A 38-year-old patient with full-blown jaundice, small cutaneous hemorrhages, general weakness and loss of appetite underwent puncture biopsy of liver. Histological examination revealed disseminated dystrophy, hepatocyte necrosis, Councilman's bodies. Lobule periphery has signs of significant infiltration by lymphocytes, there are also individual multinuclear hepatocytes. What is the most probable diagnosis?

Answer options

1. Acute alcoholic hepatitis
2. Toxic degeneration of liver
3. Acute viral hepatitis
4. Chronic hepatitis
5. Miliary hepatic cirrhosis

Explanation

The morphological changes in acute viral hepatitis are virtually the same regardless of the causative agent and can be mimicked by drug reactions. Histologically, hepatocellular injury reveals hydropic and ballooning degeneration of hepatocytes, necrosis of certain cells, and the presence of Kunselman's bodies. Portal and lobular stroma are also infiltrated mostly with lymphocytes and macrophages as well as with a small number of polymorphonuclear lymphocytes.