Intracisternal hyalin in hepatocytes of human liver biopsies.

Abstract

In 3 liver biopsies (2 cirrhoses, 1 progressive not clearly definable liver damage) hepatocellular hyaline bodies were found which originate from the accumulation of proteinaceous material within dilated cisternas of rough endoplasmic reticulum. The staining properties and the fine structure of the inclusion substance were not identical in the 3 cases. In case I the PAS-reaction was positive, in cases II and III negative. The included material was rather homogeneous in cases I and III. In case II there was a peculiar pattern of irregulary arranged 400 A tubules. The variations of the accumulated material could be explained by the existence of different defects in the pathway of protein synthesis and secretion, as for example defective transportation, faulty coupling of carbohydrates, or synthesis of a false protein. Alternatively, if the intracisternal storage is caused in principle by only one of these mechanisms, one has to postulate variations of the specific point of attack. In either case the appearance of intracisternal hyalin should not be considered as specific for α1-antitrypsin deficiency, a condition in which the protein, lacking in the serum, is accumulated intracisternally like in our cases. In the cases reported there was always a positive PAS-reaction and never a tubular structure described. A classification of hepatocellular hyalin is proposed based on the different cytoplasmic compartments from which hyaline bodies can originate: 1. Hyaloplasmic hyalin (= alcoholic hyalin), 2. Mitochondrial hyalin (= giant mitochondria), 3. Intracisternal hyalin, 4. Lysosomal hyalin (=blood plasma inclusions or large autophagic vacuoles).