Table 1.
Patterns of Necrosis in Liver Disease
| Pattern of Necrosis | Description | Underlying Cause |
|---|---|---|
| Apoptosis (apoptotic body, acidophil body, or Councilman body) | Necrosis of single cells | Hepatitis (viral, autoimmune, drug) |
| Focal/spotty | Necrosis involving small clusters of hepatocytes | Hepatitis (viral, autoimmune, drug) |
| Zonal necrosis | ||
| Centrilobular | Necrosis around central vein (acinar zone 3) | Ischemia, drugs, VOI, P/R injury |
| Periportal (IH/piecemeal necrosis) | Necrosis of periportal zone (acinar zone 1) | Hepatitis (viral, autoimmune, drug) |
| Confluent necrosis | ||
| Localized (multilobular) necrosis | Necrosis of a part of the liver | Localized ischemia, transarterial embolization treatment |
| Submassive/massive necrosis | Subtotal/total hepatocellular necrosis (often with prominent ductular reaction) | Hepatitis (viral, autoimmune, drug), acute allograft failure, fulminant Wilson's disease |
Abbreviations: P/R, preservation/reperfusion; VOI, venous outflow impairment.