Piecemeal necrosis of the liver is thought to lead to liver cell necrosis. However the process does not lead to necrosis but rather lead to gradual progressive piecemeal removal of liver cell cytoplasm by T lymphocytes which are sensitized to antigens presented on the liver cell surface to form the immunologic synapse. The cytoplasm is taken up by the T cell and digested by the lysosome in the lymphocyte. By this mechanism the liver cell gradually disappears like the Cheshire cat in Alice in Wonderland.
Keywords: Autoimmunity; Immunologic synapse; Necrosis.
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