Adult-onset herpes simplex virus hepatitis with diffuse myofibroblastic transformation of hepatic stellate cells (Ito cells) in non-necrotic areas.
The myofibroblastic transformation of hepatic stellate cells (HSC; also known as Ito cells) usually occurs following necrosis of adjacent liver cells. No report has previously found that such a transformation occurs in herpes simplex virus (HSV) hepatitis. We present an autopsy case of HSV hepatitis with myofibroblastic transformation of HSC that is different from the usual transformation of HSC. The patient was a 66-year-old woman who had received various therapies for cutaneous T-cell lymphoma. An autopsy revealed submassive hepatic necrosis with hemorrhage due to HSV hepatitis. HSV infection was confirmed by DNA in situ hybridization in liver tissue. Immunohistochemical staining for alpha-smooth muscle actin (ASMA) showed a strong positive reaction in almost all of the HSC in non-necrotic areas. However, in necrotic areas, the HSC were completely negative for ASMA. These findings indicate that not only liver cells but also HSC can become necrotic in HSV hepatitis. In contrast, in non-necrotic areas, almost all of the HSC showed active transformation to myofibroblasts.
Toi
M
M
First Department of Pathology, Kochi Medical School, Kochi, Japan. mtoi@med.kochi-ms.ac.jp
Kuroda
N
N
Tao
L
L
Jin
Y
Y
Guo
L
L
Miyazaki
E
E
Hayashi
Y
Y
Hiroi
M
M
Komatsu
N
N
Nakata
H
H
Ogata
K
K
Enzan
H
H
D000199:Actins / Q000378:metabolism; D000368:Aged; D005260:Female; D005347:Fibroblasts / Q000473:pathology*; D006525:Hepatitis, Viral, Human / Q000378:metabolism / Q000473:pathology* / Q000821:virology*; D006561:Herpes Simplex; D006801:Humans; D007150:Immunohistochemistry; D008099:Liver / Q000378:metabolism / Q000473:pathology* / Q000648:ultrastructure; D009130:Muscle, Smooth / Q000378:metabolism / Q000473:pathology*; D009336:Necrosis
D000199:Actins