肿，但在肝脏中均未发现双折射物质。在有病毒抗原的肝脏组中，AH和CAH更为常见。我们的组织学和免疫组织化学数据证实了目前的观点，即在大多数情况下，吸毒成瘾者的肝脏病变由病毒病因引起，而药物、酒精或污染物未被发现有显著的致病作用。一种或几种病毒的反复感染可能解释了吸毒成瘾者肝炎相对特殊的组织学特征。
