What histopathologic features are typical of viral hepatitis?

• A. Interface activity with lymphocytic infiltrates, hepatocyte ballooning degeneration, and lobular disarray.
• B. Fatty change with Mallory bodies.
• C. Granulomatous inflammation.
• D. Bile duct proliferation only.

Answer: (A)

Viral hepatitis is driven by a cell-mediated immune response that targets infected hepatocytes, producing a distinctive pattern of hepatocellular injury. The hallmark is interface activity, with lymphocytes infiltrating at the limiting plate where the portal tract meets the liver parenchyma, often accompanied by hepatocyte damage. This injury manifests as hepatocyte ballooning degeneration, reflecting cytoplasmic swelling from cellular stress, and as lobular disarray from disrupted hepatic cords due to necrosis and repair. Together, these features illustrate active hepatocellular inflammation and injury characteristic of viral hepatitis. In contrast, fatty change with Mallory bodies points to alcoholic or metabolic steatohepatitis, granulomatous inflammation suggests granulomatous diseases or certain infections, and bile duct proliferation alone indicates chronic cholestasis or biliary disease rather than viral hepatitis.