Checkpoint inhibitor-induced hepatotoxicity: Role of liver biopsy and management approach

Figure 1 Pathological changes of drug-induced liver injury -induced by atezolizumab used for treatment of hepatocellular carcinoma (H&E 40×). A: Portal inflammation and interfase hepatitis; B: Focal lobular necrosis; C: Frequent lobular acidophilic bodies; D: Ductal damage and migration of inflammatory cells into ductal epithelium; E: Hepatocyte rosettes as a result of liver regeneration; F: Hepatocanalicular cholestasis and biliary plugs.

Figure 2 Proposal algorithm on the role of liver biopsy in immunological checkpoint inhibitors –induced drug-induced liver injury. ICIs: Immunological checkpoint inhibitors.