Three-dimensional image analysis of the hepatic restructuring process in chronic active hepatitis.
OBJECTIVE
To elucidate the process of hepatic restructuring in the course of chronic hepatitis from a morphologic viewpoint.


METHODS
The three-dimensional (3-D) liver structure was investigated by computer-aided reconstruction in five cases (one autopsy and four surgical cases) of chronic active hepatitis (type C), including early to late stages of restructuring.


RESULTS
Our 3-D reconstruction revealed the following. At an early stage, portal and periportal inflammation and fibrosis widened the portal tracts, giving rise to the formation of portal-to-portal and portal-to-hepatic venous connections, although most central veins were still located at an almost normal site in the hepatic lobules. In a middle stage, bridging fibrosis developed to create a network of interstitium where the central veins were rather decreased in number, with regenerative nodules multiplying in the parenchyma. At the late stage, the lobular structure was destroyed, and the parenchyma consisted uniformly of regenerative nodules, with remaining but rearranged lobules among them.


CONCLUSIONS
The above changes of liver structure suggest that in cirrhogenesis from chronic hepatitis, a combination of nodular regeneration and formation of an interstitial network come to replace the normal lobular structure, hastening the development of liver cirrhosis.
Sakata
A
A
Department of Pathology, Jikei University School of Medicine, Tokyo, Japan.
Takasaki
S
S
Kawakami
M
M
D000328:Adult; D005260:Female; D019698:Hepatitis C, Chronic / Q000473:pathology*; D006801:Humans; D019044:Image Cytometry / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008103:Liver Cirrhosis / Q000209:etiology* / Q000473:pathology; D008115:Liver Regeneration; D008297:Male; D008875:Middle Aged