Interesting Case of the Month - (IGHP, ICOM) - August
august 2024
Clinical History-
45-year-old maleunderwent DDLT presented with rising liver enzymes about a week post-transplant. Non responsive to pulse dose of steroids.
USG Examination: Coarse hepatomegaly 23.2 cm. Enlarged necrotic pre and paraaortic lymph nodes.
LFT: Total Bill 5.6 / 2.6 mg/ dl SGOT 2590IU/ l SGPT 1966IU/ L SAP: 128IU/ L, Albumin -3.59, TLC 16600, INR-1.012
From the images below identify the likely disease?
Microscopic Images-
Histology showing large areas of necrosis f widespread well demarcated and punched out necrosis. The viable hepatocytes at the necrotic rim show nuclear clearing, peripheral margination of chromatin and nuclear molding. Few hepatocytes show multinucleation with similar nuclear changes.
Special Stains-
MT stain showed no significant increase in fibrosis.
Immunohistochemistry-
IHC performed for HSV and C4d. C4d is negative
