Has portal inflammation with interface activity and lobular inflammation bridging necrosis can cause a nodular appearance from low power mimicking bridging fibrosis or cirrhosis. This picture is unusual for the various conditions listed previouslywhen interface hepatitis is absent or mild aih is unlikely and care should be taken to prevent unnecessary therapy.
Lacks interface hepatitis and portal based fibrosis may have monomorphism and marked atypia of the infiltrating cells.
Interface hepatitis autoimmune hepatitis histology. Autoimmune hepatitis is a liver disease caused by cells from the immune system attacking and damaging the cells in the liver. Autoimmune hepatitis formerly called lupoid hepatitis is a chronic autoimmune disease of the liver that occurs when the bodys immune system attacks liver cells causing the liver to be inflamed. It may be identified as actual necrosis of cells or by irregularity of the limiting plates which is caused ioss hepatocytes and replacement with inflammatory cells andor fibrosis.
Laboratory studies show ele vated aminotransferase values hypergammaglobulinemia. Autoimmune hepatitis is a rare complication of thymoma. Active hepatitis with bridging necrosis.
Abundant plasma cells seen at higher power ll 400x. It happens to both women and men but it is three times more common in women. Especially in cases of fulminant autoimmune hepatitis both autoantibodies and igg elevation may be absent.
Piecemeal necrosis in liver aka interface hepatitis is necrosis of the limiting plates by inflammatory cells. Aih is char acterized by prominent interface hepatitis and varying degrees of lobular hepatitis. Pas without diastase shows interface hepatitis ur 200x.
In autoimmune hepatitis a lowmagnification image strongly suggests the diagnosis because of prominent interface and zone 1 lobular hepatitis fig. The simplified aih score evaluates interface hepatitis emperipolesis and rosetting all three being required for the diagnosis of aih typical. Common initial symptoms include fatigue or muscle aches or signs of acute liver inflammation including fever jaundice and right upper quadrant abdominal pain.
Geller md autoimmune hepatitis aih a chronic hepatic necroin flammatory disorder occurs mostly in women. Histology and the exclusion of more likely liver disease. Autoimmune hepatitis aih is an inflammatory liver disease affecting mainly females characterized by elevated transaminase and immunoglobulin g igg levels interface hepatitis on histology and positive autoantibodies whose profile allows its distinction into two types.
We present a 35 year old healthy male initially thought to have drug induced liver injury who was subsequently diagnosed with thymoma induced autoimmune hepatitis a rare syndrome of which only two previous cases have been reported. Pas with diastase shows intense inflammation of portal triad stroma with some reduplication of ductal epithelium. Piecemeal necrosis generally refers to a necrosis that occurs in fragments.
Expanded portal regions with dull edges suggestive of interface hepatitis ul 40x.