Dancygier H, Runne U, Leuschner U, Milbradt R, Classen M
Hepatogastroenterology. 1983 Jun;30(3):93-5.
The first electron-microscopic description of DTIC-induced human liver injury is presented. A 61-year-old man developed signs of hepatic failure during the second treatment cycle with DTIC for malignant melanoma. Light-microscopic examination revealed extensive centrilobular liver necrosis. Terminal hepatic venules did not show any signs of vasculitis or thrombosis and there was a lack of inflammatory infiltration. At the ultrastructural level intracytoplasmic, membrane-bound, organelle-free vacuoles were found in the hepatocytes. Liver cells showed bleb formation. Bile canaliculi were dilated and their microvilli flattened. In the pericanalicular exoplasm electron-dense fibrillary material, thought to be of microfilamentous origin, accumulated. The patient received 250 mg methylprednisolone i.v. at the very onset of symptoms and was discharged 12 days after the peak rise of transaminases with normal liver parameters.
本文首次对达卡巴嗪（DTIC）引起的人类肝损伤进行了电子显微镜描述。一名61岁男性在接受DTIC治疗恶性黑色素瘤的第二个疗程中出现肝功能衰竭迹象。光镜检查显示广泛的小叶中心性肝坏死。终末肝静脉未显示任何血管炎或血栓形成迹象，且无炎症浸润。在超微结构水平上，肝细胞内发现了胞浆内、膜结合、无细胞器的空泡。肝细胞出现了气泡形成。胆小管扩张，其微绒毛变平。在胆小管周围的外质中，积聚了被认为起源于微丝的电子致密纤维状物质。患者在症状出现之初静脉注射了250毫克甲泼尼龙，并在转氨酶峰值升高12天后出院，肝功能参数正常。
