Autoimmune Hepatitis: Histopathology
Autoimmune Hepatitis: Histopathology
Autoimmune Hepatitis: Histopathology
021 1211
This table has been adapted with permission from Biopsy Interpreta-
tion of the Liver, 2nd ed.
12
*Steatosis is particularly seen with genotype 3 hepatitis C virus.
Bile duct injury is rarely seen in AIH but is characteristic of AIC.
11
0 5 no change, 15 minimal or mild change, 115 moderate
change, 1115 marked change.
TABLE 3 Key Histopathology Features of AIH
1. Liver biopsy shows a moderate to severe necroinflammatory process with
prominent portal inflammation, interface hepatitis, a lymphoplasmacytic
infiltrate including many plasma cells, and acinar transformation of
hepatocytes (rosettes).
2. Plasma cells are not always the dominant inflammatory cells and may be
prominent only at the interface.
3. Fibrosis/cirrhosis is often seen on first biopsy.
4. It may present as acute, fulminant liver failure with massive or submassive
necrosis, including centrilobular (zone 3) necrosis.
5. Autoimmune liver disease variants may show features of more than one
immune disorder (overlap syndromes).
6. AIC is a distinct disorder histologically resembling PBC (without anti-
mitochondrial antibodies in serum and with anti-nuclear antibodies).
R E V I E W Autoimmune Hepatitis Histopathology Geller
22 Clinical Liver Disease, Vol 3, No 2, February 2014 An Official Learning Resource of AASLD
and the developing nodules vary greatly in size. Dysplastic
nodules can be seen, as can small hepatocellular carcinomas.
Key features of AIH are summarized in Table 3. n
CORRESPONDENCE
Stephen A. Geller, M.D., Department of Pathology and Laboratory Medicine,
Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065.
E-mail: stg2013@med.cornell.edu.
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23 Clinical Liver Disease, Vol 3, No 2, February 2014 An Official Learning Resource of AASLD