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Hepatocellular Hyalin in Cholestasis and Cirrhosis: Its Diagnostic Significance

1973; Elsevier BV; Volume: 64; Issue: 1 Linguagem: Inglês

10.1016/s0016-5085(73)80095-2

1528-0012

Michael A. Gerber, William C. Orr, Helmut Denk, Fenton Schaffner, Hans Pópper,

Liver Disease Diagnosis and Treatment

Liver tissue of patients with various stages of alcoholic liver injury, with cholestatic liver diseases and with various types of cirrhosis, were examined for the presence of hyalin, mainly by light microscopy and, in selected instances, also by electron microscopy. Hyalin was detected in alcoholic liver disease and in prolonged cholestasis, mainly in primary biliary cirrhosis. It was not found in diseases in which cholestasis was of shorter duration and was predominantly central in location. Electron microscopically, hyalin was identical in alcoholic hepatitis and in primary biliary cirrhosis, although the pattern of injury of hepatocytic organelles was different in these diseases. A morphologic relation between hyalin and cholestasis or any other hepatocellular abnormalities could not be detected. Hyalin was also found in advanced nonalcoholic cirrhosis, in Wilson's disease, and in Indian childhood cirrhosis, and with the exception of the last, it was always associated with peripheral cholestasis. Centrolobular hyalin in specimens with intact lobular architecture is diagnostic for alcoholic liver injury. Peripheral hyalin in the absence of cirrhosis favors primary biliary cirrhosis over extrahepatic biliary obstruction. Hyalin throughout nodules in advanced cirrhosis does not necessarily indicate alcoholic liver disease, Wilson's disease, or Indian childhood cirrhosis, but also occurs in cryptogenic cirrhosis.