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Ground-glass hepatocellular inclusions are associated with polypharmacy
Hsiang-Chih Lu 1 , Iván A González 1 , Kathleen Byrnes 2
Affiliations
Affiliations
1
Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, United States of America.
2
Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, United States of America. Electronic address: [email protected].
PMID: 33836412 DOI: 10.1016/j.anndiagpath.2021.151740
Abstract
Ground-glass (GG) hepatocytes are classically associated with chronic hepatitis B (HBV) infection, storage disorders, or cyanamide therapy. In a subset of cases, an exact etiology cannot be identified. In this study, we sought to characterize the clinical, histological, and ultrastructural findings associated with HBV-negative GG hepatocytes. Our institutional laboratory information system was searched from 2000 to 2019 for all cases of ground-glass hepatocytes. Ten liver biopsies with GG hepatocellular inclusions and negative HBV serology, no known history of storage disorders, or cyanamide therapy were reviewed. Half of the patients had history of organ transplantation and/or malignancy. These patients took on average 8.1 medications (range: 3-14) with the most common medications being immunosuppressive and health supplements. Histologically, GG hepatocytes show either peri-portal or centrizonal distribution. The inclusions are PAS-positive and diastase sensitive. Electron microscopy showed intracytoplasmic granular inclusions with low electron density, consistent with unstructured glycogen. In summary, GG hepatocytes are a rare finding in liver biopsies, but are more common in patients with hepatitis B. They can also be seen in HBV-negative patients who have polypharmacy. In these cases, they are the result of unstructured glycogen accumulation putatively due to altered cell metabolism.
Keywords: Cellular inclusions; Drug-induced liver injury; Glycogen; Liver glycogen; Polypharmacy.
Copyright © 2021 Elsevier Inc. All rights reserved. |
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