Amiodarone-induced reversible and irreversible hepatotoxicity: two case reports

Fig. 1. a Computed tomographic scan shows diffuse high attenuation of the liver parenchyma (96 Hounsfield units). b Massive ascites and splenomegaly were found, in addition to diffuse high attenuation of the liver parenchyma. c Regenerative nodules and well-developed bridging fibrosis were observed (hematoxylin and eosin stain, magnification × 20), as were marked neutrophilic infiltration, a remarkable amount of Mallory bodies (arrowheads), and ballooned hepatocytes (arrow) (hematoxylin and eosin stain, magnification × 200). d Numerous whorled or lamellar inclusions in lysosomes were detected by electron microscopy

Fig. 2. a Computed tomogram shows diffuse high attenuation of the liver parenchyma (120 Hounsfield units). b Distinct collagen deposition is seen in the periportal, perivenular, and pericellular locations, which formed bridging fibrosis (Azan stain, magnification × 100). There were numerous Mallory bodies (arrowheads) as well as hepatocellular ballooning (arrows) and mild macrovesicular and microvesicular fatty changes. Mild lymphocytic and neutrophilic infiltration was also observed (hematoxylin and eosin stain, magnification × 400). c After discontinuation of amiodarone, the patient’s liver density dramatically improved to a normal level (45 Hounsfield units) during the course of 9 months