TY - JOUR T1 - Granular cells as a marker of early amiodarone hepatotoxicity: a pathological and analytical study. JF - Journal of Clinical Pathology JO - J Clin Pathol SP - 418 LP - 423 DO - 10.1136/jcp.40.4.418 VL - 40 IS - 4 AU - N A Shepherd AU - A M Dawson AU - P R Crocker AU - D A Levison Y1 - 1987/04/01 UR - http://jcp.bmj.com/content/40/4/418.abstract N2 - Two contrasting cases of amiodarone hepatotoxicity are described. In one, perivenular collections of swollen cells, probably macrophages, with granular cytoplasm in an otherwise nearly normal liver were observed. Transmission electron microscopy showed that the cytoplasmic granularity was due to lysosomal bodies of various sizes. X-ray energy and wavelength spectroscopic analysis showed a high iodine content in these lysosomal bodies, good presumptive evidence of the presence of amiodarone or one of its metabolites. In the second case there was a micronodular cirrhosis, and similar granular cells also containing iodine were seen in the fibrous connective tissue. These cases seem to represent the very early and late stages of amiodarone hepatotoxicity. In a patient taking this drug aggregates of swollen granular cells may be a sensitive and histopathologically useful marker of early amiodarone toxicity. ER -