Hepatitis mononucleosa

Elevated LAP values are found predominantly in biliary and cholestatic diseases - in accordance with AP. In liver diseases due to alcohol abuse, LAP values are exhibited both more frequently and with higher values than AP. In hepatitis mononucleosa, LAP is generally also more clearly elevated than AP. Significant increases in LAP are found in pancreatic and breast cancer as well as in collagenoses of the vascular type. LAP is not found in bone there is no evidence of elevated LAP in bone diseases. Normal LAP in connection with an increase in AP consequently rules out hepatobiliary diseases and requires further investigation. In these cases, parallel determination of AP and LAP is advisable. 

In the portal fields, plasmacellular and lymphocytic infiltrates prevail. However, they are also present in the liver parenchyma, arranged linearly inside the sinusoids, which is why this finding can indeed be mistaken for hepatitis mononucleosa. There are no granulocytic components. 

Fig. 23.1 Agglomeration of activated Kupffer cells (partially beaded), especially in the sinusoidal vessels, with single-cell necrosis. Clinical diagnosis hepatitis mononucleosa (HE)...

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