Microscopic features of different types of Hepatitis

1. GANDAKI MEDICAL
COLLEGE
CORRELATION SEMINAR
GI SYSTEM
PRESENTED BY:
SAJANA BHANDARI
SUDARSHAN ACHARYA

2. OBJECTIVE
 TO DESCRIBE THE MICROSCOPIC
FEATURES OF DIFFERENT TYPES OF
HEPATITIS

3. HEPATITIS
It is the inflammationof liver .
Usually 2 types:
VIRAL HEPATITIS
NON-VIRAL HEPATITIS

4. VIRAL Hepatitis
Hepatitis A – Infectious hepatitis
Hepatitis B – Serum hepatitis
Hepatitis C – Non-A non-B or Post
transfusion hepatitis
Hepatitis D – associated with Hep B
Hepatitis E - Epidemic hepatitis

5. NON-Viral hepatitis
 Staph aureus (toxic shock)
 Gram-Negative (Cholangitis)
 Parasitic (liver fluke)
 Amoeba (abscesses)
 AUTOIMMUNE
 ALCOHOLIC HEPATITIS

6. MORPHOLOGY OF ACUTE
AND CHRONIC HEPATITIS
Acute Hepatitis
Hepatocyte injury
Hepatocyte necrosis
Regenerative changes
Sinusoidal cell reactive changes
Portal tracts changes

7. 1.Hepatocyte injury
Diffused
swelling(balloonin
g degeneration)
Cholestasis:
canalicular bile
plug
HCV: Focal fatty
changes of

8. 2.Hepatocyte necrosis
 Isolated cells
Cytolysis or
Apoptosis
Bridging
necrosis(portal-
portal , central –
central, portal –
portal)
Lobular
disarray: loss of
normal
architecture

9. 5.Portal tracts:
 Mixture of
inflammator
y cells:
mainly
mononuclea
r
Interface
hepatitis

10. 3.Regenerative changes:
 hepatocyte proliferation
4.Sinusoidal cell reactive changes:
 Accumulation of phagocytosed cellular debris in
kupffer cells
 Hypertrophy and hyperplasia of Kupffer cells

11. Chronic hepatitis
 Like acute hepatitis has similar;
Hepatocyte injury,necrosis
, regeneration, sinusoidal cell reactive changes
 Portal tract changes
Inflammatio Fibrosis
n

12. “Councilman” Bodies

13. FIBROSIS
• Hallmark: deposition of fibrous
tissue
1
• HBsAg: “Ground – glass
2 hepatocytes”
• HCV infection: Lymphoid
aggregation and Bile duct damage
3

14. Fibrosis of liver

15. Fulminant Hepatitis

16. Fulminant Hepatitis
Hepatic insufficiency leading to hepatic
encephalopathy
Histology: 2 forms
A) Submassive necrosis
Orderly regeneration
Partial necrosis usually in
centrilobular and mid zone
Collapsed reticulin framework

17. B)Massive necrosis
• Necrosis of entire lobule
• Loss of hepatic
parenchyma
• Collapsed and condensed
reticulin framework
• Disordered regeneration
• Fibrosis doesn’t occur

18. ANY
….
…..
…..
…..
…….
Queries...?

19. THANK U !!!!!