Fulminant Hepatic Failure Attributed to Ackee Fruit Ingestion in a Patient with Sickle Cell Trait
Figure 2
Histologic sections from the explanted liver. (a) The portal tracts are close together separated by hemorrhagic areas with hepatocyte loss (H&E, ×20). (b) Trichrome stain highlights a portal tract (P), but pale areas of parenchymal collapse (arrows) are unstained (×100). (c) Hepatocytes with microvesicular steatosis and sickled red blood cells (H&E, ×200). (d) Ductular hepatocytes and inflammatory cells adjacent to an area with hepatocyte loss and sickled cells (H&E, ×200). (e) Periportal ductular hepatocytes in an area of confluent necrosis. Microvesicular steatosis (arrow) and sickled cells of varying ages (arrow heads) are also highlighted in this section (H&E, ×40). (f). Regenerating hepatocytes adjacent to an older area of parenchymal loss. Note multinucleated giant hepatocytes with cholestasis in a largely hypocellular background with some macrophages (H&E, ×200).
