Acute Hepatitis

Hepatocyte injury: swelling (ballooning degeneration)

Cholestasis: canalicular bile plugs

HCV: mild focal fatty change of hepatocytes

Hepatocyte necrosis: isolated cells or clusters

Cytolysis (rupture) or apoptosis forming Councilman bodies
If severe: bridging necrosis (portal-portal, central-central, portal-central)

Lobular disarray: loss of normal architecture

Regenerative changes: hepatocyte proliferation

Sinusoidal cell reactive changes:
Accumulation of phagocytosed cellular debris in Kupffer cells
Influx of mononuclear cells into sinusoids

Portal tracts:

Inflammation: 1)predominantly mononuclear
2)Inflammatory spillover into adjacent parenchyma, with hepatocyte necrosis.

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