Diffuse liver injury in amebic abscess of the liver: An electron microscopic study

Liver biopsies of eight patients with amebic abscess of the liver were studied by light and electron microscopy. In four patients, they were repeated on complete clinical recovery, after specific antiamebic treatment. Ligh-microscopic changes were nonspecific and suggested diffuse parenchymal injury in some biopsy specimens. The ultrastructural changes in the hepatocytes were consistent in all patients. These consisted of dilatation of endoplasmic reticulum, vesicle formation and fragmentation, reduction in microsomes, and mitochondrial abnormalities in addition to other associated changes. Many cells showed features of regenerative activity. These changes are similar to those reported in patients with the nonsuppurative form of disease ( Tandon, Tandon, and Puri, 1974) in which group they were less severe and suggestive of more active regeneration. The changes were reversed on treatment. These observations suggest that nonsuppurative hepatic amebiasis is a distinct pathologic entity even though the light microscopic changes by themselves are not specific.