Dirschmid K, Kiesler J
Leber Magen Darm. 1980 Apr;10(2):115-8.
Histological sections of the liver taken at the autopsy of 26 patients with anthracosilicosis of different degrees of severity were investigated retrospectively. Single macrophages containing dust were found in the portal fields, as well as dust storing Kupfer cells proliferating centroacinarity. Granuloma of the walls of central and sublobular veins could be observed, containing infiltrates of lymphocytes and plasma cells, proliferating fibroblasts including histiocytes, and fibrosis and hyalinisation in later stages. It may be assumed, that dust pigments are being transported by blood and taken up by Kupler cells in the first line, to be transmitted directly to the central vein and to a lesser degree by way of lymph drainage into the portal mesenchyma in a later stage. These morphological changes of the liver apparently did not cause any clinical symptoms; they could be found in a high percentage of all patients, which did not have cirrhosis of the liver, and they could be found in all degrees of severity of anthracosilicosis. Thus liver biopsy will yield valuable diagnostic results in this granulomatous disease of the liver as well.
对26例不同严重程度的煤矽肺患者尸检时获取的肝脏组织切片进行了回顾性研究。在门管区发现了含尘的单个巨噬细胞，以及中央腺泡性增生的贮尘库普弗细胞。可观察到中央静脉和小叶下静脉壁的肉芽肿，其中含有淋巴细胞和浆细胞浸润、包括组织细胞在内的增生性成纤维细胞，后期出现纤维化和玻璃样变。可以推测，粉尘色素首先由血液运输并被库普弗细胞摄取，随后直接传输至中央静脉，后期则较少通过淋巴引流进入门管间充质。肝脏的这些形态学改变显然未引起任何临床症状；在所有无肝硬化的患者中，高比例患者均可发现这些改变，且在不同严重程度的煤矽肺患者中均能发现。因此，肝活检在这种肝脏肉芽肿性疾病中也将产生有价值的诊断结果。
