These cases also illustrate the role of the pathologist in diagnosis and treatment and the role of the autopsy in determining the cause of death. A 52 year old male was investigated for fatigue of several months duration. On physical examination the liver had a firm edge. He was positive for hepatitis B surface antigen and negative for hepatitis A and C antibodies. Piecemeal necrosis at edge of portal tract.
Lymphocytes invade the limiting plate and surround and destroy hepatocytes.
Collagen fibers extend from portal tract and surround periportal hepatocytes. Fibrous septa with no cirrhosis. Numerous hepatocytes with ground glass cytoplasm. Abundant hepatitis B surface antigen in cytoplasm of hepatocytes. Abundant hepatitis B core antigen within hepatocyte nuclei.