title: Histopathology of nonalcoholic fatty liver disease.
abstract: Histological analysis of liver biopsies remains a standard against which other methods of assessment for the presence and amount of hepatic injury due to nonalcoholic fatty liver disease (NAFLD) are measured. Histological evaluation remains the sole method of distinguishing steatosis from advanced forms of NAFLD, i.e. nonalcoholic steatohepatitis (NASH) and fibrosis. Included in the lesions of NAFLD are steatosis, lobular and portal inflammation, hepatocyte injury in the forms of ballooning and apoptosis, and fibrosis. However, patterns of these lesions are as distinguishing as the lesions themselves. Liver injury in adults and children due to NAFLD may have different histological patterns. In this review, the rationale for liver biopsy, as well as the histopathological lesions, the microscopically observable patterns of injury, and the differential diagnoses of NAFLD and NASH are discussed.
authors.affiliation: Department of Pathology and Immunology, Washington University School of Medicine, 660 S. Euclid Ave., Campus Box 8118, St. Louis, MO 63110, United States. ebrunt@wustl.edu
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Brunt
authors.forename: Dina G
authors.initials: DG
authors.lastname: Tiniakos
mesh_terms: D000328:Adult; D001706:Biopsy; D005234:Fatty Liver / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D005355:Fibrosis; D006801:Humans; D008099:Liver / Q000473:pathology / Q000601:surgery; D016031:Liver Transplantation; D065626:Non-alcoholic Fatty Liver Disease; D012720:Severity of Illness Index