Lymphocyte subpopulations at the site of "piecemeal" necrosis in end stage chronic liver diseases and rejecting liver allografts in cyclosporine-treated patients.

Mononuclear cells in the areas of "piecemeal" necrosis in hepatic tissues from patients with different liver diseases were subtyped using monoclonal antibodies and the avidin-biotin-peroxidase complex method. T lymphocytes were the predominant infiltrating cell type in this lesion (greater than 75% of mononuclear cells) regardless of the etiology of the liver disease. M1-positive cells represented about 20% of the infiltrate. B cells were absent and rare Leu-7-positive cells (killer, natural killer) showed random tissue distribution in both the periportal areas and the parenchyma. In contrast, the T8+ (suppressor-cytotoxic) lymphocytes accumulated selectively in the areas of piecemeal necrosis, where the tissue T4/T8 ratios were consistently less than 1. T8+ lymphocytes were also more numerous than T4+ cells around the hepatitis B surface antigen-positive hepatocytes in piecemeal necrotic areas of livers from patients with hepatitis B surface antigen-positive chronic active hepatitis. In liver tissues of patients with primary biliary cirrhosis, alcoholic cirrhosis, chronic active hepatitis, and rejecting liver allografts, selective accumulations of T8+ lymphocytes at the sites of hepatocyte necrosis were a characteristic and uniform finding. This subpopulation of lymphocytes may be an important part of the immunologically mediated destruction of hepatocytes that occurs in chronic active liver diseases and is characterized by piecemeal necrosis.