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What is "Groundglass hepatocytes" are seen in which of the following viral hepatitis? and explain in detail?
Ans. b (Hepatitis B) (Ref Robbins 7th/899; TABLE 18-7)Robbins 7th/B99HBV HISTOLOGY# HBV infected hepatocytes may exhibit a cytoplasm packed with spheres and tubules of HBsAg, producing a finely granular eosinophilic cytoplasm (GROUNDGLASS HEPATOCYTES).Key Morphologic Features of Viral HepatitisAcute Hepatitis (Enlarged. reddened liver: greenish if cholestatic)Parenchymal changes:Regenerative changes:Hepatocyte injury: swelling (ballooning degeneration)- hepatocyte proliferationCholestasis: canalicular bile plugs- Sinusoidal cell reactive changesHCV: mild focal fatty change of hepatocytes- Accum of phagocytosed debris in Kupffer cellsHepatocyte necrosis: isolated cells or clusters- Influx of mononuclear cells into sinusoidsCytolysis (rupture) or apoptosis (shrinkage)- Portal tracts: Inflammation: pred mononuclearIf severe: bridging necrosis (portal-portal, central-central, portal-central)- Inflammatory spillover into adj parenchymaLobular disarray: loss of normal architecture- hepatocyte necrosisChronic Hepatitis- Changes shared with acute hepatitis: Hepatocyte injury, necrosis, and regeneration- Sinusoidal cell reactive changes; Portal tracts:- Inflammation: Confined to portal tracts, or Spillover into adjacent parenchyma, with necrosis of hepatocytes (interface hepatitis); Bridging inflammation and necrosis- Fibrosis: Portal deposition, or Portal and periportal deposition, or Formation of bridging fibrous septa- HBV: "ground-glass" hepatocytes ; "sanded" nuclei- HCV: bile duct epithelial cell proliferation, lymphoid aggregate formation; Cirrhosis: The end-stage outcome