熱帯地域における各種急性肝障害の肝細胞病変を主とした病理組織学的特異性： 妊娠中毒症，肝炎ウイルス性劇症肝炎，黄熱，アフラトキシン中毒症の比較検討

Abstract

Histopathological findings of tropical acute liver diseases such as eclampsia, fulminant viral hepatitis, yellow fever, and aflatoxicosis are characteristic. In eclampsia, edema of liver tissue, sinusoidal dilatation and inflammatory exudate with Kupffer cell mobilization were seen. Liver cell cords were atrophic and showed irregular structures and pleomorphism of liver cell nuclei. Complicated and irregular pattern of degenerative or necrotic liver parenchyma in intermediate and outer zones of hepatic lobules were observed, while centrilobular areas were intact. Fulminant viral hepatitis showed irregular necrosis of liver parenchyma with inflammatory exudate and periportal bile duct proliferation. In contrast to other three diseases, lobular regenerative arrangements of remaining liver cell cords surrounded by necrotic or collapsed parenchyma were distinctive feature. Yellow fever showed zonal necrosis in intermediate zones of hepatic lobules. Centrilobular areas were relatively intact. Scattered acidophilic bodies of unicellular necrosis of liver cell were also seen in inconspicuous sinusoids. Inflammatory reaction of polymorphonuclear leukocytes was relatively slight. In aflatoxicosis, centrilobular necrotic changes of liver cells were prominent. Inflammatory exudate was slight. These results suggest that there are different kinds of etiological factors and mechanism to cause characteristic histological features of acute liver lesions in the tropics. Regenerative change is specific in viral hepatitis, while in other three diseases parenchymal lesions are primary changes.