Elsevier Pathology

Anatomic Pathology: Liver Pathology

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277) The liver biopsy specimen demonstrating abnormal centrilobular hepatocytes shown in the image was obtained from an adult patient. Which of the following conditions does this patient MOST likely have?

• Postinfantile giant cell transformation (PIGCT) is a rare histologic finding in adult liver tissue (in contrast to multinucleated giant hepatocytes in a neonatal liver biopsy specimen, which is a frequent change).

• The major histologic differential diagnosis of PIGCT includes autoimmune hepatitis and HCV infection with or without HIV coinfection. Other possible causes include drug hepatotoxicity and, less commonly, primary sclerosing cholangitis.

• PIGCT affects only centrilobular hepatocytes.

• In chronic hepatitis C, the prevalence of PIGCT is slightly more than 2% of cases (see Devaney et al.).

Devaney K, Goodman ZD, Ishak KG: Postinfantile giant-cell transformation in hepatitis. Hepatology 1992;16(2):327-333.

Micchelli ST, Thomas D, Boitnott JK, et al: Hepatic giant cells in hepatitis C virus (HCV) mono-infection and HCV/HIV co-infection. J Clin Pathol 2008;61(9):1058-1061.

Moreno A, Moreno A, Pérez-Elías MJ, et al: Syncytial giant cell hepatitis in human immunodeficiency virus-infected patients with chronic hepatitis C: 2 cases and review of the literature. Hum Pathol 2006;37(10):1344-1349.

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