Hepatitis C

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Hepatitis C is type of chronic viral hepatitis caused by the hepatitis C virus.

It is a type of medical liver disease

General

Associated pathology:

Microscopic

Features:

  • Lobular inflammation - this is non-specific finding.
    • Usually Grade 1, rarely Grade 2 and almost never Grade 3 or Grade 4.[1]
  • Periportal steatosis in genotype 3.[2]
    • Steatosis in hepatitis C is usually a secondary pathology, i.e. a separate pathologic process.[3]

Images

Hepatitis C virus. Metavir Activity Index 1 (PMN 0 LN 1).Hepatitis C virus. Metavir Activity Index 1 (PMN 0 LN 1).
Hepatitis C virus. Metavir Activity Index 1 (PMN 0 LN 1).Hepatitis C virus. Metavir Activity Index 1 (PMN 0 LN 1).
Hepatitis C virus. Metavir Activity Index 1 (PMN 0 LN 1).Hepatitis C virus. Metavir Activity Index 1 (PMN 0 LN 1).

Hepatitis C virus. Metavir Activity Index 1 (PMN 0 LN 1). Preserved architecture shows small, inflamed triads [red arrows] and foci of spotty necrosis [blue arrows] (Row 1 Left 40X). Trichrome shows periportal fibrosis [blue arrow] and central venous sclerosis [green arrow] (Row 1 Right 100X). A higher power view of an inflamed triad with interface hepatitis, but a smooth outline, suggesting no piecemeal necrosis (Row 2 Left 200X). A focus of spotty necrosis near an unafflicted triad below it (Row 2 Right 200X). Reticulin shows collapse [arrows] extending from/near portal triad without piecemeal necrosis (Row 3 Left 200X). Reticulin shows collapse [arrows] extending from/near central vein (Row 3 Right 200X).

Inflamed bands cross hepatocytes with steatosis (Row 1 Left 40X).Trichrome shows extensive bridges (Row 1 Right 40X).
Trichrome also documents early nodule formation (Row 2 Left 40X).Reticulin shows regeneration (two nuclei per cord) in a nodule, but not throughout (Row 2 Right 200X).
Hematoxylin and eosin shows piecemeal necrosis as inflammatory cells surrounding hepatocytes (Row 3 Left 400X).Reticulin shows black lines about hepatocytes, indicating confluent piecemeal necrosis (Row 3 Right 400X).

Hepatitis C with metavir stage IV fibrosis (advanced fibrosis/cirrhosis) and confluent piecemeal necrosis. Inflamed bands cross hepatocytes with steatosis (Row 1 Left 40X). Trichrome shows extensive bridges (Row 1 Right 40X). Trichrome also documents early nodule formation (Row 2 Left 40X). Reticulin shows regeneration (two nuclei per cord) in a nodule, but not throughout (Row 2 Right 200X). Hematoxylin and eosin shows piecemeal necrosis as inflammatory cells surrounding hepatocytes (Row 3 Left 400X). Reticulin shows black lines about hepatocytes, indicating confluent piecemeal necrosis (Row 3 Right 400X).

Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3
Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3
Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3

Hepatitis C. Metavir Activity Index 2 (PMN2, LN1), Metavir fibrosis stage 3. Expanded dark triads, indicating interface hepatitis [red arrows], foci of steatosis [green arros], potential bridge [blue arrow] (Row 1 Left 20X). Extending from triad are stretches of apparent necrosis [green arrows], inflammatory cells bound hepatocytes afflicted by piecemeal necrosis [yellow arrows], ballooning degeneration denoted by cytoplasmic tufts [blue arrows] (Row 1 Right 400X). Reticulin shows collapse (necrosis) with thick bands [red arrows], as well as rosettes [green arrows] indicating dilated cholangioles (Row 2 Left 200X). Reticulin here shows continuous piecemeal necrosis with black bounded hepatocyte islets [arrows] (Row 2 Right 200X). Reticulin here shows a bridge with regeneration, wherein two or more nuclei lie between reticulin lines [arrows] (Row 3 Left 200X). Trichrome demarcates one of the bridges (Row 3 Right 200X).

DDx:

See also

References

  1. STC. 6 December 2010.
  2. Yoon EJ, Hu KQ. Hepatitis C virus (HCV) infection and hepatic steatosis. Int J Med Sci. 2006;3(2):53-6. Epub 2006 Apr 1. PMID 16614743. Avialable at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1415843. Accessed on: September 9, 2009.
  3. OA. September 2009.