Chronic steatohepatitis in liver fine-needle aspiration biopsy: the pathomorphology of activity and reparative processes


  • V.A. Tumanskiy
  • S.V. Fen
  • L.M. Tumanskaya
Keywords: steatohepatitis, pathomorphology, reparative processes, liver biopsy.

Abstract

Purpose of the work - to characterize the possibilities of pathomorphological determination in liver fine-needle aspiration biopsy activities of chronic steatohepatitis of various origins and directionality of reparative processes. The liver examined of 160 patients with alcoholic steatohepatitis (ASH), 123 patients with nonalcoholic steatohepatitis (NASH), 30 patients with chronic viral hepatitis C, and 30 hepatobiopsy patients who did not suffer from steatohepatitis, using histological, histochemical and immunohistochemical methods. It was established that the pathomorphological parameters of the activity of ASH and NASH is an increase in the severity and prevalence of hepatocyte steatosis of the liver; an increase in the number of hepatocytes with Mallory-Denk bodies and balloon hepatocytes; intensification of steatonecrosis, balloon lysis, apoptosis and hepatocyte ferroptosis; an increase in the number and expansion of foci of steatonecrosis in the liver; distribution of focal and diffuse leukocyte-lymphocytic infiltration of the liver lobules. The genesis of steatohepatitis (alcoholic, non-alcoholic, viral) is specified only with the relevant clinical and laboratory data of the patient. The peculiarities of the reparative processes in the liver are: the differentiation of progenitor liver cells through intermediate hepatobiliary and hepatocyte-like cells into hepatocytes in the presence of laminin in the hepatic lobules; early development of pericellular fibrosis and delayed activation of the ductular reaction with increased portal and bridge portal-portal fibrosis; the final fibrosis is micronodular cirrhosis of the perisinusoidal-pericellular or portal-Z1-3perisinusoidal type. Thus, in an adequate liver fine-needle aspiration biopsy, it is possible to determine the activity of NASH and ASH (or its absence), the type and severity of liver fibrosis, as well as the severity and direction of reparative processes in the liver.

Author Biographies

V.A. Tumanskiy

Tumanskiy V. A., MD, PhD, DSc, Professor of the Department of Pathologic Anatomy and Forensic Medicine, Zaporizhzhia State Medical University, Honorary Scientist and Engineering Worker of Ukraine.

S.V. Fen

Fen’ S.V., Assistant of the Department of Pathological Anatomy and Forensic Medicine, Zaporozhye State Medical University, Ukraine.

L.M. Tumanskaya

Tumanskaya L.M., PhD, Associate Professor of the Department of Pathologic Anatomy and Forensic Medicine, Zaporizhzhia State Medical University.

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Published
2019-07-03
How to Cite
Tumanskiy, V., Fen, S., & Tumanskaya, L. (2019). Chronic steatohepatitis in liver fine-needle aspiration biopsy: the pathomorphology of activity and reparative processes. Reports of Vinnytsia National Medical University, 23(1), 46-53. https://doi.org/https://doi.org/10.31393/reports-vnmedical-2019-23(1)-07