Pathology
Steatosis is usual, most frequently macrovesicular, and there may be cirrhosis. The hepatitis is characterised by:
- ballooning and necrosis of hepatocytes:
- mainly in zone 3, near the central veins
- hepatocellular damage results in retention of secretory proteins and water, causing the cells to swell
- Mallory bodies:
- due to disorganisation of the cytoskeleton by alcohol or acetaldehyde
- also seen in Wilson's disease and primary biliary cirrhosis
- inflammatory infiltrate:
- polymorphonuclear leukocytic infiltrate
- polymorphonuclear leukocytic infiltrate
- pericellular and perivenular fibrosis:
- attributed to the transformation of Ito cells to fibroblasts
- fibrous septae may eventually form between contiguous perivenular areas and between hepatic veins and portal tracts
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