多核巨細胞の多数出現をみた亜急性肝萎縮の1剖検例

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A 73-year-old female with Hashimoto's thyroiditis proven histologically, has been received replacement therapy for hypothyroidism since four years ago. She had suddenly increasing jaundice. The biopsy liver specimen on the 19th hospital day showed marked cholestasis, spotty necrosis and severe infiltration of small round cells in the portal tracts, focally lymphfolliculoid. In addition, many multinucleated giant liver cells were recognizable throughout the lobules. On the 82th hospital day, she died of hepatic failure due to subacute liver atrophy. Histological section obtained on autopsy showed less of multinucleated giant liver cells than the biopsy liver. Multinucleated giant liver cells contained many bile plugs in the cytoplasm, suggesting that these cells were formed by fusion of hepatocytes. <BR>She had also positive Coombs' tests, very high cold agglutinin titers and abnormal results of other serological tests. Therefore, it was suggested that the liver disorder in the present case occurred in association with an autoimmune basis.
社団法人日本肝臓学会の論文