[Cholestasis, hepatitis, peliosis--morphological substrate and clinical aspects of anabolic-induced liver damage].
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Biomedical subjects
Publications and source records attributed to G Roschlau.
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A hepatitis with bridging necrosis following dihydralazine therapy has been diagnosed bioptically in 20 cases, preferably in women. The duration of drug intake ranged from 2 weeks to 11 months. A relapse following drug re-exposure occurred in 3 cases, one of them had the fifth relapse within 10 years. Histologic features were centrolobular confluent necrosis with inflammatory infiltration in the adjacent liver parenchyma. The periportal parenchyma showed no or slight alteration. The knowledge of the hepatitis with bridging necrosis is important in order to avoid misdiagnosis as chronic or cirrhotic liver processes. 2 cases had been misdiagnosed as extrahepatic obstruction and were laparotomised. After drug withdrawal the liver damage was reversible and had no tendency to a chronic course even in severe cases.
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A case of alpha1-antitrypsin deficiency with liver cirrhosis bioptically diagnosed is described. The 49 year old woman had a decreased serum-level of alpha1-antitrypsin and characteristic, PAS-positive, diastase-resistant conclusions in the cytoplasma of the liver cells. An emphysema of the lungs was not seen.
Two cases of multiple nodular hyperplasia of liver in patients with intake or oral contraceptives for several years are described. In one case the tumours appeared simultaneously, in the other case succesively. Macroscopically the nodular hyperplasia was misdiagnosed as metastasis. Microscopially the nodes presented an intense inflammatory infiltration of the septa, in one case with tuberculoid granulomas. The lesions showed a marked vascularity. Extremely dilated sinusoids could be seen in the needle biopsy of the macroscopically unchanged liver, a phenomenon occasionally seen in cases treated with oral contraceptives.
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