Fig. 1

a Low-power magnification of a biopsy specimen from 8 months prior to presentation shows chronic hepatitis with mild steatosis, and mild portal and lobular inflammation. b High-power magnification of specimen in (a) demonstrates the component of steatohepatitis, composed of areas of steatosis, ballooned hepatocytes, and lobular inflammation. c and d Diagnostic core needle biopsy performed one week before liver transplantation shows hepatocytes with positive immunohistochemical nuclear staining for hepatitis B virus core antigen (c) and positive immunohistochemical cytoplasmic staining for hepatitis B virus surface antigen (d). Arrows in (c) and (d) indicate examples of positive immunohistochemical staining. Immunohistochemistry for hepatitis B virus surface antigen was negative on a liver biopsy specimen obtained 8 months prior to presentation (not shown). e Core needle biopsy performed 1 week before liver transplantation shows severe hepatitis with bridging and confluent necrosis, marked inflammation, and ductular reaction. f High-magnification view of liver explant specimen shows confluent necrosis and bridging necrosis with bile ductular reaction and cholestasis