Gordon S C, Reddy K R, Gould E E, McFadden R, O'Brien C, De Medina M, Jeffers L J, Schiff E R
J Hepatol. 1986;2(3):475-84. doi: 10.1016/s0168-8278(86)80059-9.
Abnormal liver chemistries, unexplained fevers, or hepatomegaly prompted 36 liver biopsies on 34 patients with the acquired immunodeficiency syndrome. The most common finding was the presence of hepatic granulomas, seen in 13 of the biopsy specimens. Eight of these granulomas were ill-defined, and 5 were more clearly associated with mycobacterial disease. Portal fibrosis and fatty infiltration were common, but a paucity of significant inflammatory activity was seen despite elevated aspartate aminotransferase levels, perhaps related to the underlying immunoincompetent status. Other noteworthy histopathologic findings included 1 patient each with peliosis hepatis and cryptococcal hepatitis. Electron-microscopic evidence of cytoplasmic tubular structures or viral particles were seen within the hepatocytes of 2 patients. It is concluded that a broad spectrum of hepatic histopathology may be seen in the acquired immunodeficiency syndrome, and that liver biopsy may be diagnostically valuable in the clinical investigation of such patients.
异常的肝功能、不明原因的发热或肝肿大促使对34例获得性免疫缺陷综合征患者进行了36次肝脏活检。最常见的发现是肝肉芽肿的存在，在13份活检标本中可见。其中8个肉芽肿边界不清，5个与分枝杆菌病更明确相关。门脉纤维化和脂肪浸润很常见，但尽管天冬氨酸转氨酶水平升高，仍未见明显的炎症活动，这可能与潜在的免疫功能不全状态有关。其他值得注意的组织病理学发现包括各有1例肝紫癜和隐球菌性肝炎患者。在2例患者的肝细胞内可见细胞质管状结构或病毒颗粒的电子显微镜证据。结论是，在获得性免疫缺陷综合征中可观察到广泛的肝脏组织病理学表现，肝脏活检在对此类患者的临床研究中可能具有诊断价值。
