Pratt D S, Fawaz K A, Rabson A, Dellelis R, Kaplan M M
Division of Gastroenterology, New England Medical Center, Boston, Massachusetts, USA.
Gastroenterology. 1997 Aug;113(2):664-8. doi: 10.1053/gast.1997.v113.pm9247489.
In patients with chronic hepatitis, the diagnosis of autoimmune hepatitis is made on the basis of increased gamma-globulin levels and the presence of circulating autoantibodies. Because these test results are not abnormal universally in patients with autoimmune hepatitis, liver biopsy remains an important part of the evaluation. The classical histological finding in autoimmune hepatitis is lymphocytic infiltration of the portal triads and periportal zone (zone 1) with periportal hepatocyte necrosis. This case report describes 4 patients with glucocorticoid-responsive hepatitis, presumably autoimmune in nature, who had pericentral necrosis (zone 3) with relative sparing of the portal areas in their liver biopsy specimens, a previously undescribed histological finding in autoimmune hepatitis.
在慢性肝炎患者中，自身免疫性肝炎的诊断基于γ-球蛋白水平升高和循环自身抗体的存在。由于这些检测结果在自身免疫性肝炎患者中并非普遍异常，肝活检仍是评估的重要组成部分。自身免疫性肝炎的经典组织学表现是汇管区三联征和汇管周围区（1区）的淋巴细胞浸润伴汇管周围肝细胞坏死。本病例报告描述了4例糖皮质激素反应性肝炎患者，推测本质上为自身免疫性肝炎，其肝活检标本显示中央静脉周围坏死（3区），而汇管区相对 spared，这是自身免疫性肝炎中以前未描述过的组织学表现。
