case_images: PMC1299324_01
case_images: Intracytoplasmic inclusions with ground-glass appearance affecting most of the hepatocytes in this area. Mononuclear inflammatory infiltrate in a portal area is also seen. Hematoxylin-eosin, x40. Inset: Higher magnification of this area, (H&E, x200).
case_images: 1471-230X-5-36-1.jpg
case_images: PMC1299324_01_1471-230X-5-36-1.jpg
case_images: F1
case_images: However, the most remarkable finding was the presence of abundant intracytoplasmic, sharply bordered, pale eosinophilic inclusions that exhibited a ground-glass appearance (Figure 1).
case_images: Strong and diffuse immunohistochemical positivity of the inclusions for fibrinogen, x40. Inset: Same area with higher magnification. (x200).
case_images: 1471-230X-5-36-2.jpg
case_images: PMC1299324_01_1471-230X-5-36-2.jpg
case_images: F2
case_images: Diffuse and strong positivity was observed for fibrinogen in cytoplasmic inclusions (Figure 2).
case_images: On ultrastructure, inclusions appear as finely granular, homogeneous material bounded by membranes (arrows). x4400
case_images: 1471-230X-5-36-3.jpg
case_images: PMC1299324_01_1471-230X-5-36-3.jpg
case_images: F3
case_images: Ultrastructurally, the inclusions were found to be moderately electron-dense, finely granular, homogenous bodies that are encircled by membranes, corresponding to a dilated endoplasmic reticulum (Figure 3).
case_images: In the second biopsy, inclusions and chronic hepatitic changes are dramatically reduced, (H&E, x200).
case_images: 1471-230X-5-36-4.jpg
case_images: PMC1299324_01_1471-230X-5-36-4.jpg
case_images: F4
case_images: Parenchymal and portal inflammation, steatosis and necroinflammatory activity were remarkably reduced in the second liver biopsy (Figure 4).