PMC6098865_01
Time-course of liver function studies. The x-axis spans from Day 0 (day of admission and cessation of crizotinib therapy) to Day 79.
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fig1
The AST showed immediate improvement, peaking on the first day of admission (Figure 1). All liver chemistries had normalized at follow-up 79 days after admission (Figure 1).
(a) H&E-stained histologic section of the liver biopsy demonstrating severe acute hepatitis characterized by a panlobular mixed inflammatory infiltrate with extensive hepatocyte necrosis (200x magnification). (b) H&E-stained histologic section of the liver biopsy demonstrating bridging parenchymal necrosis (red arrow) and cholestasis (black arrow) (200x magnification). (c) Periodic acid-Schiff stained histologic section of the liver biopsy with diastase pretreatment highlighting numerous ceroid pigment-laden macrophages (red arrow) (200x magnification). (d) Reticulin-stained histologic section of the liver biopsy demonstrating areas of parenchymal collapse (red arrow) and regenerative thickening of the hepatocyte plates (black arrow) (100x magnification).
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fig2
Histologic sections of the liver biopsy were notable for a predominantly lymphohistiocytic panlobular inflammatory infiltrate accompanied by swaths of parenchymal dropout (Figures 2(a) and 2(b)). Periodic acid-Schiff (PAS) stain with diastase pretreatment drew attention to the ceroid pigment-laden Kupffer cells indicative of the significant hepatocyte death that must have preceded this biopsy (Figure 2(c)). Reticulin and trichrome stains highlighted areas of hepatocyte loss and parenchymal collapse (Figure 2(d)).