Liver cell rosettes: structural differences in cholestasis and hepatitis

Abstract

ABSTRACT— Cholestatic and hepatitic liver cell rosettes, gland‐like formations found respectively in chronic cholestasis and in chronic active hepatitis, represent structural modifications of liver cell plates in response to injury. Differences in cytokeratin expression, ultrastructure and three‐dimensional (3‐D) configuration have been investigated. Cholestatic rosettes are considered to be a form of biliary metaplasia of hepatocytes, linking with newly‐formed bile ductules in adjacent septa and probably providing some protection from injury caused by abnormal bile constituents. Hepatitis rosettes, by contrast, are a form of liver cell regeneration developing in isolated surviving hepatocytes or small groups of hepatocytes within areas of collapse.

HBcAg and HBsAg expression in ductular cells in chronic hepatitis B

“…The detection of HBsAg in "ductular hepato-cytes" has been deemed to be further proof of their dual nature, giving support to the stem cell theory (14). According to other studies, ductular formation occurs as a result of biliary modulation of liver cell plates (8, 16,17,20,25,26), while keratin seems to represent one of the earliest appearing ductular markers during the phenotypic shift (27). The gradual tubulization of hepatic cords and the presence of keratin-positive hepatocytes with no other phenotypic alteration, not only at the periphery but also deep in acinar zone 1 and within cirrhotic nodules, favor the metaplastic process.…”

“…Atypical ductules appear in a variety of liver diseases (15,16) and their histogenetic origin is still controversial. Part of their population consists of intermediate cells bearing immunohistochemical and ultrastructural features of both biliary and hepatic cells (17)(18)(19)(20). Similar to "biliary hepatocytes" are the bipotential "oval cells" in rats which have been observed during carcinogenesis (21,22) and are considered by some investigators to be facultative stem cells (23,24).…”

Anatomy, pathophysiology and basic mechanisms of disease

“…These rosettes express some keratins characteristic of biliary epithelium, and by three-dimensional reconstruction they are found to communicate with small bile ducts and ductules. 385 They are thus thought to be an adaptive mechanism to chronic cholestasis.…”

Freshwater clam extract supplement‐induced acute cholestasis

“…A previous report described how, instead of the normal arrangement of two or three more hepatocytes around a small bile canaliculus, the number of cells is increased. The lumen of the canaliculus is enlarged considerably . The lumens of the rosettes might then engender the formation of ductular structures.…”

“…The lumen of the canaliculus is enlarged considerably. 5 The lumens of the rosettes might then engender the formation of ductular structures. These false bile ductule features are expected to be different for every cell around the pericentral zone.…”