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Review
. 2016 Aug;65(8):1080-6.
doi: 10.1016/j.metabol.2015.11.008. Epub 2015 Dec 2.

Histopathology of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis

Gregory Thomas Brown  1 , David E Kleiner  2
Affiliations
Review

Histopathology of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis

Gregory Thomas Brown et al. Metabolism. 2016 Aug.

Abstract

Nonalcoholic fatty liver disease (NAFLD) is the liver injury most often associated with disorders of insulin resistance, including obesity, diabetes and the metabolic syndrome. The term encompasses several patterns of liver injury, including a relatively benign condition of steatosis without hepatocellular injury, nonalcoholic steatohepatitis (NASH), and a pattern of zone 1 steatosis, inflammation and fibrosis mainly observed in prepubertal children. Staging and grading systems have been developed to characterize the histological changes in NAFLD, mainly as a tool for clinical research. The histological features of NAFLD across these different manifestations and the scoring systems used to evaluate disease severity are discussed.

Keywords: Histology; Liver biopsy; Steatohepatitis; Steatosis.

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Conflict of interest statement

Conflicts of Interest: The authors have no financial conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Liver biopsy of Non-Alcoholic Steatohepatitis (NASH). A) Histologic features of NASH include steatosis, ballooning, and lobular inflammation. In severe cases such as this, balloon cells are readily identified. H&E, 4×. B) Zone 1 steatosis in NASH demonstrating variability in the distribution pattern. H&E, 4×
Figure 2
Figure 2
Histologic features commonly seen in NASH. A) Steatosis, 10×. B) Balloon cells. Note wispy cytoplasmic elements. 40×. C) Mallory-Denk bodies (arrow), 60×, cropped. D) Megamitochondria (arrowhead) in a cell with microvesicular steatosis. 60×, cropped. E. Lipogranuloma, 60×. F. Glycogen nuclei, 60×.
Figure 3
Figure 3
Peri-sinusoidal fibrosis in NASH. Masson’s Trichrome, 10× (A) and 20× (B).
See this image and copyright information in PMC

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