急性薬剤過敏性肝障害生検肝の病理組織学的ならびに組織計測的検討

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Histopathological and histometrical studies on drug-induced acute hepatic injuries were made. Liver biopsy specimens submitted were as follows: Forty-two cases with acute drug-induced hepatic injury to hypersensitivity reaction (DIH), 52 cases with acute hepatitis type B (HB), 19 cases with obstructive jaundice and 22 cases with minimal changes as a normal control. Results obtained were as follows: 1. Multinucleated hepatocytes containing more than three nuclei were detected more abundantly in DIH than in HB and obstructive jaundice. Intralobular distribution of the cells was predominantly centrilobular. 2. Bile canalicular bile plugs were found to be more prevalent per unit area in DIH than in HB, and in the former, bile plugs were observed for long periods after the clinical onset. In HB, they showed a remarkable tendency to disappear in a relatively early stage. 3. In DIH, the amount of the multinucleated hepatocytes was closely correlated to that of bile plugs. No such relationship was found in HB. 4. Cholestasis in DIH was predominantly centrilobular and the pattern was clearly different from that in obstructive jaundice. It was concluded that the above findings would be useful as practical "hallmarks" for histopathological diagnosis on drug-induced acute hepatic injury.
社団法人日本肝臓学会の論文