RCPA Examinations in Anatomical pathology - Questions ... - Rcpa.tv

Case 10: Male 4 days old –
neonatal liver failure and death
• MICROSCOPIC
• The hepatic architecture appears to have been intact with normal central vein - portal
tract relationships. Geographic areas of acute hepatocellular necrosis n
with very little
inflammation are present. Within the areas of necrosis there are e degenerate cells
with eosinophilic nuclear inclusions and marginated chromatin. These inclusions
appear to be viral in nature. Cytoplasmic inclusions are unable e to be identified and
the nuclei do not appear to the markedly enlarged.
• Comment
• The viral inclusions are consistent with herpes virus infection and
immunohistochemistry for HSV 1 and HSV 2 as well as PCR for herpes es virus 1 and
herpes virus 2 will be undertaken to confirm the nature of the virus. v
The morphology
of the infected cells is not typical for cytomegalovirus and the necrosis and the type
of cells infected are not typical for parvovirus B 19 however immunohistochemistry
munohistochemistry
and PCR can also be undertaken to exclude these diagnoses.
• SUMMARY
• Liver: Herpes simplex virus infection.