LIVER PATHOLOGY IN PORPHYRIA CUTANEA TARDA

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Hepatic lesions were studied in patients with porphyria cutanea tarda. The patients were men aged 33 to 77 years, all having a hestory of exessive alcohol consumption. Serum transaminase level was elevated slightly in 6 cases and bromosulfophthalein or indocyanine green retention was increased in 5 cases. Serum total bilirubin was normal in all cases. Histological examination revealed varying degrees of the following changes: liver cell necrosis (6 cases), portal inflammation (6 cases), destruction of limiting plate (6 cases), fatty change (2 cases) and fibrosis (5 cases). Cirrhosis was noted in 1 case. Hemosiderin and lipofuscin deposits in hepatocytes were observed in all cases. Brown needle-shaped cytoplasmic inclusions were found in all cases. They occured both singly and in clusters and did not show any particular distribution within the lobules. Electron microscopical examination showed needle-shaped electrolucent areas associated with surrounding lysosomal material. These inclusions are considered to be characteristic and highly diagnostic of this disease.
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