A 28-year-old woman presents with acute hepatitis, Coombs-negative haemolytic anaemia, neuropsychiatric symptoms, and Kayser-Fleischer rings. Serum ceruloplasmin is 8 mg/dL (low). Which of the following features on liver histology is most characteristic of Wilson's disease?
- A Ground-glass inclusions representing HBsAg
- B Rosette formation with lymphoplasmacytic infiltrate
- C Glycogenated nuclei in hepatocytes with steatosis and periportal copper deposition ✓
- D Mallory-Denk bodies with zone 3 necrosis
Correct answer: C. Glycogenated nuclei in hepatocytes with steatosis and periportal copper deposition
Explanation
Wilson's disease liver histology characteristically shows glycogenated hepatocyte nuclei (swollen, pale nuclei due to glycogen accumulation), macrovesicular steatosis, and variable degrees of fibrosis, with copper deposition demonstrable by rhodanine or orcein stains. Ground-glass inclusions are characteristic of chronic HBV. Rosette formation with lymphoplasmacytic infiltrate is seen in autoimmune hepatitis. Mallory-Denk bodies with zone 3 necrosis is the pattern of alcoholic hepatitis.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.