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File:IPLab2FattyChange7.jpg|A high-power photomicrograph of the liver parenchyma shows that each individual liver cell is filled with a large, clear droplet which represents the space remaining after lipid was dissolved by the dehydration procedure used to embed the tissue. Note that each empty space is surrounded by a thin rim of eosinophilic cytoplasm; in many instances, the hepatocyte nucleus can be seen as well. The red body (arrow) seen within a cell in the center of the slide is an acidophilic body associated with alcoholic hepatitis.
File:IPLab2FattyChange8.jpg|An oil red O stain for fat was performed on a frozen section of this liver tissue. The red droplets represent fat in the tissue which is typical of fatty degeneration in the liver. By using frozen sections the tissues do not have to be dehydrated through alcohol solutions and thus the fat does not get washed out.
File:IPLab2FattyChange9.jpg|This photomicrograph of the liver is from another patient with a history of alcohol use. There are some clear vacuoles indicating fat droplets (1) and there are numerous red-staining granular deposits within the cytoplasm of hepatocytes (23)this is alcoholic hyalin. Alcoholic hyalin is easily distinguished from red blood cells (32) that are also present in this section.
File:IPLab2FattyChange10.jpg|This is a low-power photomicrograph of liver stained with a trichrome stain. In this section, connective tissue stains green (arrows) and hepatic parenchymal cells are red. Note that many of the parenchymal cells have clear spaces indicating fatty degeneration. The proliferation of scar tissue between the liver lobules is the result of cirrhosis.
File:IPLab2FattyChange11.jpg|This gross photograph of liver demonstrates severe nodular cirrhosis. Note the extensive scarring of the capsule and the nodular projections of tissue through the uncut capsule in this tissue. The green color is due to the accumulation of bile pigment.
File:IPLab2FattyChange12.jpg|This is a cut surface of the same tissue seen in the previous slide. Note the marked nodular pattern. The paler-staining areas between the round nodules represent fibrous connective tissue.
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== Virtual Microscopy ===== Liver: Fatty Change and Cirrhosis ===<peir-vm>IPLab2FattyChange</peir-vm> === Normal Liver ===<peir-vm>UAB-Histology-00149</gallerypeir-vm>
== Study Questions ==
In this case, alcohol abuse (toxin) is the most likely etiologic agent.
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* <spoiler text=" What causes hepatocellular steatosis in an alcoholic?"> Alcohol induces hepatic steatosis primarily by: * the shunting of normal substrates away from catabolism and toward biosynthesis due to generation of excess NADH by alcohol dehydrogenase,* impaired assembly and secretions of lipoproteins,* and increased peripheral catabolism of fat. Many other factors also come into play.</spoiler>* <spoiler text=" Is the accumulation of fat in this liver a reversible or an irreversible change?"> Reversible</spoiler> == Additional Resources == === Reference === * [http://emedicine.medscape.com/article/185856-overview eMedicine Medical Library: Cirrhosis]* [http://emedicine.medscape.com/article/170539-overview eMedicine Medical Library: Alcoholic Hepatitis]* [http://www.merckmanuals.com/professional/hepatic_and_biliary_disorders/alcoholic_liver_disease/alcoholic_liver_disease.html Merck Manual: Alcoholic Liver Disease]* [http://www.merckmanuals.com/professional/hepatic_and_biliary_disorders/fibrosis_and_cirrhosis/cirrhosis.html Merck Manual: Cirrhosis] === Journal Articles ===* Satapathy SK, Narayan S, Varma N, Dhiman RK, Varma S, Chawla Y. [http://www.ncbi.nlm.nih.gov/pubmed/11595070 Hyposplenism in alcoholic cirrhosis, facts or artifacts? A comparative analysis with non-alcoholic cirrhosis and extrahepatic portal venous obstruction]. ''J Gastroenterol Hepatol'' 2001 Sep;16(9):1038-43. === Images ===* [{{SERVER}}/library/index.php?/tags/128-cirrhosis PEIR Digital Library: Cirrhosis Images]* [{{SERVER}}/library/index.php?/tags/231-fatty_change PEIR Digital Library: Fatty Change Images]* [http://library.med.utah.edu/WebPath/LIVEHTML/LIVERIDX.html#2 WebPath: Cirrhosis] == Related IPLab Cases ==* [[IPLab:Lab 5:α1 Antitrypsin Deficiency|Lab 5: Lung: α1-Antitrypsin Deficiency]]* [[IPLab:Lab 11:Schistosomiasis|Lab 11: Schistosomiasis]]* [[IPLab:Lab 12:Alcoholic Cirrhosis|Lab 12: Liver: Alcoholic Cirrhosis]]
{{IPLab 2}}
[[Category: IPLab:Lab 2]]
