Incidental findings on liver autopsy with specific emphasis on Hepatitis B

Jaya Ganesh,Vimal Chander,J Mahendran

doi:10.21276/apalm.1419

Jaya Ganesh, Vimal Chander + Show 1 more

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https://doi.org/10.21276/apalm.1419

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Abstract

Background: Silent liver disease is a major cause of morbidity and mortality in the population due to its silent progression to end stage liver disease without significant symptoms. These have to be detected at an earlier stage to reduce the morbidity. This study is aims at correlating the gross and microscopic morphology of 100 liver specimens obtained by autopsy and to correlate with the clinical parameters. Methods: 100 liver specimens obtained by the autopsy of 100 patients, who died of causes like road traffic accidents, poisoning etc. with no medical history during the period from 2007 to 2012, were taken for the study. Histological samples of liver specimens were stained with the routine heamatoxylin and eosin staining, along with special stains like PAS, Reticulin, Perl’s Prussian blue and Orcein staining. Result: The most common pathology was steatosis (25%) following normal histology (49%), which was followed by chronic venous congestion (12%), chronic hepatitis (6%), cirrhosis (4%), liver cell dysplasia (2%) and metastases (2%). These findings have been correlated with age, sex and special staining. Orcein staining identified ground-glass hepatocytes with detection of Hepatitis B surface antigen in a background of chronic hepatitis and cirrhosis, indication the most probable etiology of Hepatitis B. Conclusion: This study reiterates the unexpected higher prevalence of NASH among the younger generation and the importance of clinical autopsy in understanding the magnitude of clinically silent liver lesions, mainly Hepatitis B. DOI: 10.21276/APALM.1419

Highlights

Silent liver disorders, similar to disease processes in other organs of the body may be symptomatic or may not sometimes produce evident phenotypic features to aid in early diagnosis and treatment
To identify the pathology of viral hepatitis, especially hepatitis B using the special technique of Orcein staining and to associate its clinical implication in undiagnosed hepatitis B cases which pose a threat to the community
[4] Later, Bauer and Robbins have suggested that there exists a discrepancy between the clinical diagnosis and anatomical findings, all of which cumulatively suggest the indispensable nature of autopsy to clarify the clinical diagnosis to help in better disease detection and in treatment of the cases that follow.[5]

Summary

Introduction

Similar to disease processes in other organs of the body may be symptomatic or may not sometimes produce evident phenotypic features to aid in early diagnosis and treatment. Through this study we would like to study the presence of various diseases in the absence of clinical history by examining the gross and microscopic morphologies of liver specimens correlated with their age and sex prevalence obtained from the autopsy of 100 patients. Silent liver disease is a major cause of morbidity and mortality in the population due to its silent progression to end stage liver disease without significant symptoms. These have to be detected at an earlier stage to reduce the morbidity. This study is aims at correlating the gross and microscopic morphology of 100 liver specimens obtained by autopsy and to correlate with the clinical parameters

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Conclusion