Liver & Gall Bladder
The term “piecemeal necrosis” refers to which one of the following abnormalities of liver? (AIIMS May 2014)
|A||Congo red-positive extracellular deposits surrounding necrotic hepatocytes in acinar zone 1|
|B||Destruction of the limiting plate with necrosis of hepatocytes surrounding the portal triad.|
|C||Fibrosis around the central hepatic veins with apoptosis of adjacent hepatocytes|
|D||Random necrosis of individual or small clusters of hepatocytes in acinar zone 3|
a. Chronic hepatitis has been defined clinically as an inflammatory process of the liver that lasts longer than 6 months.
b. Chronic hepatitis was classified histologically into chronic active hepatitis and chronic persistent hepatitis.
c. In chronic active hepatitis, an intense inflammatory reaction with numerous plasma cells spreads from portal tracts into periportal areas.
d. The reaction destroys the limiting plate and causes necrosis of the hepatocytes surrounding the portal triad.
e. This histologic change is called “piecemeal necrosis” or “interface hepatitis.” Chronic persistent hepatitis was differentiated from chronic active hepatitis by the fact that the portal inflammation did not extend into the periportal areas; that is, there was no piecemeal necrosis.
f. In contrast to destruction of the limiting plate, Congo red—positive extracellular deposits surrounding hepatocytes are diagnostic for amyloidosis; fibrosis around central hepatic veins suggests alcoholic liver disease; and apoptosis of hepatocytes suggests viral hepatitis.