Schulz F, Püschel K
Gerichtsärztlicher Dienst der Behörde für Arbeit, Gesundheit und Soziales, Hamburg.
Pathologe. 1996 Mar;17(2):154-6. doi: 10.1007/s002920050150.
A 28-year-old drug addict who had injected intravenously died of hepatic failure and coma caused by fulminant hepatitis (simultaneously: hepatitis A, persistent hepatitis B, hepatitis C and superinfection by delta hepatitis). Liver histology disclosed cirrhosis with severe necrotizing hepatitis and extensive microvesicular steatosis, compatible with a delta virus infection. Moderate pulmonary fat embolism (grade I-II according to Falzi) was accompanied by fat deposits in alveolar macrophages. It is postulated that protracted fat mobilization from necrotizing hepatocytes may be the cause of pulmonary fat embolism; the extravasation of fat from the vessels into the alveoli results in phagocytosis by alveolar macrophages.
一名28岁的静脉注射吸毒者死于暴发性肝炎（同时感染甲型肝炎、慢性乙型肝炎、丙型肝炎及丁型肝炎重叠感染）所致的肝衰竭和昏迷。肝脏组织学检查显示为肝硬化，伴有严重坏死性肝炎和广泛的微泡性脂肪变性，符合丁型病毒感染。中度肺脂肪栓塞（根据法尔齐分级为I-II级）伴有肺泡巨噬细胞内的脂肪沉积。据推测，坏死肝细胞的长期脂肪动员可能是肺脂肪栓塞的原因；脂肪从血管渗入肺泡导致肺泡巨噬细胞进行吞噬作用。
