Pathological anatomy of hepatitis.

Abstract

The histopathological features of hepatitis have been studied in preparations of tissue obtained by needle biopsy in nonfatal cases and at autopsy in others. The nonfatal forms are classified as acute, persistent, or recurrent. The basic lesion is the result of the degeneration, necrosis, and disappearance of hepatic parenchymal cells; to this are added mononuclear cell increase, reticuloendothelial proliferation, and regenerative phenomena, which alter the lobular pattern but do not damage the reticular framework. Healing may be complete. The fatal forms include fulminant viral hepatitis, subchronic (subacute) atrophy, and posthepatitic cirrhosis. In these forms the destruction of parenchyma is followed by regenerative activity so varied in extent, duration, distribution, and intensity that a wide variety of lesions result. Collapsed lobules, eccentrically placed vessels, and gross deformity by regenerative nodules interfere with the normal flow of blood and result in an increased flow of lymph. The number of lymphatic vessels countable in the hepatoduodenal ligament increases, and their walls become dilated and hypertrophic. These and other types of circulatory disturbance probably contribute to the progression of the cirrhosis in the absence of further infection.