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Differential Diagnosis of Ground-Glass Inclusions Within Hepatocytes

Purpose: To consider possible causes for a ground-glass appearance to the cytoplasm of hepatocytes.

Description

A number of conditions can cause the cytoplasm of hepatocytes to have a "ground-glass" appearance. The cytoplasm of the hepatocytes show homogeneous areas that are weakly eosinophilic after H & E staining, sometimes with a finely granular appearance. The areas may resemble an inclusion but are actually pseudo-inclusions.


Cause

Features

chronic viral hepatitis B

positive orcein stain; positive immunostain for HBV

Lafora disease

clinical myoclonus epilepsy; PAS positive, diastase sensitive; positive on colloidal iron and other stains

cyanamide therapy (to reduce alcohol abuse)

history of alcohol abuse; PAS positive. diastase resistant

chemotherapy for acute leukemia

history, exclusion of other causes

therapy with other drugs

history, exclusion of other causes

following liver or other transplantation

PAS positive, diastase sensitive (probable polyglucosan bodies)

Type IV glycogenosis

PAS positive, diastase sensitive

fibrinogen accumulation

positive immunostain for fibrinogen

 

Electron microscopy can help to distinguish the different types of inclusions if necessary.

 


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Specialty

Objective

ICD-10