Hepatitis B

Hepatitis B is a relatively common medical liver disease caused by the hepatitis B virus.

General

• May lead to hepatocellular carcinoma without cirrhosis.
• High prevalence.
• Diagnosis is by serology - details of serologic testing are in the medical liver disease article.
• A vaccination is available and done routinely in a many jurisdictions.

Associated pathology:

• Polyarteritis nodosa (PAN).
• Membranoproliferative glomerulonephritis.
• Membranous nephropathy.

Microscopic

Features:

• Lobular inflammation - this is non-specific finding.
  • Hepatocyte necrosis:
    • Necrotic hepatocytes look a lot like neutrophils - however:
      • Cytoplasm is more pink.
      • Round apoptotic bodies.
• Ground glass hepatocytes - important.

DDx:

• Hepatitis C.
• Autoimmune hepatitis.
• Primary biliary cirrhosis without granulomas.
• Drug reaction.

Image

• 

  GGH - high mag. (WC)

IHC

• Hepatitis B +ve.

See also

• Medical liver disease.