Alcoholic liver disease.

Full Abstract

Alcohol excess is associated with a spectrum of disease ranging from simple steatosis through steatohepatitis to cirrhosis and, in some, hepatocellular carcinoma. Alcoholic steatohepatitis itself has a variable histological picture, but a constant feature is the presence of ballooning degeneration of hepatocytes. Recent studies have emphasized the importance of apoptosis as a mechanism of cell death in this condition. It is accompanied by varying degrees of perivenular, centrilobular, and pericellular fibrosis. When severe and associated with perivenular liver cell necrosis (central sclerosing hyaline necrosis), there may be precirrhotic portal hypertension. The pattern of fibrosis may initially be diffuse with little nodule formation, but in time there is frequently the development of a micronodular cirrhosis. In approximately 15% of patients with established cirrhosis, hepatocellular carcinoma develops; several precursor lesions are now recognized which can be detected histologically. Several authors have drawn attention to additional components of the spectrum of alcoholic liver disease, including vascular changes, portal tract inflammation and fibrosis, ductular reaction, and iron overload. The morphology of alcoholic liver disease can be significantly affected by abstinence; furthermore, the clinical and morphological phenotype can be significantly influenced by the presence of comorbid conditions such as nonalcoholic fatty liver disease or viral hepatitis. Biopsy appearances can provide important prognostic information in alcoholic liver disease, and this review incorporates a proposed grading and staging schema for assessment of histological severity.

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Author information

Author/s: Yip, William W (WW); Burt, Alastair D (AD);

Affiliation: Department of Pathology, Alice Ho Miu Ling Nethersole Hospital, Tai Po, New Territories, Hong Kong.

Journal and publication information

Publication Type: Journal Article; Review

Journal: Seminars in diagnostic pathology (Semin Diagn Pathol), published in United States. (Language: eng)

Reference: -2006 Aug-Nov; vol 23 (issue 3-4) : pp 149-60

Dates: Created 2007/03/14; Completed 2007/04/05; Revised 2007/05/16;

PMID: 17355088, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Fatty Liver - pathology
Humans
Liver Diseases, Alcoholic - pathology

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