NASH

NASH
Matthew M. Yeh, MD, PhD
Low-power view of a liver biopsy in a child with steatohepatitis reveals chronic portal inflammation image. Macrosteatosis is noted within the hepatic lobules image, and bridging fibrosis is evident.
A chronic portal inflammation image with expansion into zone 1 image is illustrated here. The lobular inflammatory cells are situated among steatotic hepatocytes.
TERMINOLOGY
ETIOLOGY/PATHOGENESIS
Mechanism
  • Abnormal accumulation of lipids in hepatocytes provides source of oxidative stress
  • Leads to injury/inflammation
  • Subsequent activation of TGF-β and hepatic stellate cells results in liver fibrosis
Associated Conditions
  • Diabetes, obesity, hyperlipidemia, dyslipidemia, drugs, malabsorption, malnutrition
CLINICAL ISSUES
Presentation
  • Hepatomegaly
  • Metabolic syndrome
    • Central (visceral) obesity
    • Type 2 diabetes
    • Dyslipidemia (hypertriglyceridemia and low HDL)
    • Systemic hypertension
Laboratory Tests
  • Elevated transaminases
Prognosis
  • May lead to liver fibrosis, cirrhosis, and hepatocellular carcinoma
MICROSCOPIC PATHOLOGY
Histologic Features
Jul 8, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on NASH

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