Some affected mothers and infants have inherited long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) deficiency
Top Differential Diagnoses
Extensive microvesicular steatosis involves the centrilobular or zone 3 hepatocytes. A central vein
is present in the center of the image.
High-power view demonstrates the extensive microvesicular steatosis typical of fatty liver of pregnancy. Numerous small steatotic vacuoles
surround and focally indent the hepatocyte nucleus.
There is a background of extensive microvesicular steatosis, but there is relative sparing of a small rim of periportal hepatocytes
.
with necrosis 
may also occur in patients with fatty liver of pregnancy.
