Necrotic hepatocytes

Single-cell necrosis Necrotic hepatocytes are found both as groups and in isolation. Initially, they either form small patches or are disseminated throughout the liver. The reticular fibres at first remain, but are later removed. 

Lobular inflammation Whereas lobular, diffusely distributed inflammation is more evident, in acute hepatitis portal and periportal inflammation predominates in chronic hepatitis and lobular hepatitis is less pronounced. Generally, it consists of separate small clusters of mononuclear cells. Scattered necrotic hepatocytes (= acidophilic / Councilman bodies) are found the hepatocellular nuclei are in disarray (= anisonucleosis) there is swelling of the hepatocytes, and mitoses are present. Marked lobular hepatitis in conjunction with considerable portal and periportal inflammation is typical of flares of chronic viral hepatitis or autoimmune hepatitis. In addition to single-cell necroses, there are confluent necroses, which affect entire lobules. Bridging necroses link portal tracts with other portal tracts or with terminal venules, (l)... 

Figure 4. Liver of rat intubated with DNUA-HLA. Pyknosis and fragmentation of necrotic hepatocytes. Hematoxylin and eosin, x500. (Reproduced with permission from Ref. 32. Copyright 1979, Geron-X Inc.)...

As shown in Figure 36.9a, with synthetic AZA-1, the liver showed changes similar to those seen with the natural compound, seen in Figure 36.1 (a and b), namely, fatty degeneration and sporadic necrotized hepatocytes. The small intestine erosion and characteristic changes of late recovery at lamina propria were confirmed (Figure 36.9a-i and ii). 

With use of the isomer, the liver showed fatty degeneration, but necrotized hepatocytes were seen at the central area (Figure 36.9b-liver), and the injury to the small intestine was unclear. (Figure 36.9b). 

Microscopic lesions include swollen and necrotic hepatocytes, hepatocyte vac-uolation, periportal flbrosis, occasional bile duct proliferation, renal tubular necrosis, hemoglobin casts in renal tubules, arxl excessive fragmented erythrocytes in t)ie spleen. 

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