Pathology Education: Gastrointestinal

Gastrointestinal Pathology for Medical II Students

Lab 3g Alcoholic hepatitis with Early Cirrhosis (56000-48500-E5512)

These sections were taken from a patient with chronic alcoholic liver disease.

Slide 1 The hepatic architecture is disturbed by portal and sinusoidal (pericellular) fibrosis. Some of the fibrous bands are just beginning to link-up to circumscribe nodules of hepatic parenchyma. This patient not only has very early cirrhosis but also acute alcoholic hepatitis.
Slide 2 Shows portal fibrosis (f) and sinusoidal fibrosis (sf). The latter may be especially common in the livers of patients with severe alcoholic and non-alcoholic types of steatohepatitis.
Slide 3 Shows prominent pericellular fibrosis (individual and small clusters of hepatocytes completely surrounded by fibrous tissue). This sinusoidal or pericellular fibrosis is usually most severe in centrilobular regions and is a common feature of alcoholic hepatitis. Note that many of the hepatocytes contain Mallory bodies.
Slide 4 Mallory bodies (arrow) appear as violaceous, ropy, hyaline inclusions located in the perinuclear region of the cytoplasm of the hepatocytes. They are composed of degenerated intermediate (cytokeratin) filaments of the cytoskeleton of the liver cells. Mallory bodies are chemotactic for neutrophils, and polymorphonuclear inflammation is characteristic of alcoholic hepatitis. As a matter of fact, some investigators feel that enzymes released by polymorphonuclear leukocytes may be responsible for the pericellular fibrosis seen in alcoholic liver disease. You will remember that the inflammation in acute viral hepatitis, on the other hand, is predominantly mononuclear.

Digital Legends for Labs/Cases
Lab 1
1.a | 1.b | 1.c | 1.d | 1.e | 1.f | 1.g | 1.h | 1.i | 1.j | 1.k | 1.l | 1.m
Lab 2
2.a | 2.b | 2.c | 2.d | 2.e | 2.f | 2.g | 2.h | 2.i | 2.j | 2.k | 2.l | 2.m
Lab 3
3.a | 3.b | 3.c | 3.d | 3.e | 3.f | 3.g | 3.h | 3.i | 3.j | 3.k | 3.l

Updated January 8, 2009