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Morphologic features of extrahepatic manifestations of hepatitis C virus infection.

Ko HM, Hernandez-Prera JC, Zhu H, Dikman SH, Sidhu HK, Ward SC, Thung SN - Clin. Dev. Immunol. (2012)

Bottom Line: The most documented of these entities is mixed cryoglobulinemia.Other HCV-associated entities include porphyria cutanea tarda, lichen planus, necrolytic acral erythema, membranous glomerulonephritis, diabetic nephropathy, B-cell non-Hodgkin lymphomas, insulin resistance, sialadenitis, sicca syndrome, and autoimmune thyroiditis.This paper highlights the histomorphologic features of these processes, which are typically characterized by chronic inflammation, immune complex deposition, and immunoproliferative disease in the affected organ.

View Article: PubMed Central - PubMed

Affiliation: The Lillian and Henry M. Stratton-Hans Popper Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029, USA. mabel.ko@mssm.edu

ABSTRACT
Cirrhosis and hepatocellular carcinoma are the prototypic complications of chronic hepatitis C virus infection in the liver. However, hepatitis C virus also affects a variety of other organs that may lead to significant morbidity and mortality. Extrahepatic manifestations of hepatitis C infection include a multitude of disease processes affecting the small vessels, skin, kidneys, salivary gland, eyes, thyroid, and immunologic system. The majority of these conditions are thought to be immune mediated. The most documented of these entities is mixed cryoglobulinemia. Morphologically, immune complex depositions can be identified in small vessels and glomerular capillary walls, leading to leukoclastic vasculitis in the skin and membranoproliferative glomerulonephritis in the kidney. Other HCV-associated entities include porphyria cutanea tarda, lichen planus, necrolytic acral erythema, membranous glomerulonephritis, diabetic nephropathy, B-cell non-Hodgkin lymphomas, insulin resistance, sialadenitis, sicca syndrome, and autoimmune thyroiditis. This paper highlights the histomorphologic features of these processes, which are typically characterized by chronic inflammation, immune complex deposition, and immunoproliferative disease in the affected organ.

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Lichen planus: there is a band-like infiltrate of lymphocytes at the epidermal-dermal junction with damage to the basal cell layer and pigment incontinence. The epidermis has a saw-toothed appearance (hematoxylin-eosin, original magnification ×200).
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fig7: Lichen planus: there is a band-like infiltrate of lymphocytes at the epidermal-dermal junction with damage to the basal cell layer and pigment incontinence. The epidermis has a saw-toothed appearance (hematoxylin-eosin, original magnification ×200).

Mentions: Lichen planus (LP) is a relatively common inflammatory skin disease in the general population and is thought to be related to autoimmunity [28]. The relationship between HCV infection and LP is controversial; however, literature analysis has found that, in most studies, the proportion of HCV-positive patients is higher in the LP group compared to the general population with the prevalence of HCV ranging from 16% to 55% and 1-2%, respectively [5, 29–31]. HCV-related LP lesions are similar to those of classic LP with the exception of oral involvement, which also occurs in the majority of HCV-related LP. Histologically, LP is characterized by band-like, subepidermal, lymphohistiocytic infiltrate with interface change, “sawtooth” rete ridges, and pigmentary continence (Figure 7) [9].


Morphologic features of extrahepatic manifestations of hepatitis C virus infection.

Ko HM, Hernandez-Prera JC, Zhu H, Dikman SH, Sidhu HK, Ward SC, Thung SN - Clin. Dev. Immunol. (2012)

Lichen planus: there is a band-like infiltrate of lymphocytes at the epidermal-dermal junction with damage to the basal cell layer and pigment incontinence. The epidermis has a saw-toothed appearance (hematoxylin-eosin, original magnification ×200).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3420144&req=5

fig7: Lichen planus: there is a band-like infiltrate of lymphocytes at the epidermal-dermal junction with damage to the basal cell layer and pigment incontinence. The epidermis has a saw-toothed appearance (hematoxylin-eosin, original magnification ×200).
Mentions: Lichen planus (LP) is a relatively common inflammatory skin disease in the general population and is thought to be related to autoimmunity [28]. The relationship between HCV infection and LP is controversial; however, literature analysis has found that, in most studies, the proportion of HCV-positive patients is higher in the LP group compared to the general population with the prevalence of HCV ranging from 16% to 55% and 1-2%, respectively [5, 29–31]. HCV-related LP lesions are similar to those of classic LP with the exception of oral involvement, which also occurs in the majority of HCV-related LP. Histologically, LP is characterized by band-like, subepidermal, lymphohistiocytic infiltrate with interface change, “sawtooth” rete ridges, and pigmentary continence (Figure 7) [9].

Bottom Line: The most documented of these entities is mixed cryoglobulinemia.Other HCV-associated entities include porphyria cutanea tarda, lichen planus, necrolytic acral erythema, membranous glomerulonephritis, diabetic nephropathy, B-cell non-Hodgkin lymphomas, insulin resistance, sialadenitis, sicca syndrome, and autoimmune thyroiditis.This paper highlights the histomorphologic features of these processes, which are typically characterized by chronic inflammation, immune complex deposition, and immunoproliferative disease in the affected organ.

View Article: PubMed Central - PubMed

Affiliation: The Lillian and Henry M. Stratton-Hans Popper Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029, USA. mabel.ko@mssm.edu

ABSTRACT
Cirrhosis and hepatocellular carcinoma are the prototypic complications of chronic hepatitis C virus infection in the liver. However, hepatitis C virus also affects a variety of other organs that may lead to significant morbidity and mortality. Extrahepatic manifestations of hepatitis C infection include a multitude of disease processes affecting the small vessels, skin, kidneys, salivary gland, eyes, thyroid, and immunologic system. The majority of these conditions are thought to be immune mediated. The most documented of these entities is mixed cryoglobulinemia. Morphologically, immune complex depositions can be identified in small vessels and glomerular capillary walls, leading to leukoclastic vasculitis in the skin and membranoproliferative glomerulonephritis in the kidney. Other HCV-associated entities include porphyria cutanea tarda, lichen planus, necrolytic acral erythema, membranous glomerulonephritis, diabetic nephropathy, B-cell non-Hodgkin lymphomas, insulin resistance, sialadenitis, sicca syndrome, and autoimmune thyroiditis. This paper highlights the histomorphologic features of these processes, which are typically characterized by chronic inflammation, immune complex deposition, and immunoproliferative disease in the affected organ.

Show MeSH
Related in: MedlinePlus