case_images: PMC11052559_01
case_images: Clinical course. TDF, tenofovir disoproxil; HU, high urgency; VCI, vena cava inferior; MOF, multi-organ failure; ALT, alanine aminotransferase; INR, international normalized ratio.
case_images: crg-2024-0018-0001-538342_F01.jpg
case_images: PMC11052559_01_crg-2024-0018-0001-538342_F01.jpg
case_images: F1
case_images: The clinical course is depicted in Figure 1.
case_images: Macroscopy of the liver explant. A slice of the liver specimen with a nutmeg appearance.
case_images: crg-2024-0018-0001-538342_F02.jpg
case_images: PMC11052559_01_crg-2024-0018-0001-538342_F02.jpg
case_images: F2
case_images: The liver explant showed a mottled, nutmeg appearance without signs of nodularity (Fig. 2).
case_images: Microscopic findings of liver explant. Microscopic findings, using hematoxylin and eosin (H&E) stained tissue, showed the preserved architecture of the liver parenchyma, regularly areas of necrosis (areas with sinusoidal congestion and extravasation of blood cells; blue arrows) (a); areas with confluent necrosis (yellow dotted line) and portal inflammation (blue dotted line) (b); central perivenulitis (yellow arrow) and dropout of hepatocytes (red dotted line), congestion (blue arrows), and lymphoplasmacytic infiltrates (green arrows) (c); and the preserved architecture of the liver parenchyma, regularly areas of necrosis (areas with sinusoidal congestion and extravasation of blood cells; arrows) (d). e In addition, immunohistochemistry showed HBsAg-positive hepatocytes (arrows).
case_images: crg-2024-0018-0001-538342_F03.jpg
case_images: PMC11052559_01_crg-2024-0018-0001-538342_F03.jpg
case_images: F3
case_images: Histological findings (Fig. 3) showed confluent hepatocyte necrosis throughout the parenchyma, accompanied by moderate lobular infiltration and periportal ductular reaction.