Diagnostic Histopathological Features of Major Liver Diseases (Article review)

The liver is an essential organ that participates in the processes of metabolism, detoxification, bile production, and regulation of systemic homeostasis. Because of its central position and exposure to numerous insults, liver is susceptible to a broad range of disease, from viral infections and metabolic disorders to autoimmune diseases and cancers. While histopathological evaluation is still the gold standard for the diagnosis of liver diseases, there is no doubt that information on the type, severity and progression of hepatic injury obtained by this approach is critical. We review histopathological similarities and differences between the four major liver diseases: hepatitis, non-alcoholic fatty liver disease (NAFLD), cirrhosis and hepatocellular carcinoma (HCC)

Clinical features Hepatitis shows portal inflammatory infiltrate, interface hepatitis, hepatocyte ballooning and apoptotic bodies and variable fibrosis depending on chronicity Macrovesicular steatosis, hepatocyte ballooning, lobular inflammation, Mallory-Denk bodies, and zone 3 fibrosis characterize NAFLD (which may develop into NASH and cirrhosis). IntroductionCirrhosis is a pathologic process characterized by late-stage liver damage, diffuse scarring and regenerative nodules, architectural distortion, and frequently portal tract expansion and bile duct hyperplasia. HCC, which usually develops in cirrhotic liver, demonstrates cellular atypia and pleomorphism (cup-, rosette-, and trabecular-like formations), irregular architecture, vascular invasion (intrahepatic or distant metastasis), and, in some cases, encapsulation with fibrous tissue. Immunohistochemical markers like HepPar-1, Glypican-3 and Arginase-1 help in establishing hepatocellular origin.