坏死后肝硬化.PPTVIP

Liver 1 Viral hepatitis 2 Alcoholic liver disease 3 Liver cirrhosis 4 Primary carcinoma of liver Zhu keqing 竺可青 Pathology Department Zhejiang University School of Medicine 2014-12-1 1 Viral hepatitis 肝炎病毒 肝实质细胞变性坏死 The Hepatitis Viruses Hepatitis A Virus B Virus C Virus D Virus E Virus G Virus* Agent Icosahedral capsid, ssRNA Enveloped dsDNA Enveloped ssRNA Enveloped ssRNA Unenveloped ssRNA ssRNA virus Transmission Fecal-oral Parenteral; close contact Parenteral; close contact Parenteral; close contact Waterborne Parenteral Incubation period 2-6 wk 4-26 wk 2-26 wk 4-7 wk 2-8 wk Unknown Carrier state None 0.1-1.0% of blood donors in U.S. and Western world 0.2-1.0% of blood donors in U.S. and Western world 1-10% in drug addicts and hemophiliacs Unknown 1-2% of blood donors in U.S. Chronic hepatitis None 5-10% of acute infections 50% 5% coinfection, 80% upon superinfection None None Hepatocellular carcinoma No Yes Yes No increase above HBV Unknown, but unlikely Clinicopathologic Syndromes  Acute asymptomatic infection with recovery: serologic evidence only Acute symptomatic hepatitis with recovery: anicteric or icteric 黄疸 Chronic hepatitis: without or with progression to cirrhosis Fulminant hepatitis: with massive to submassive hepatic necrosis Basic pathological change Degeneration Ballooning change Fatty change,steatosis Acidophilic Necrosis Acidophilic body/councilman body/apoptosis Spotty necrosis Piecemeal necrosis Bridging necrosis Submassive necrosis/ massive necrosis Inflammatory cell infiltration Proliferation Liver cell Kupffer cells underg