Giant Cell Transformation of the Liver in Chronic Hepatitis with Confluent Lobular Collapse (Report of A Case)

Abstract

We present a case of diffuse giant cell transformation of the liver in an adult male patient with known chronic active hepatitis who recently developed confluent lobular collapse. The patient was a 41 year-old man with known chronic liver disease under close follow- up for 5 years, who was recently given 400 packs of unknown herb medicine for newly developed duodenal ulcer. Subsequently slow progressive abnormalities of liver function test developed. Hepatic needle biopsy showed considerably compromised lobular architectures by the features of chronic active hepatitis with superimposed multifocal lobular collapse and diffuse replacement of hepatocytes by multinucleated giant cells. Many giant cells showed intracytoplasmic accumulation of protein -bound copper pigments and canalicular cholestasis. A cytoplasmic mozaic pattern of stainability was partly related to the amount of glycogen in the liver. Chronic active hepatitis with multifocal lobular collapse seems to be another causative form of giant cell transformation of hepatocytes in adulthood, and this phenomenon is assumed to reflect reparative process of immature hepatocytes following lobular collape.