بسم الله الرحمن الرحيم. Noushin Afshar Moghaddam , M.D Associate Professor of Medicine Pathology Department Isfahan University of Medical Sciences. Fatty liver. Steatosis.
بسم الله الرحمن الرحيم
Associate Professor of Medicine
Isfahan University of Medical Sciences
Steatosis (fatty liver, fatty change) corresponds to accumulation of triglycerides in the cytoplasm of hepatocytes. It is a frequent finding and represents a manifestation of reversible cell injury
Acute fatty liver of pregnancy. Detail of lobular parenchyma characterized by microvesicular steatosis and a small number of lymphocytes. (H&E)
The causes are multiple.
NASH with Fibrosis
Histological section of a murine liver showing severe steatosis. The clear vacuoles would have contained lipid in the living cells, however the histological fixation caused it to be dissolved and hence only empty spaces remain
Deficiency of glucose-6-phosphatase results in accumulation of glycogen in hepatocytes. The liver is enlarged. The hepatocytes are swollen and a mosaic histological pattern with compression of the sinusoids is seen. Macro- and/or microvesicular steatosis can be present
Alcoholic steatohepatitis with neutrophilic acute hepatitis
macrovesicular steatosis and ballooning
inclusions of variable size and shape. It composed of
hyperphosphorylated CK (7, 18, 19) together with
Ubiquitin heat shock protein.
Source: Ibdah 2003
Steatohepatitis:Some hepatocyte nuclei show glycogen vacuolation
periportalhepatic steatosis, as may be seen due to steroid
use. Trichrome stain
Source: Ibdah 2003
Micrograph of inflamed fatty liver (steatohepatitis)
Pericellular collagen and Mallory bodies (asterisks) in ballooned hepatocytes are stained blue. Chromotrope Aniline Blue stain.
(zone 3) sinusoidal fibrosis, typical of alcoholic
Steatohepatitis with cirrhosis.
Grading and staging the histopathologic
Lesions of NASH
Staging Fibrosis in NASH
(related to obesity and insulin resistance)
(post bypass surgery, drugs, and toxins)
Hit 1: ? Insulin resistance, endotoxins, …
Hit 2: ? Oxidative stress, …
Hit 3: ? Oxidative stress, …
May loose fat