A 35-year-old woman presents with fatigue, jaundice, and elevated transaminases. ANA is 1:640 positive. Viral markers are negative. Liver biopsy shows extensive interface hepatitis with plasma cells and hepatocyte rosettes. Which of the following is the most characteristic histological feature supporting the diagnosis of autoimmune hepatitis in this patient?

• A Microvesicular steatosis
• B Mallory-Denk bodies
• C Granulomatous bile duct destruction
• D Interface hepatitis with plasma cells ✓

Explanation

Interface hepatitis, characterized by a dense plasma cell infiltrate at the portal-parenchymal border and hepatocyte rosettes, is the hallmark histological finding in autoimmune hepatitis. Microvesicular steatosis is typical of acute fatty liver of pregnancy or drug toxicity. Mallory-Denk bodies are characteristic of alcoholic steatohepatitis. Granulomatous bile duct destruction is the typical feature of primary biliary cholangitis.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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