title: Electron microscopic findings in non-alcoholic fatty liver disease: is there a difference between hepatosteatosis and steatohepatitis?
abstract: OBJECTIVE
  Non-alcoholic fatty liver disease has long been accepted as benign; however, recent evidence suggests that the disease may progress to cirrhosis and hepatocellular carcinoma, although the natural course of the disease is still unclear. This study was designed to comparatively evaluate electron microscopic features of non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH).
  
  
  METHODS
  Quantitative and semi-quantitative ultrastructural evaluations were performed on liver biopsies from 23 patients, 10 with NAFL and 13 with NASH.
  
  
  RESULTS
  No statistically significant difference was noted between NAFL and NASH patients in ultrastructural features of hepatocytes including megamitochondria, intramitochondrial crystalline inclusions, mitochondrial matrix granules, foamy cytoplasmic appearance, electron-lucent and glycogen-containing nuclear regions, lipofuscin granules, or an increased frequency of vesicles containing electron-dense material in peribiliary Golgi zone; however, the mitochondrial diameter was significantly higher in the NASH patients. Intercellular distance and microvilli between hepatocytes, collagen and electron-dense material accumulation in the space of Disse, electron-dense material accumulation and microvillus density in bile canaliculi did not differ significantly between the groups.
  
  
  CONCLUSIONS
  Our data show that, although NAFL and NASH can be distinguished by their distinct light microscopic features, ultrastructural characteristics are similar, which suggests that NAFL may also have the potential to progress to fibrosis and cirrhosis like NASH.
authors.affiliation: Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. emelahishali@yahoo.com
authors.forename: Emel
authors.initials: E
authors.lastname: Ahishali
authors.forename: Kadir
authors.initials: K
authors.lastname: Demir
authors.forename: Bulent
authors.initials: B
authors.lastname: Ahishali
authors.forename: Filiz
authors.initials: F
authors.lastname: Akyuz
authors.forename: Binnur
authors.initials: B
authors.lastname: Pinarbasi
authors.forename: Sule
authors.initials: S
authors.lastname: Poturoglu
authors.forename: Duygu
authors.initials: D
authors.lastname: Ibrisim
authors.forename: Mine
authors.initials: M
authors.lastname: Gulluoglu
authors.forename: Sadakat
authors.initials: S
authors.lastname: Ozdil
authors.forename: Fatih
authors.initials: F
authors.lastname: Besisik
authors.forename: Sabahattin
authors.initials: S
authors.lastname: Kaymakoglu
authors.forename: Gungor
authors.initials: G
authors.lastname: Boztas
authors.forename: Yilmaz
authors.initials: Y
authors.lastname: Cakaloglu
authors.forename: Zeynel
authors.initials: Z
authors.lastname: Mungan
authors.forename: Yurdagul
authors.initials: Y
authors.lastname: Canberk
authors.forename: Atilla
authors.initials: A
authors.lastname: Okten
mesh_terms: D000328:Adult; D001706:Biopsy; D003593:Cytoplasm / Q000648:ultrastructure; D005234:Fatty Liver / Q000473:pathology*; D005235:Fatty Liver, Alcoholic / Q000473:pathology; D005260:Female; D006056:Golgi Apparatus / Q000648:ultrastructure; D006801:Humans; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D008930:Mitochondria, Liver / Q000648:ultrastructure*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity