散发性戊型肝炎肝组织细胞学观察  

Pathological observation of the liver tissues from patients with sporadic hepatitis E

作　　者：刘平[1] 赵景民[1] 王松山[1] 周光德[1] 孙艳玲[1] 孟二红 

机构地区：[1]解放军第三○二医院病理科,北京100039

出　　处：《传染病信息》2002年第2期73-75,共3页Infectious Disease Information

摘　　要：目的观察散发性戊型病毒性肝炎组织细胞学特征。方法收集18例散发性戊型病毒性肝炎穿刺肝组织进行详尽的光、电镜观察。结果 18例肝组织均呈急性肝炎的典型病变,较其它型病毒性肝炎相对特征性病变为:肝细胞变性明显,细胞连接面多数呈分离状态,毛细胆管微绒毛多数脱失,腔扩大,腔内存积细颗粒絮状物。病变重者,肝细胞核浓缩,粗面内质网(RER)扩张,核糖体脱失,被Kupffer细胞包围、吞噬,或坏死的肝细胞堕入窦周间隙,胞质内见多数溶酶体。变性乃至坏死的肝细胞旁常见淋巴细胞包围,且淋巴细胞伸出伪足状突起与肝细胞接触,肝细胞往往出现胞膜部分脱失,浸润于肝细胞的淋巴细胞胞质中偶见圆形或杆状的致密颗粒。汇管区炎及周围炎突出,以淋巴细胞、浆细胞为主的单个核细胞向小叶内溢入。结论散发性戊型病毒型肝炎有其相对病理学特征;细胞免疫性损伤可能是散发性戊型肝炎的主要肝损伤机制。Objective To explore the histological characteristics of sporadic hepatitis E. Methods The bioptic liver tissues from 18 cases of patients with sporadic hepatitis E were observed under light and electron microscope. Results The total liver tissues showed the changes of acute hepatitis. Their pathological features were feathery degeneration, con- nective separation of hepatocytes, loss of villi and cholestasis of cholangioles. Furthmore, the heaptocytes with the nuclear condensation, dilation of rough endoreticula, loss of ribosomes and increase of lysosomes were surrounded, phagocytosed or fell into Disse's spaces. The lymphocytes there were stick - like granules in some of them embraced and attached the de- generate or necrotic hepatocytes. There were predominant inflammation in portal areas, presenting that mononuclear cells such as lymphocytes, plasmocytes and so on were extruded into the lobules. Conclusions There were a few histopatholo- gical characteristics in sporadic hepatitis E. The cell - mediated immune injury might be a main pathogenesis of hepatitis E.

关 键 词：散发性戊型肝炎 组织细胞学 戊型病毒型肝炎 肝脏 病理学 超微结构 HE 

分 类 号：R512.6[医药卫生—内科学]