Photomicrographs of liver biopsy and bone marrow aspirate. (A) High-power photomicrograph of liver biopsy; the field shows a perivenular zone with canalicular cholestasis (arrowheads), vacuolar degeneration of hepatocytes, and prominent neutrophils and Kupffer cells, many of the latter containing protoporphyrin aggregates (arrows). Tissue was stained with hematoxylin and eosin and was examined through a Plan 40 ×/0.65 numerical objective lens, using an Olympus BX50 microscope fitted with an Olympus C-4040 digital camera (Olympus, Melville, NY). Images were acquired using Adobe Photoshop 5.0.2 (Adobe Systems, San Jose, CA). (B) Fluorescence microscopy of bone marrow aspirate showing intense red autofluorescence, indicating the presence of protoporphyrin in the cytoplasm of erythroid precursor cells and erythrocytes. Bone marrow smears were mounted in Vectashield (Alpha Laboratories, Eastleigh Hampshire, United Kingdom), and photomicrographs were taken with a Zeiss Axioplan microscope (Carl Zeiss, Welwyn Garden City, United Kingdom) using a tetramethylrhodamine isothiocyanate filter at 200 × total magnification using a 20 ×/0.50 objective lens.