Pathological diagnosis of autoimmune hepatitis

Autoimmune hepatitis （AIH） is an immune-mediated inflammatory disease of the liver parenchyma， which is characterized by hypergammaglobulinemia， the presence of autoantibodies， and typical abnormalities in liver histology； however， the diverse clinical manifestations of AIH and the lack of specific serological markers have brought difficulties and challenges in the diagnosis of AIH. Although portal lymphoplasmacytic infiltration， interface hepatitis， lymphocyte emperipolesis， and hepatocyte rosettes are the typical histological features of AIH， many other histological features can also be observed in AIH， including centrilobular necrosis and Kupffer cell hyaline globules. Therefore， no single histological feature can be used for the diagnosis of AIH， and a confirmed diagnosis should be made with reference to clinical and laboratory examinations， with the exclusion of liver diseases due to other causes. This article summarizes the histological features of AIH， different histopathological spectrum， common clinical issues， differential diagnosis， and recent advances.