Non-viral causes of hepatocellular carcinoma

Figure 3 Progression of non-alcoholic fatty liver disease to cryptogenic cirrhosis. The explanation for the disappearance of steatosis remains uncertain but it is likely to be multifactorial and to involve changes in blood flow and exposure to fat-promoting hormones, as well as possible changes in the intracellular metabolism as a result of long-standing exposure to lipid peroxidation. Theoretically, this could represent a form of lipoatrophy that occurs within the fat-storing hepatocytes. Other forms of chronic liver disease may also present with a well-established bland cirrhosis. Efforts are needed to define better residual markers of past silent disease to improve our understanding of cryptogenic cirrhosis. Reprinted from Caldwell SH, Crespo DM. The spectrum expanded: cryptogenic cirrhosis and the natural history of non-alcoholic fatty liver disease. J Hepatol 2004; 40: 578-584, Copyright (2004), with permission from Elsevier[31]. NALFD: Non-alcoholic fatty liver disease; NASH: Non-alcoholic steatohepatitis.