8. Alcoholic hepatitis

As of spring 2020 this topic is not part of the curriculum, so you shouldn’t have to learn it.

Overview

Staining: HE

Organ: Liver

Description:

There are five characteristics that can be seen:

1. Some hepatocytes are swollen with very pale cytoplasm. This is called ballooning degeneration
2. Some hepatocytes have no nuclei. This indicates necrosis
3. Some hepatocytes have bright eosinophilic inclusion bodies called Mallory bodies
4. Fibrosis is visible
5. Neutrophils are present

I’m not sure all those leukocytes are neutrophils but at least some of them are. You can recognize them by their slightly U-shaped nucleus.

Diagnosis: Alcoholic hepatitis

Causes:

• Chronic (years of) alcohol consumption

Theory:

These five histological findings are the five histological criteria that must be fulfilled to say that it is an alcoholic hepatitis.

This patient would probably also have an AST/ALT ratio of above 2:1, and possibly macrocytic anaemia as well.

All the characteristics are visible around the big portal triad, so I’d suggest you start looking there.

Fibrosis in the portal triad

Mallory bodies kinda look like RBCs inside hepatocytes

Ballooning degeneration of hepatocytes