PMC7367179_01
Summary of the patient progress after the diagnosis with chronic myeloid leukemia.
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F1
However, retrial of nilotinib after one month of drug holiday caused liver enzymes to rise more rapidly (Figure 1). Prednisolone treatment (30 mg daily) was started and caused rapid normalization of liver enzyme levels (Figure 1).
(A) Hematoxylin and eosin-stained section (Original magnification X100). Solid-lined square focuses on the centrilobular architecture and dot-lined square depicts the portal triad. (B) CD8 stain (Original magnification X200). (C) CD56 stain (Original magnification X200). (D) CD38 and HLA-DR staining results of intrahepatic CD8+ T cells.
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F2
Percutaneous needle liver biopsy on the second day showed extensive centrilobular infiltration of immune cells and destruction of the lobular architecture (solid-lined square) with minimal inflammation in the portal triad (dot-lined square; Figure 2A). CD8 showed that numerous CD8+ T cells were in contact with dying hepatocytes (Figure 2B). CD56 staining demonstrated that many CD56+ cells, including natural killer (NK) cells, also infiltrated the site of inflammation (arrowheads; Figure 2C). Multicolor fluorescence-activated cell-sorting analysis using liver biopsy specimens revealed that a considerable number of intrahepatic CD8+ T cells in the patient (42.4%) showed an activated phenotype (CD38+ HLA-DR+) compared with those in the healthy liver (8.9%; Figure 2D).