Ultrastructure of alcoholic hyalin and fate of the affected hepatocytes

In liver biopsy specimens, foci of satellitosis, i.e., foci of alcoholic hyalin containing hepatocytes surrounded by accumulated leukocytes, were studied by means of electron-microscopic investigation. Within satellitosis hepatocytes, the same morphologic variants of alcoholic hyalin were observed as formerly described in nonsatellitosis liver cells: (1) clusters of randomly oriented smooth filaments of homogenous electron density, (2) bundles of filaments aligned in parallel arrays and exhibiting irregular densities and indistinct boundaries, and (3) masses of a strongly osmiophilic amorphous material, presumably lipidic in nature. The individual hyalin body was composed of one, two, or all three components in varying proportions; an uptake by cytosegresomes was never observed. The leukocytes of satellitosis foci, mostly polymorphonuclear ones without obvious alterations, had close contact to the central hepatocytes, and sometimes covered large holes in the hepatocellular plasma membrane. In other cases, hepatocytes and neutrophils were both destroyed and the hyalin bodies were found unaltered within the sinusoids. It is suggested that alcoholic hyalin represents an inert proteinaceous storage material, deposited at the site of synthesis which in the course of time becomes superimposed by a lipid component. In cases of alcohol-induced hepatocellular lesions, those hepatocytes which produce hyalin bodies may have a special metabolic sensitivity to alcohol which on the one hand may result in hyalin synthesis and accumulation and on the other hand may, under special conditions, lead to plasma membrane destruction with secondary satellitosis formation.