Shah H A, Kayani N, Sheikh H, Jafri S W, Hamid S, Khan A H
Department of Medicine, Aga Khan University Medical Center, Karachi, Pakistan.
Indian J Gastroenterol. 1995 Jul;14(3):91-4.
To study the histological features of chronic active hepatitis C (CAH-C) and to compare these with those of chronic active hepatitis B (CAH-B).
Thirty-two liver biopsy specimens from patients with chronic active hepatitis and presence of antibodies to hepatitis C on second generation enzyme immunoassay were studied and compared with those in 34 patients with CAH-B. Seventeen of the 32 CAH-C patients had fully developed or developing cirrhosis of liver whereas the remainder had only chronic active hepatitis.
Among 32 patients with CAH-C, fatty change (20), Kupffer cell hyperplasia (30), sinusoidal lymphocytosis (27) lymphoid follicles aggregates in portal tracts (26) and bridging necrosis (16) were regular features. Focal necrosis, bile duct necrosis, cholestasis and ground glass cells were however seen much less often. On the other hand, in patients with CAH-B, fatty change (no patient), sinusoidal lymphocytosis (one patient) and lymphoid follicles/aggregates in portal tracts (one patient) were rare. Also, Kupffer cell hyperplasia (22 patients) was seen less commonly in patients with CAH-B as compared to CAH-C. Focal necrosis (34 patients), bile ductular proliferation (9 patients), cholestasis (17 patients) and ground glass cells (15 patients) were more prominent in CAH-B.
Presence of certain histological features can help in distinguishing between CAH-C and CAH-B.
研究慢性丙型活动性肝炎（CAH-C）的组织学特征，并与慢性乙型活动性肝炎（CAH-B）的组织学特征进行比较。
对32例慢性活动性肝炎患者的肝活检标本进行研究，这些患者经第二代酶免疫测定显示存在丙型肝炎抗体，并与34例CAH-B患者的标本进行比较。32例CAH-C患者中，17例已出现或正在发展为肝硬化，其余患者仅有慢性活动性肝炎。
在32例CAH-C患者中，脂肪变性（20例）、库普弗细胞增生（30例）、窦状淋巴细胞增多（27例）、汇管区淋巴滤泡聚集（26例）和桥接坏死（16例）是常见特征。然而，局灶性坏死、胆管坏死、胆汁淤积和毛玻璃样细胞则较少见。另一方面，在CAH-B患者中，脂肪变性（无患者出现）、窦状淋巴细胞增多（1例患者）和汇管区淋巴滤泡/聚集（1例患者）很少见。此外，与CAH-C患者相比，CAH-B患者中库普弗细胞增生（22例患者）较少见。局灶性坏死（34例患者）、胆小管增生（9例患者）、胆汁淤积（17例患者）和毛玻璃样细胞（15例患者）在CAH-B中更为突出。
某些组织学特征的存在有助于区分CAH-C和CAH-B。
