Hematoxylineosin (HE)
stain,
reticular fiber stain, Masson's
stain and Perl's
iron stain were used to assess liver biopsies from 31 patients with
hemochromatosis. The Ishak scoring system and Deugnier scoring system were used to assess the histological change in liver and to semi-quantify the excess of hepatic
iron. Genetic testing results were received from a portion of the patients and used in analysis.
RESULTS: One patient had hereditary (-HFE)
hemochromatosis complicated with
Gilbert's syndrome, for which the pattern of
iron deposition was similar to that of the four patients with
Gilbert's syndrome.
Iron accumulation appeared as fine granules predominating at the biliary pole of cells and was distributed throughout the lobule with a decreasing gradient spanning from the periportal to centrolobular areas. Mild chronic
inflammation was found to be commonly associated with low stage
fibrosis.One patient had HFE
hemochromatosis complicated with
hepatitis B virus infection, and the pattern of
iron deposition resembled that in the eight patients with viral
hepatitis, wherein the deposition was mainly in the sinusoidal cells and/or portal macrophages. Histological grading and
fibrosis staging differed among patients. The five patients with blood disordered showed
iron accumulation mainly in the periportal hepatocytes, but mesenchymal
iron deposits were also present. The grade of
inflammation, as well as of
fibrosis,was mild. The five patients with alcoholic disease and the five patients with
drug-induced hepatitis showed hepatic
iron deposition in swollen or ballooned hepatocytes. The two patients with excessive
iron supply showed
iron deposition localized within the parenchymal and mesenchymal cells.
CONCLUSION: