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Pathology

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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

  • 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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