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Alcoholic and nonalcoholic steatohepatitis
1Department of Pathology, Saint Louis University School of Medicine, 4th Floor, SLUH, 3635 Vista Avenue, St. Louis, MO 63110, USA. bruntem@slu.edu
Clinics in Liver Disease
|July 19, 2002
Summary
Histopathologic lesions of alcoholic and nonalcoholic steatohepatitis share similarities, including steatosis and inflammation. Distinguishing between them often relies on clinical factors, despite overlapping microscopic findings.
Area of Science:
- Hepatology
- Pathology
- Gastroenterology
Background:
- Alcoholic steatohepatitis (ASH) and nonalcoholic steatohepatitis (NASH) are liver diseases with overlapping histopathologic features.
- Understanding these shared lesions is crucial for diagnosis, natural history studies, and etiopathogenesis research.
Purpose of the Study:
- To describe the constellation of histopathologic lesions in ASH and NASH.
- To highlight commonalities and differences in liver injury patterns.
- To emphasize the role of clinical context in differentiating these entities.
Main Methods:
- Histopathologic examination of liver biopsies.
- Comparative analysis of lesions in ASH and NASH.
- Review of clinical and experimental data.
Main Results:
- Common lesions include steatosis, ballooning, lobular inflammation, and perisinusoidal fibrosis.
- Mallory's hyaline, megamitochondria, and iron may be present in both.
- Hepatocellular carcinoma is a complication of both, more frequent in ASH.
- Severe manifestations like sclerosing hyaline necrosis are more characteristic of ASH.
Conclusions:
- Histopathologic similarities suggest common pathogenetic pathways for ASH and NASH.
- Microscopic findings alone may not definitively distinguish between ASH and NASH.
- Clinical information is essential for accurate diagnosis and differentiation.