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| Necrosis | ||
| Etiology •Necrosis of the liver cells is seen with many different disorders affecting the liver. | ||
| Pathogenesis •Coagulation necrosis of the liver cell may follow from vascular compromise as in thrombosis of the hepatic artery or from right-sided heart failure. •Certain toxic injuries, on the other hand, result in apoptosis and give rise to characteristic cells with deeply eosinophilic cytoplasm and a pyknotic nucleus (Councilman bodies). •Necrosis due to vascular or toxic injury generally affects the centri-lobular area. •Periportal necrosis occurs in eclampsia and in phosphorous toxicity. •Mid-lobular necrosis is rare., | ||
| Epidemiology •Not uncommon | ||
| General Gross Description •Grossly, the liver with large areas of necrosis may appear shrunken and yellowishdue to the necrosis. •Focal necrosis may appear as focal areas of yellowish discoloration visible on cross section. •Examples: | ||
| General Microscopic Description •Microscopically, toxic liver injury characteristically causes apoptosis with shrunken cells, which are deeply eosinophilic, with a disintegrating nucleus. •Truly necrotic cells, on the other hand, go through a phase of "hydropic degeneration" followed by rupture of the cell. •Examples: | ||
| Clinical Correlation •Focal necrosis is followed an inflammatory infiltrate which results in removal of the necrotic debris and restructuring of the lobular structure, by division of existing cells within the connective tissue framework. •Repeated bouts of necrosis and repair may result in disruption of the structure of the liver and result in cirrhosis. •Massive necrosis, on the other hand, can result in liver failure and death. | ||
| References • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 833 Please be patient during transfer. Medline will open in a new window. To return, close the Medline Window Necrosis
| Synopsis by: T.V.Rajan, M.D., Ph.D. (T56000M54000)[596]
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