Silent liver diseases in autopsies from forensic medicine of Tehran

Histology is the unique method for diagnosis of silent liver diseases; so, we aimed to determine the prevalence of fatty liver and other silent liver diseases among those who passed away for causes other than liver diseases in Tehran.

Over a two-year period (2002 - 2004) we enrolled autopsies performed at the Forensic Medicine Center in Tehran. Demographic information, history of known acute and chronic liver diseases, and causes of death were determined. Samples from the right and left lobe and one sample from deeper areas of the liver as well as specimens from any grossly visible lesions were obtained in each case. Tissue sections stained by hematoxylin and eosin were evaluated. Reticulin and Masson's trichrome stains were also performed for evaluation of liver architecture and degree of fibrosis when necessary.

Satisfactory tissue samples for histologic evaluation were available in 896 cases (777 males) with a mean age of 43.8 years. Normal histology was found in 467 cases (52.1%). Important findings included: steatosis in 283 (31.6%), steatohepatitis in 19 (2.1%), chronic hepatitis in 23 (2.6%), and cirrhosis in 7 (0.8%) cases. Causes of death were: trauma (35%), acute myocardial infarction (30%), opiate overdose (13%), cerebrovascular accidents (4%), infectious diseases (3%), and others (15%).

Silent diseases of the liver are not uncommon. Steatosis is the most common finding but inflammatory disorders comprise a significant minority.