Published online Nov 28, 2014. doi: 10.3748/wjg.v20.i44.16474
Revised: July 28, 2014
Accepted: September 12, 2014
Published online: November 28, 2014
Processing time: 192 Days and 23.9 Hours
The liver involvement in alcoholic liver disease (ALD) classically ranges from alcoholic steatosis, alcoholic hepatitis or steatohepatitis, alcoholic cirrhosis and even hepatocellular carcinoma. The more commonly seen histologic features include macrovesicular steatosis, neutrophilic lobular inflammation, ballooning degeneration, Mallory-Denk bodies, portal and pericellular fibrosis. Nonalcoholic steatohepatitis (NASH) is a condition with similar histology in the absence of a history of alcohol intake. Although the distinction is essentially based on presence or absence of a history of significant alcohol intake, certain histologic features favour one or the other diagnosis. This review aims at describing the histologic spectrum of alcoholic liver disease and at highlighting the histologic differences between ALD and NASH.
Core tip: Alcoholic steatohepatitis (ASH) is well described. Absence of steatosis should not rule out ASH. Nonalcoholic steatohepatitis though histologically similar to ASH, does have important differences, which a pathologist should recognize.