自身免疫性肝炎的肝组织病理学诊断

苗琪; 陈晓宇

doi:10.3969/j.issn.1001-5256.2020.04.003

自身免疫性肝炎的肝组织病理学诊断

DOI: 10.3969/j.issn.1001-5256.2020.04.003

苗琪,
陈晓宇

上海交通大学医学院附属仁济医院消化内科上海市消化疾病研究所

基金项目:

国家自然基金科学面上项目(81770563)；

详细信息

中图分类号: R575.1
计量
- 文章访问数: 1285
- HTML全文浏览量: 38
- PDF下载量: 358
- 被引次数: 0
出版历程
- 出版日期: 2020-04-20

Liver histopathological diagnosis of autoimmune hepatitis

Research funding:

摘要

摘要: 自身免疫性肝炎的肝组织病理学可表现各异,界面性肝炎伴淋巴-浆细胞浸润、"玫瑰花环"样结构及穿入现象是相对特征性表现,但非特异性。以上组织学表现需结合临床资料排除其他原因引起的肝炎才能诊断。主要阐述了自身免疫性肝炎的特征性组织学表现和特殊类型自身免疫性肝炎的组织学表现,讨论了组织学在自身免疫性肝炎的诊断与鉴别诊断中的价值。
- 肝炎,自身免疫性 /
- 病理学,临床 /
- 诊断
Abstract: Autoimmune hepatitis may have various liver histopathological manifestations,with interface hepatitis with lymphoplasmacytic infiltration,rosette formation,and emperipolesis as relatively characteristic manifestations,but they are not specific. The above histological manifestations should be combined with clinical data to exclude hepatitis caused by other reasons. This article mainly elaborates on the characteristic histological manifestations of AIH and the histological manifestations of special types of AIH and discusses the value of histology in the diagnosis and differential diagnosis of AIH.
- hepatitis,autoimmune /
- pathology,clinical /
- diagnosis

HTML全文

参考文献(23)

[1] MACK CL,ADAMS D,ASSIS DN,et al. Diagnosis and management of autoimmune hepatitis in adults and children:2019practice guidance and guidelines from the American Association for the study of liver diseases[J]. Hepatology,2019.[Epub ahead of print]

[2] WASHINGTON MK. Autoimmune liver disease:Overlap and outliers[J]. Mod Pathol,2007,20(Suppl 1):s15-s30.

[3] GUINDI M. Histology of autoimmune hepatitis and its variants[J]. Clin Liver Dis,2010,14(4):577-590.

[4] GLEESON D,HENEGHAN MA,British Society of Gastroenterology. British Society of Gastroenterology(BSG)guidelines for management of autoimmune hepatitis[J]. Gut,2011,60(12):1611-1629.

[5] BALITZER D,SHAFIZADEH N,PETERS MG,et al. Autoimmune hepatitis:Review of histologic features included in the simplified criteria proposed by the international autoimmune hepatitis group and proposal for new histologic criteria[J].Mod Pathol,2017,30(5):773-783.

[6] MIAO Q,BIAN Z,TANG R,et al. Emperipolesis mediated by CD8 T cells is a characteristic histopathologic feature of autoimmune hepatitis[J]. Clin Rev Allergy Immunol,2015,48(2-3):226-235.

[7] KLEINER DE,CHALASANI NP,LEE WM,et al. Hepatic histological findings in suspected drug-induced liver injury:Systematic evaluation and clinical associations[J]. Hepatology,2014,59(2):661-670.

[8] STRAVITZ RT,LEFKOWITCH JH,FONTANA RJ,et al. Autoimmune acute liver failure:Proposed clinical and histological criteria[J]. Hepatology,2011,53(2):517-526.

[9] TAKAHASHI A,ARINAGA-HINO T,OHIRA H,et al. Autoimmune hepatitis in Japan:Trends in a nationwide survey[J]. J Gastroenterol,2017,52(5):631-640.

[10] ZEN Y,NOTSUMATA K,TANAKA N,et al. Hepatic centrilobular zonal necrosis with positive antinuclear antibody:A unique subtype or early disease of autoimmune hepatitis?[J]. Hum Pathol,2007,38(11):1669-1675.

[11] AIZAWA Y,ABE H,SUGITA T,et al. Centrilobular zonal necrosis as a hallmark of a distinctive subtype of autoimmune hepatitis[J]. Eur J Gastroenterol Hepatol,2016,28(4):391-397.

[12] MEHENDIRATTA V,MITROO P,BOMBONATI A,et al. Serologic markers do not predict histologic severity or response to treatment in patients with autoimmune hepatitis[J]. Clin Gastroenterol Hepatol,2009,7(1):98-103.

[13] CHAZOUILLRES O,WENDUM D,SERFATY L,et al. Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome:Clinical features and response to therapy[J]. Hepatology,1998,28(2):296-301.

[14] NAKANUMA Y,ISHIZU Y,ZEN Y,et al. Histopathology of IgG4-related autoimmune hepatitis and IgG4-related hepatopathy in IgG4-related disease[J]. Semin Liver Dis,2016,36(3):229-241.

[15] ALVAREZ F,BERG PA,BIANCHI FB,et al. International Autoimmune Hepatitis Group Report:Review of criteria for diagnosis of autoimmune hepatitis[J]. J Hepatol,1999,31(5):929-938.

[16] HENNES EM,ZENIYA M,CZAJA AJ,et al. Simplified criteria for the diagnosis of autoimmune hepatitis[J]. Hepatology,2008,48(1):169-176.

[17] QIU D,WANG Q,WANG H,et al. Validation of the simplified criteria for diagnosis of autoimmune hepatitis in Chinese patients[J]. J Hepatol,2011,54(2):340-347.

[18] GURUNG A,ASSIS DN,MCCARTY TR,et al. Histologic features of autoimmune hepatitis:A critical appraisal[J]. Hum Pathol,2018,82:51-60.

[19] DELEMOS AS,FOUREAU DM,JACOBS C,et al. Drug-induced liver injury with autoimmune features[J]. Semin Liver Dis,2014,34(2):194-204.

[20] SUZUKI A,BRUNT EM,KLEINER DE,et al. The use of liver biopsy evaluation in discrimination of idiopathic autoimmune hepatitis versus drug-induced liver injury[J]. Hepatology,2011,54(3):931-939.

[21] HARADA K,HIEP NC,OHIRA H. Challenges and difficulties in pathological diagnosis of autoimmune hepatitis[J]. Hepatol Res,2017,47(10):963-971.

[22] GONZALEZ RS,WASHINGTON K. Primary biliary cholangitis and autoimmune hepatitis[J]. Surg Pathol Clin,2018,11(2):329-349.

[23] DHALIWAL HK,HOEROLDT BS,DUBE AK,et al. Longterm prognostic significance of persisting histological activity despite biochemical remission in autoimmune hepatitis[J].Am J Gastroenterol,2015,110(7):993-999.

施引文献

资源附件(0)

访问统计