Viral Hepatitis
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jun 7, 2007; 13(21): 2918-2922
Published online Jun 7, 2007. doi: 10.3748/wjg.v13.i21.2918
Ultrastructure of oval cells in children with chronic hepatitis B, with special emphasis on the stage of liver fibrosis: The first pediatric study
Maria Elzbieta Sobaniec-Lotowska, Joanna Maria Lotowska, Dariusz Marek Lebensztejn
Maria Elzbieta Sobaniec-Lotowska, Department of Clinical Pathomorphology, Medical University of Bialystok, Poland
Joanna Maria Lotowska, Department of Clinical Pathomorphology, Medical University of Bialystok, Poland
Dariusz Marek Lebensztejn, IIIrd Department of Pediatrics, Medical University of Bialystok, Poland
Author contributions: All authors contributed equally to the work.
Correspondence to: Professor Maria E Sobaniec-Lotowska, Department of Clinical Pathomorphology, Medical University of Bialystok, Waszyngtona 13 Street, 15-269 Bialystok, Poland. mariasl@zeus.amb.edu.pl
Telephone: +48-85-7485940 Fax: +48-85-7485990
Received: December 12, 2006
Revised: December 30, 2006
Accepted: January 14, 2007
Published online: June 7, 2007
Abstract

AIM: To investigate the ultrastructure of oval cells in children with chronic hepatitis B, with special emphasis on their location in areas of collagen fibroplasia.

METHODS: Morphological investigations were conducted on biopsy material obtained from 40 children, aged 3-16 years with chronic hepatitis B. The stage of fibrosis was assessed histologically using the arbitrary semiquantitative numerical scoring system proposed by Ishak et al. The material for ultrastructural investigation was fixed in glutaraldehyde and paraformaldehyde and processed for transmission–electron microscopic analysis.

RESULTS: Ultrastructural examination of biopsy specimens obtained from children with chronic hepatitis B showed the presence of two types of oval cells, the hepatic progenitor cells and intermediate hepatic-like cells. These cells were present in the parenchyma and were seen most commonly in areas of intense periportal fibrosis (at least stage 2 according to Ishak et al) and in the vicinity of the limiting plate of the lobule. The activated nonparenchymal hepatic cells, i.e. transformed hepatic stellate cells and Kupffer cells were seen in close proximity to the intermediate hepatic-like cells.

CONCLUSION: We found a distinct relationship between the prevalence of oval cells (hepatic progenitor cells and intermediate hepatocyte-like cells) and fibrosis stage in pediatric patients with chronic hepatitis B.

Keywords: Pediatric patients; Oval cells; Ultrastructural study; Chronic hepatitis B; Liver biopsy; Fibrosis