Human liver biopsy in P. falciparum and P. vivax malaria. A light and electron microscopy study.

Liver biopsy, in one patient with P. falciparum and in five patients with P. vivax malaria revealed non-specific hepatocellular damage chracterized by pathologic changes of the endoplasmic reticulum and mitochondria. Also the sinusoidal pole of hepatic cells was altered mainly by depletion of microvilli and/or distortion and swelling of the endothelial cells. Von Kupffer cells were hyperplastic and hypertrophic and exhibited considerable phagocytic activity for both parasitized and non-parasitized erythrocytes. It is believed that the altered sinusoidal pole causes a deficient exchange between the hepatic cells and the blood stream.

Clumped parasitized and non-parasitized erythrocytes were frequently observed in the sinusoids, a finding that could be interpreted as the manifestation of a disturbed coagulation process and/or an immunological mechanism in progress. This local circulatory disturbance is only part of a more general pathogenetic mechanism through which hepatocellular hypoxemic damage would be produced.

Full text article: https://link.springer.com/article/10.1007/BF00555648