Adenovirus hepatitis: Clinicopathologic analysis of 12 consecutive cases from a single institution

Kurt B. Schaberg, Neeraja Kambham, Richard K. Sibley, John P.T. Higgins

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Adenoviruses are common pathogens that usually cause self-limited infections. However, in the immunocompromised host they can cause severe infections involving multiple organs including the liver. A search of the pathology database at Stanford University Medical Center (1995 to 2016) identified 12 cases of adenovirus hepatitis including biopsy and autopsy specimens. There were 8 pediatric patients, 7 of which had received orthotropic liver transplants and 1 of which was receiving chemotherapy for lymphoblastic leukemia. There were 4 adult patients, of which 1 was actively receiving chemotherapy for chronic lymphocytic leukemia and 2 had undergone hematopoietic stem cell transplantation for hematologic malignancies. One patient had lymphoplasmacytic lymphoma and had received chemotherapy over a year prior but was not receiving therapy at the time he contracted adenovirus hepatitis. In all cases, histologic sections showed nonzonal coagulative hepatocyte necrosis and characteristic intranuclear inclusions. Hepatocyte necrosis ranged from spotty to massive. The majority of cases (7/12; 58%) had no associated inflammation. If present, inflammation was focal and lymphohistiocytic. In 1 case, findings were focal within the liver, requiring an imageguided biopsy. This patient underwent a simultaneous nontargeted liver biopsy that lacked histologic evidence of adenovirus. Among the pediatric patients, 63% (5/8) died secondary to organ failure, while there was 100% (4/4) mortality in the adult population.

Original languageEnglish (US)
Pages (from-to)810-819
Number of pages10
JournalAmerican Journal of Surgical Pathology
Volume41
Issue number6
DOIs
StatePublished - May 1 2017
Externally publishedYes

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Keywords

  • Adenoviral
  • Adenovirus
  • Liver transplantation
  • Opportunistic infection
  • Viral hepatitis

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

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