Clinical History:
- A 45-year-old man had a 30 year history of alcohol abuse. He died from head trauma in a motor vehicle accident. At autopsy, the liver showed a diffusely nodular, firm surface. (image 8.1 demonstrates a normal liver in situ for comparison; image 8.2 shows the gross appearance of the liver in this case, and images 8.3 and 8.4 show the microscopic findings).
- Diagnose and describe the liver lesions seen grossly and microscopically.
There is a pattern of micronodular cirrhosis in which fibrous
connective tissue extends from portal areas to surround liver lobules. The
fibrous tissue also contains chronic inflammation. The hepatocytes show
variably-sized cytoplasmic vacuoles typical of fatty
change.
- Which process is reversible (in weeks)?
The fatty change is reversible; the cirrhosis is not readily reversible (the cirrhotic liver will slowly remodel over years if the excessive alcohol use is discontinued).
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