Liver and intrahepatic bile ducts-nontumor
Viral hepatitis
Adenovirus hepatitis

Author: Abul Ala Syed Rifat Mannan, M.D. (see Authors page)
Editor: Songyang Yuan, M.D., Ph.D.

Revised: 10 November 2015, last major update November 2015

Copyright: (c) 2003-2015,, Inc.

PubMed Search: Adenovirus hepatitis [title]
Cite this page: Adenovirus hepatitis. website. Accessed October 22nd, 2017.
Definition / general
  • Adenovirus is major cause of morbidity and mortality in immunocompromised patients, and may result in severe diseases, such as pneumonia, nephritis, hepatitis, encephalitis, pancreatitis or disseminated disease
  • In patients with allogenic hematopoietic stem cell transplantation (HSCT), adenovirus is the third most common viral infection, after herpes simplex and cytomegalovirus (Arch Pathol Lab Med 2003;127:e246)
  • In HSCT recipients, adenovirus infection can result in fulminant hepatitis / fulminant hepatic failure (Intern Med 2006;45:975, Intern Med 2012;51:405)
Case reports
Microscopic (histologic) description
  • Adenovirus hepatitis is characterized by small or large areas of coagulative necrosis, with no particular zonal distribution (Arch Pathol Lab Med 2003;127:e246)
  • Inflammatory response is usually sparse or absent
  • Intranuclear viral inclusions are characterized by smudgy appearance and chromatin margination
  • May have random areas of bland coagulative necrosis
  • Nuclear inclusions are either large and basophilic or bubbly and vesicular, with smudgy nuclei and chromatin margination
  • Adenovirus immunostaining is important for confirming the diagnosis, particularly because of high incidence of coinfection with other viruses (especially herpes simplex and cytomegalovirus) in transplant recipients (Bone Marrow Transplant 2000;26:1333)
Microscopic (histologic) images

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Case of the Week #354, adenovirus immunostain (last two images)

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Adenovirus stains