Ground glass hepatocyte

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Ground glass hepatocytes. H&E stain. (WC)

The ground glass hepatocyte, abbreviated GGH, is a histologic finding that is seen in medical liver pathology and usually suggest a chronic hepatitis B infection.

General

Classification

  • GGHs are not routinely classified.

Notes:

  • Several different types of GGHs are recognized.[1]

Classification:[2]

  • Type I ground glass hepatocytes (GGHs).
    • Weak Pre-S2 positive immunostaining; morphology: GGHs scattered singly.
  • Type II GGHs.
    • Pre-S2 negative immunostaining; morphology: GGHs in clusters.

There is some suggestion that type II GGHs predispose to HCC, based on data in children[3] and based on an animal model.[4]

Microscopic

Features:

  • Eosinophilic dull/hazy, somewhat irregular cytoplasm.
    • Ground glass[5] = glass with a rough/flat finish; glass that is translucent and has a matte finish.
      • The term is frequently used in radiology to describe hazy radiodense areas in the lung.[6]
  • Usually suggests chronic HBV infection.
    • Pattern NOT seen in acute HBV.
    • Caused by virion particles.

DDx:

  • Pseudo-Lafora bodies in patients on disulfiram (anatabuse) - rare.

Images

www:

See also

References

  1. Wang HC, Wu HC, Chen CF, Fausto N, Lei HY, Su IJ. Different types of ground glass hepatocytes in chronic hepatitis B virus infection contain specific pre-S mutants that may induce endoplasmic reticulum stress. Am J Pathol. 2003 Dec;163(6):2441-9. PMID 14633616. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=14633616. Accessed on: September 11, 2009.
  2. Wang HC, Wu HC, Chen CF, Fausto N, Lei HY, Su IJ. Different types of ground glass hepatocytes in chronic hepatitis B virus infection contain specific pre-S mutants that may induce endoplasmic reticulum stress. Am J Pathol. 2003 Dec;163(6):2441-9. PMID 14633616. Available at: [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1892360&rendertype=figure&id=f1 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1892360&rendertype=figure&id=f1]. Accessed on: 17 September 2009.
  3. Pre-S2 deletion mutants of hepatitis B virus could have an important role in hepatocarcinogenesis in Asian children. Abe K, Thung SN, Wu HC, Tran TT, Le Hoang P, Truong KD, Inui A, Jang JJ, Su IJ. Cancer Sci. 2009 Aug 6. [Epub ahead of print] PMID 19719772.
  4. Ground glass hepatocytes contain pre-S mutants and represent preneoplastic lesions in chronic hepatitis B virus infection. Su IJ, Wang HC, Wu HC, Huang WY. J Gastroenterol Hepatol. 2008 Aug;23(8 Pt 1):1169-74. Epub 2008 May 26. Review. PMID 18505413.
  5. URL: http://en.wikipedia.org/wiki/Ground_glass. Accessed on: 7 June 2010.
  6. URL: http://www.healthsystem.virginia.edu/internet/radiology/educ/groundglass.cfm. Accessed on: 7 June 2010.