Diphenhydramine as a Cause of Drug-Induced Liver Injury

Figure 2

On Hematoxylin and Eosin stain (100x and 400x), there is centrilobular and bridging necrosis accompanied by portal and lobular inflammation including eosinophils and plasma cells. There is evidence of cholestasis and bile duct injury is noted in some portal tracts. Hepatocellular injury, that is, hepatocyte ballooning degeneration, is also present. Fibrosis is absent on Trichrome staining. There is no evidence of steatosis, glycogenic nuclei, Mallory’s hyaline, or copper deposition. Overall, these findings favor a diagnosis of drug-induced liver injury.

(a) Liver biopsy sample at 100x magnification

(b) Liver biopsy sample at 400x magnification